Maxillary morphology of chimpanzees: Captive versus wild environments.

Morphological studies typically avoid using osteological samples that derive from captive animals because it is assumed that their morphology is not representative of wild populations. Rearing environments indeed differ between wild and captive individuals. For example, mechanical properties of the diets provided to captive animals can be drastically different from the food present in their natural habitats, which could impact cranial morphology and dental health. Here, we examine morphological differences in the maxillae of wild versus captive chimpanzees (Pan troglodytes) given the prominence of this species in comparative samples used in human evolution research and the key role of the maxilla in such studies. Size and shape were analysed using three-dimensional geometric morphometric methods based on computed tomography scans of 94 wild and 30 captive specimens. Captive individuals have on average larger and more asymmetrical maxillae than wild chimpanzees, and significant differences are present in their maxillary shapes. A large proportion of these shape differences are attributable to static allometry, but wild and captive specimens still differ significantly from each other after allometric size adjustment of the shape data. Levels of shape variation are higher in the captive group, while the degree of size variation is likely similar in our two samples. Results are discussed in the context of ontogenetic growth trajectories, changes in dietary texture, an altered social environment, and generational differences. Additionally, sample simulations show that size and shape differences between chimpanzees and bonobos (Pan paniscus) are exaggerated when part of the wild sample is replaced with captive chimpanzees. Overall, this study confirms that maxillae of captive chimpanzees should not be included in morphological or taxonomic analyses when the objective is to characterise the species.

Analysis of palatal marginal alveolar exostosis and palatal torus using cone-beam computed tomography.

The aim of the present study was to analyze palatal marginal alveolar exostosis (PMAE) and palatal torus (PT). Cone-beam computed tomography (CBCT) of the maxilla in multiplanar sections and volumetric renderings were used to assess this. PT and PMAE were classified according to location and morphology. Height, width, length, and thickness of the overlying mucosa were determined. The prevalence of PT and PMAE was assessed according to sex and age group. The correlation between the occurrence of PMAE and PT was also evaluated. A total of 385 CBCT scans were examined. PT was found in 38.70% of the sample and located more frequently in the middle third of the maxilla (52.35%) with a flat shape (42.95%). PMAE was found in 54.80% of the sample, bilaterally in 56.40% of the cases, and located more frequently in the molar region (62.42%) in the form of small nodules (36.97%). The mucosa covering PMAE was generally thicker than that over PT. The use of CBCT for the identification of PT and PMAE in vivo showed high frequencies of both conditions. The occurrence of PMAE was independent of the presence of PT.

Factors influencing speech improvement following maxillary complete-arch implant-supported restorations: A retrospective study.

OBJECTIVE: This study explored factors affecting speech improvement in patients with an edentulous maxilla after the delivery of a complete-arch implant-supported fixed dental prosthesis (IFDP). MATERIALS AND METHODS: Patients who had received IFDP for edentulous maxilla were enrolled, and various potential speech improvement-related factors were considered, including patient demographics, anterior residual bone volume, preoperative facial features, preoperative acoustic parameters, and adaptation time. Acoustic analysis and perceptual ratings were used to assess three fricatives [s], [f], and [ɕ]. Correlation and regression analyses were conducted to assess the association between changes in fricatives and potential factors (α = .05). RESULTS: The study included 50 patients (18 females and 32 males, aged 50.62 ± 15.71 years, range 19-76). Significant correlations were found among the change in the center of gravity (ΔCoG) of [s] and anterior residual bone volume, zygomatic implants number and proportion (p < .05). These correlations were largely mirrored in the perceptual score (ΔPS) changes. After controlling for age, sex, preoperative acoustic parameters, and adaptation time, the ΔCoG and ΔPS of fricatives were mainly correlated with the anterior residual bone volume, preoperative acoustic parameters, and adaptation time. CONCLUSION: Speech improvements post-IFDP delivery are mainly related to preoperative speech characteristics, anterior residual bone volume, and adaptation time. The residual bone volume's impact on consonants varies with specific articulatory gestures. This study provides insights into forecasting speech outcomes following IFDP restoration and provides recommendations and methods for data collection in developing future prediction models.

Maxillary bone augmentation with calvarial bone graft for immediate full-arch rehabilitation: Insights from a 10-year proof-of-concept retrospective analysis.

OBJECTIVE: Evaluate the long-term outcomes of full-arch rehabilitation using immediate dental implant placement and continuous functional loading with full-fixed dental prostheses (FFDPs). MATERIALS AND METHODS: Fifty-six patients received temporary implants (n = 327) at maxillary augmentation with calvarial bone. A provisional acrylic FFDP was immediately loaded onto these implants. After 6 months, the temporary implants were replaced with definitive implants (n = 326) and immediately loaded with a second provisional FFDP (N = 55). Subsequently, a baseline radiograph was taken following a 6-month healing period. The second bridge was then substituted with a definitive FFDP. Primary outcomes included peri-implant marginal bone level (MBL) and definitive implant survival. Secondary outcomes evaluated provisional implant and prostheses survival, complications, and patient satisfaction. RESULTS: The provisional implants had a survival rate of 97.9%. One patient was excluded from further analysis due to loss of temporary implants and first FFDP. The definitive implant survival rate after 10 years was 92.2%, with a moderate but significant decrease in MBL between baseline radiography and 10 years later (-0.08 ± 0.18 vs. -0.24 ± 0.44). However, large individual variations were observed, with 65.8% of implants showing no bone loss and 9.2% showing loss ≥0.5 mm. Sinusitis was experienced by 14.3% of patients upon surgery. Patient satisfaction was high or reported no issues after protocol completion (80%). One patient lost all six definitive implants and definitive FFDP 8.2 years after implant placement. CONCLUSIONS: The described protocol can be regarded as a long-term, highly successful method for full-arch rehabilitation of atrophied maxillae while enabling continuous masticatory and speaking functionality.

Comparison of Mineral Density of Dental Structures of Ancient Human Skeletons from the Roman Period with Modern-Day Human Dental Structures.

OBJECTIVES: Comparison of maxillary, mandibular, dental crown and root mineral density in human skeletons identified in historical excavations with today's human maxillary, mandibular dental crown and root. METHODS: After the skull images were obtained, four groups were created: maxilla 1, mandible 1 from the old period, maxilla 2 from the images taken from today's patients, and mandible 2 from the images taken from today's patients. Seventeen skeletons were previously classified as young age, middle age, and older age. Among the archive tomography images, 17 images from young (15-35), middle (36-56) and older (57 and over) age images were included in the study. HU value of the desired region was calculated automatically by the device using Region of interest (ROI). RESULTS: In this study, 34 jaws and 68 teeth were evaluated, including 7 mandibles and 10 maxillae from the late Roman period, and 8 mandibles and 9 maxillae from today's people. The average HU value of the crowns of mandibular anterior teeth from the late Roman period was measured as 2406.0. The average HU value of the crowns of maxillary anterior teeth was found to be 3383.8. In the posterior aspect, the average crown HU value measured in the maxilla was found to be higher than that in the mandible. CONCLUSIONS: The finding showed that the density of dental tissues of ancient people, such as enamel and dentin forming the crown, and cementum and dentin forming the root, was significantly higher than today's people.

Predicting the Risk of Maxillary Canine Impaction Based on Maxillary Measurements Using Supervised Machine Learning.

OBJECTIVES: To predict palatally impacted maxillary canines based on maxilla measurements through supervised machine learning techniques. MATERIALS AND METHODS: The maxilla images from 138 patients were analysed to investigate intermolar width, interpremolar width, interpterygoid width, maxillary length, maxillary width, nasal cavity width and nostril width, obtained through cone beam computed tomography scans. The predictive models were built using the following machine learning algorithms: Adaboost Classifier, Decision Tree, Gradient Boosting Classifier, K-Nearest Neighbours (KNN), Logistic Regression, Multilayer Perceptron Classifier (MLP), Random Forest Classifier and Support Vector Machine (SVM). A 5-fold cross-validation approach was employed to validate each model. Metrics such as area under the curve (AUC), accuracy, recall, precision and F1 Score were calculated for each model, and ROC curves were constructed. RESULTS: The predictive model included four variables (two dental and two skeletal measurements). The interpterygoid width and nostril width showed the largest effect sizes. The Gradient Boosting Classifier algorithm exhibited the best metrics, with AUC values ranging from 0.91 [CI95% = 0.74-0.98] for test data to 0.89 [CI95% = 0.86-0.94] for crossvalidation. The nostril width variable demonstrated the highest importance across all tested algorithms. CONCLUSION: The use of maxillary measurements, through supervised machine learning techniques, is a promising method for predicting palatally impacted maxillary canines. Among the models evaluated, both the Gradient Boosting Classifier and the Random Forest Classifier demonstrated the best performance metrics, with accuracy and AUC values exceeding 0.8, indicating strong predictive capability.

Feasibility of spheno-occipital synchondrosis fusion stages as an indicator for the assessment of maxillomandibular growth: A mixed longitudinal study.

OBJECTIVES: This study aimed to assess the relative growth rates (RGRs) of the maxilla and mandible at varying fusion stages of the spheno-occipital synchondrosis (SOS), thereby elucidating the potential of SOS stages in predicting maxillomandibular growth. MATERIALS AND METHODS: A total of 320 subjects (171 boys and 149 girls), aged 6 to 18 years, were retrospectively included. Each subject had a minimum of two longitudinal cone-beam computed tomography (CBCT) images, with no more than one interval of SOS fusion stage change between the two scans. Subjects were categorized based on their SOS fusion stages and genders. The RGRs of the maxilla and mandible at various SOS fusion stages were measured and compared using longitudinal CBCT images. RESULTS: Significant statistical differences were observed in maxillomandibular RGRs across various SOS fusion stages. In girls, the sagittal growth of the maxilla remained stable and active until SOS 3, subsequently exhibited deceleration in SOS 4-5 (compared to SOS 3-4, P < .05) and continued to decrease in SOS 5-6. Whereas in boys, the sagittal growth of the maxilla remained stable until SOS 4, and a deceleration trend emerged starting from SOS 5 to 6 (P < .01 compared to SOS 4-5). Mandibular growth patterns in both genders exhibited a progression of increasing-accelerating-decelerating rates from SOS 2 to 6. The highest RGRs for total mandibular length were observed in SOS 3-4 and SOS 4-5. CONCLUSION: Spheno-occipital synchondrosis fusion stages can serve as a valid indicator of maxillomandibular growth maturation.

High-Resolution Ultrasound of Odontogenic Cutaneous Sinus Tract: An International Multicentric Experience and a Review of the Literature.

OBJECTIVES: To investigate the role of high-resolution ultrasound (HR-US) in the initial and differential diagnosis of the Odontogenic Cutaneous Sinus Tract (OCST) in a multicentric setting. METHODS: Skin HR-US examinations of OCSTs performed between January 2019 and June 2023 at different Institutions were retrospectively reviewed. Epidemiological and clinical data (age, gender, location of the skin lesion, causative tooth, and the clinical suspicion) as well as HR-US imaging findings (morphology and length of the sinus tract, Doppler signal, and cortical bone interruption of maxilla or mandible) were collected. US examinations were performed by expert radiologists using a high-performance US scanner, employing a high-frequency linear probe (15 MHz or higher frequencies). In only one patient the HR-US exam was integrated with strain elastography (SE). RESULTS: Sixteen patients were enrolled with a median age of 37.6 years (range 16-70 years). The most frequent clinical suspicion was epidermal cyst, while OCST was suspected in only two cases. In all cases, HR-US depicted the sinus tract as a nodular, triangular or "champignon-shaped" lesion in the subcutaneous layer, which continued with a slightly tortuous band structure, up to the focally interrupted cortical bone plate. Furthermore, color Doppler evaluation showed color signals around and/or within the lesion, expression of inflammation. On SE, the sinus tract showed a hard pattern, due to fibrous and granulomatous tissue. CONCLUSIONS: HR-US, thanks to its high spatial resolution, allows the evaluation of OCST, and play a crucial diagnostic role, mainly when the clinical suspicious is different.

Clinical outcomes of narrow- and regular-diameter implants with bone augmentation in the anterior maxilla: a systematic review and meta-analysis.

OBJECTIVES: To evaluate the clinical outcomes of narrow-diameter implants (NDIs) and regular-diameter implants (RDIs) with bone augmentation in the anterior maxilla, with implant survival rate (ISR) as the primary outcome. Additionally, secondary outcomes such as peri-implant marginal bone loss (MBL), pocket probing depth (PPD), mechanical complications, and biological complications were also considered. MATERIALS AND METHODS: A thorough literature search was performed to identify randomized controlled trials and cohort studies comparing outcomes of NDIs and RDIs with bone augmentation in the anterior maxilla published up to February 2024. Only studies with a minimum follow-up period of 12 months were selected for analysis. Meta-analysis was performed if at least two articles with similar characteristics were available. RESULTS: Of the 288 articles initially considered, 5 were included in the analysis, involving 282 NDIs and 100 RDIs. At the 36-month follow-up, no statistically significant differences in ISR, which ranged 93.8-100% for NDIs and were 100% for RDIs, were observed between the two groups (relative risk, 0.989; 95% confidence interval, 0.839-1.165; p = 0.896). Similarly, MBL and PPD did not differ significantly between the two groups. Soft tissue dehiscence was the most common complication found in RDIs. CONCLUSION: The results indicate that NDIs yield clinical outcomes similar to those of RDIs with bone augmentation in the anterior maxilla over a 36-month follow-up period. CLINICAL RELEVANCE: Considering the similar clinical outcomes, the shortened treatment duration and more rapid esthetic improvement associated with NDIs may render them preferrable to RDIs with bone augmentation, particularly in this esthetic zone.

Three-dimensional positioning of the maxilla using novel intermediate splints in maxilla-first orthognathic surgery for correction of skeletal class III deformity.

OBJECTIVES: Successful orthognathic surgery requires accurate transfer of the intraoperative surgical plan. This study aimed to (1) evaluate the surgical error of a novel intermediate splint in positioning the maxilla during maxilla-first orthognathic surgery and (2) determine factors influencing surgical error. MATERIALS AND METHODS: This prospective study examined 83 patients who consecutively underwent Le Fort I osteotomy for correction of skeletal class III deformity using a novel intermediate splint and a bilateral sagittal split osteotomy. Surgical error was the outcome variable, measured as the difference in postoperative translational and rotational maxillary position from the virtual plan. Measures included asymmetry, need and amount for mandibular opening during fabrication of intermediate splints, and planned and achieved skeletal movement. RESULTS: Mean errors in translation for vertical, sagittal, and transversal dimensions were 1.0 ± 0.7 mm, 1.0 ± 0.6 mm, and 0.7 ± 0.6 mm, respectively; degrees in rotation for yaw, roll, and pitch were 0.8 ± 0.6, 0.6 ± 0.4, and 1.6 ± 1.1, respectively. The transverse error was smaller than sagittal and vertical errors; error for pitch was larger than roll and yaw (both p < 0.001). Error for sagittal, transverse, and roll positioning was affected by the achieved skeletal movement (roll, p < 0.05; pitch and yaw, p < 0.001). Surgical error of pitch positioning was affected by planned and achieved skeletal movement (both p < 0.001). CONCLUSIONS: Using the novel intermediate splint when performing Le Fort I osteotomy allowed for accurate positioning of the maxilla. CLINICAL RELEVANCE: The novel intermediate splint for maxillary positioning can be reliably used in clinical routines.

Classifying the internal anatomy of anterior teeth in the Yemeni population using two systems: a retrospective CBCT study.

A precursor for effective root canal treatment (RCT) is a complete understanding of the internal anatomy of teeth. In this study, the authors aimed to classify the root canal morphology of anterior teeth in the Yemeni population and identify gender-based variations among them. In addition, the symmetry among adjacent quadrants was also evaluated. Cone beam computed tomography (CBCT) scans of 2935 anterior teeth, 1502 maxillary, and 1433 mandibular were analyzed for root canal morphology and symmetry. Comparison between groups and among different genders was done using the Chi-square test. All the maxillary teeth were single-rooted and had a predominantly 1TN1 (Vertucci Type I) canal morphology. In addition to 1TN1, the presence of 1TN1-2-1 (Vertucci type III) and 1TN1-2-1-2-1 (not classified NC according to Vertucci) morphologies were noticed in the maxillary canines. Among the mandibular anteriors, the canal morphologies identified include 1TN1 in majority of the scans followed by 1TN2-1 (Vertucci II), 1TN1-2-1, 1TN1-2 (Vertucci V), 1TN1-2-1-2 (Vertucci VII) was seen only in incisors and newer canal types like 1TN2-1-2-1 (NC Vertucci) and 1TN1-2-1-2-1 (NC Vertucci) was seen in canines and lateral incisors. Two roots were only seen in the mandibular canines and classified as 2TN1-2 (NC Vertucci). Variations in root and root canal morphologies were seen among both genders. However, the results were not significant. All the maxillary teeth except 0.8% were bilaterally symmetrical. In mandible, symmetry ranged between 84.5 and 86.5%. In conclusion, single-rooted teeth with 1TN1 classification are most commonly seen in all the anterior teeth. Gender-based differences were non-significant, and bilateral symmetry was high. Ahmed et al. classification could precisely represent the root canal morphology in two rooted teeth.

Long-term effectiveness of UV functionalised short (≤ 6 mm) dental implants placed in the posterior segments of the atrophied maxilla: controlled case series.

This study evaluated long-term effectiveness UV functionalised short implants (≤ 6 mm) placed in the posterior segments of the atrophied maxilla. The study included 47 patients from 2018 to 2023 (aged 27 to 56 years, 24 women and 23 men) without any systemic diseases, with unilateral/bilateral missing teeth and vertical atrophy of the posterior maxillary area. Total installed were 64 short UV-functionalized implants and 62 standard implants over 10 mm in length in segments maxilla with sufficient bone parameters. Clinical, laboratory and cone beam computed tomography (CBCT) methods were used to plan implant therapy. The clinical indices included the following parameters: ISQ, MBL, OHIP-G scale. For short implants, the median ISQ at placement was 62.2 for primary stability and the median ISQ at 5 months was 69.6 ISQ. For standard implant, the mean ISQ at placement was 64.3 ISQ, and ISQ after 5 months was 71.6 ISQ. After 6 months mean MBL short implants 0.87 mm, after 1 year 1.13 mm, after 5 years was 1.48 mm. After 6 months mean MBL standard implants 0.84 mm, after 1 year 1.24 mm, after 5 years was 1.58 mm. Mean OHIP-G scores-patients satisfaction with the implant at 4.8 ± 0.3, satisfaction with the operation 4.6 ± 0.4; satisfaction with prosthetics 4.7 ± 0.5. Cumulative success rate 5 years short implants was 96.7%, standard implants was 97.4%, and prosthesis cumulative survival rate was 97.2%. Short ultraviolet functionalized implants used in the posterior resorbed segment of maxilla have been shown to be a reliable alternative to sinus lift, demonstrating fewer complications, reduction in the number of additional surgical interventions and showed satisfactory long-term survival.

Evaluating Surgical Accuracy in Bimaxillary Surgery: A Systematic Review and Meta-Analysis of Mandible-First versus Maxilla-First Approaches.

BACKGROUND: Mandible-first surgery (MdFS) has gained attention as an alternative to the traditional maxilla-first surgery (MxFS) in bimaxillary procedures. Given the distinct sequence of operations between these approaches, evaluating the clinical advantages of MdFS compared to MxFS is crucial for optimizing surgical decision-making. This systematic review and meta-analysis examine intraoperative achievability and postoperative stability between these two surgical approaches. METHODS: A thorough literature search was performed using PubMed, Embase, Web of Science, and MEDLINE, covering articles published from 2013 to 2023. Studies included were retrospective, prospective, and randomized trials that compared the accuracy and/or stability of MdFS with MxFS. The primary endpoint for the meta-analysis was the standardized mean difference in surgical accuracy for translational movements, with a secondary focus on rotational accuracy. RESULTS: A total of 11 studies encompassing 712 patients met the inclusion criteria. The analysis suggested that MdFS might reduce accuracy in the sagittal dimension (CI, 0.05 to 0.74) but offered greater achievability in the vertical direction (CI, - 0.47 to - 0.07). Additionally, MdFS was associated with a relatively posterior (CI, - 1.18 to - 0.60) and inferior (CI, - 0.64 to - 0.07) positioning of the maxillomandibular complex. CONCLUSION: Despite certain limitations, our findings indicate that MdFS can achieve clinical outcomes similar to MxFS in terms of both accuracy and stability. However, further researches with larger sample sizes and more rigorous study designs are necessary to validate these conclusions. LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of contents or the online Instructions to Authors www.springer.com/00266 .

Validation of the pink esthetic score/white esthetic score at single tooth-supported prostheses in the esthetic zone: A randomized clinical trial.

OBJECTIVES: To validate the reproducibility and inter/intra-observer variability of the Pink Esthetic Score/White Esthetic Score (PES/WES) of single tooth-supported prostheses in the maxillary esthetic zone (13-23). MATERIALS AND METHODS: Forty-five patients were randomly assigned to one of the three treatment options (15 patients per group) receiving each one a different crown type: Porcelain fused to metal (PFM), monolithic zirconia, and lithium disilicate. Eight observers from each of four different specialties (Prosthodontists, Orthodontists, Periodontists, and Oral Surgeons) were recruited and assessed twice and four weeks apart (i.e., T1 and T2) 45 photographs of the single tooth-supported prosthesis using PES/WES and compared them with contralateral teeth. RESULTS: According to the ANOVA and post hoc tests, the zirconia crown type obtained the highest mean score by all observers, with a mean value of 16.70 ± 2.94. The prosthodontists and oral surgeons assigned the lowest mean score to PFM crowns, 13.03 ± 3.47 and 13.80 ± 3.17, respectively. Notably, the prosthodontists awarded the highest scores, specifically 17.50 ± 2.81 for the zirconia crowns. Intraobserver agreement was calculated utilizing the paired t-test. Pairwise comparisons between observers of different specialties revealed significant intraobserver agreement. Interclass correlation coefficient (ICC) scores were statistically significant among four specialties. No difference was detected concerning the interobserver agreement. CONCLUSIONS: The PES/WES index remains consistent across various observers from different specializations, yielding uniform results in the overall esthetic evaluation. Consequently, in light of the presented preliminary positive results, its use might also be considered for the esthetic assessment of single-tooth-supported prostheses. CLINICAL SIGNIFICANCE: The PES/WES index may be employed clinically to evaluate single tooth-supported prostheses as it emerged as a reproducible esthetic scoring system.

Identifying Differences in Molecular Characteristics Relevant for Remodeling of Periodontal Ligament Stem Cells from the Upper and Lower Jaw.

Periodontal defects' localization affects wound healing and bone remodeling, with faster healing in the upper jaw compared to the lower jaw. While differences in blood supply, innervation, and odontogenesis contribute, cell-intrinsic variances may exist. Few studies explored cell signaling in periodontal ligament stem cells (PDLSC), overlooking mandible-maxilla disparitiesUsing kinomics technology, we investigated molecular variances in PDLSC. Characterization involved stem cell surface markers, proliferation, and differentiation capacities. Kinase activity was analyzed via multiplex kinase profiling, mapping differential activity in known gene regulatory networks. Upstream kinase analysis identified stronger EphA receptor expression in the mandible, potentially inhibiting osteogenic differentiation. The PI3K-Akt pathway showed higher activity in lower-jaw PDLSC. PDLSC from the upper jaw exhibit superior proliferation and differentiation capabilities. Differential activation of gene regulatory pathways in upper vs. lower-jaw PDLSC suggests implications for regenerative therapies.

Prefabricated Trays Stock for Impression of Cleft lip and Palate Orthopedic Appliances: A Three-Dimensional Computational Analysis of Maxillary Jaws.

OBJECTIVE: This study aimed to propose digitally designed impression trays, for newborns with cleft lip and palate (CLP) defects, using the computer-assisted design and manufacturing (CAD/CAM) technique, based on measurements of width, length, and height made on processed and scanned plaster models. Thus, we will describe the different software and concepts that can be used for the design of these impression trays. DESIGN: A total of 59 plaster casts of newborn patients with CLP were collected and then scanned. After that, digital dental casts were three-dimensional (3D) evaluated, using precise anatomical landmarks. SETTING: The Maxillofacial Prosthodontics Team at the Dental consultation and treatment center in Rabat, Morocco. PATIENTS AND PARTICIPANTS: The study involved plaster casts of newborns with CLP, who had undergone presurgical neonatal treatment in the Maxillofacial Prosthodontics service in Rabat, Morocco. INTERVENTIONS: None. MAIN OUTCOME MEASURE(S): 3D evaluation of 59 scanned plaster casts of newborn patients with CLP. RESULTS: This work allowed us to obtain digital impression trays for each anatomical variation of orofacial clefts. These trays will limit the problems linked to conventional techniques for making neonatal orthopedic plates. We also emphasized the importance of a multidisciplinary approach involving several professionals in Morocco from various fields and specialties. CONCLUSION: This original technique is advantageous for the practitioner as well as for the patients and their parents. It allows for precise recording, better adaptation, time-saving, and parental comfort.

Three-dimensional Analysis of Maxillary Morphology in Infants with Unilateral Cleft Lip and Palate.

OBJECTIVE: To three-dimensionally (3D) analyze the maxillary morphology of infants with unilateral cleft lip and palate (UCLP) and preliminarily classify the alveolar arch to assist in personalization of sequence therapy. DESIGN: Retrospective study. SETTING: Patients with UCLP referred to outpatients' clinic. PARTICIPANTS: 84 nonsyndromic infants with complete UCLP were recruited (58 boys, 26 girls, mean age 29.48 days). MAIN OUTCOME MEASURE: Morphometric analysis was conducted on 3D maxillary models. Principal component analysis (PCA) and cluster analysis were combined to classify maxillary phenotypes preliminarily. The Wilcoxon Signed Rank test and the Kruskal-Wallis test were used to compare differences between variables. A P value less than .05 was considered statistically significant. RESULTS: The maxilla was divided into three types: narrow, homogenous and broad, accounting for 9.52%, 23.81% and 66.67% respectively. The alveolar cleft site (median value) was located in 61% of the total length of the alveolar arch. In the comparison of anterior and total alveolar lengths, the non-cleft side had longer alveolar bone than the affected side, a difference of approximately 2 mm. Pairwise comparisons of variables describing alveolar symmetry revealed significant differences in all subjects; whereas type C had poorer arch symmetry than types A and B, mainly in terms of anterior and overall symmetry. CONCLUSIONS: In infants with UCLP, the maxillary alveolar arch was inherently asymmetrical with partially bone missing (about 2 mm). Significant differences in alveolar bone morphology and symmetry exist between different types of infants, with individuals with broad clefts (type C, the largest proportion) having the worst maxillary development.

Cone-beam computed tomography of accessory canals of the canalis sinuosus and analysis of the related risk factors.

PURPOSE: Cone-beam computed tomography (CBCT) was used in this study for evaluating the diameter, prevalence, spatial location, and risk factors of the accessory canal (AC) of the canalis sinuosus. METHODS: A comprehensive assessment of the incidence rate, diameter, three-dimensional (3D) spatial location, and direction of travel of AC was performed on 1003 CBCT images. The CBCT data were used to reconstruct a 3D model of the maxilla to determine the alveolar bone volume. The obtained data were further analyzed and processed. RESULTS: AC was present in 50.1% of images. Male patients more frequently had ACs than female patients did (P < 0.01) and was positively correlated with the maxillary alveolar bone volume (P < 0.001, OR 1.532). Age or nasopalatine canal diameter were not significantly associated with the occurrence of AC (P > 0.05). Among the 502 patients with AC, AC was present on the left side, right side, and bilaterally in 189, 98, and 215, respectively. The maximum number of ACs observed per individual was eight. The average AC diameter was 0.89 ± 0.26 mm (minimum, 0.5 mm; maximum, 2.02 mm). CONCLUSIONS: As the prevalence of AC and its trajectory display considerable variation among individuals, surgeons must consider the possibility of the presence of AC when devising surgical plans involving the anterior maxillary region.

Effect of laser corticotomy on canine retraction rate: a split-mouth randomized clinical trial.

BACKGROUND: This study assessed the effect of corticotomy with Er: YAG (erbium-doped yttrium aluminium garnet) laser on the rate of canine retraction. METHODS: This randomized split-mouth controlled clinical trial was conducted on 12 patients undergoing orthodontic treatment with extraction of maxillary first premolars. Following initial leveling and alignment, an alginate impression was made from the maxillary arch, and Er: YAG laser corticotomy was performed in one of the maxillary quadrants of each patient. Canine retraction was started immediately after corticotomy by placement of nickel-titanium (NiTi) closed coil springs at both sides. At the end of each month, alginate records were repeated for 4 months. Study models were scanned, and the anteroposterior movement of canine was quantified bilaterally. Pain was also measured by a visual analog scale (VAS). Probing depth (PPD) of canines and two adjacent teeth was also evaluated and pulp vitality was assessed by performing the cold test. Data were analyzed by paired and independent t-test and one-way ANOVA (alpha = 0.05). RESULTS: The rate of canine retraction was significantly greater in the laser-assisted corticotomy quadrant than the control (P < 0.05). No significant difference existed in posterior anchorage loss, canine rotation angle, PPD, pulp vitality, or pain score between two groups (P > 0.05). CONCLUSIONS: Flapless Er: YAG laser corticotomy significantly enhanced canine retraction rate with no adverse effect on other parameters.

Management of a dentigerous cyst; a ten-year clinicopathological study.

BACKGROUND: Dentigerous cysts, deemed of developmental origin, are benign odontogenic cysts characterized by a gradual growth rate. Their occurrence is twice as prevalent in men compared to women. These cysts are recognized as the most frequent developmental cysts affecting the jaws, with a typical manifestation in individuals aged 20 to 40, while infrequently identified in young children. Notably, dentigerous cysts have the potential to attain significant dimensions, resulting in painless enlargement of the jaw and subsequent deformation. OBJECTIVES: To assess the clinicopathological features and management of ten years of experience with dentigerous cysts. METHODS: A challenging cases were reported from reviewed records of the patients who were treated by the surgical intervention of various dentigerous cysts throughout the period of ten years, 2012-2022 and only histologically confirmed cases were selected, at Ramadi Teaching Hospital in addition to Rashid, Razi, Zuhur Private Hospitals and private clinics in Iraq. RESULTS: 76 patients were included in this clinicopathological research. The highest age group affected was ≤ 18 years (68.4%), 54% were male, the mandible was more affected (63.1%) than the maxilla (36.9%). Marsupialization was applied to 30.3% of the cases, while enucleation was carried out in 69.7%. CONCLUSIONS: The significance of meticulous examination of radiographs and the consequences associated with undetected and untreated ailments is affirmed by this case study. A comprehensive understanding of oral pathology serves as a valuable resource for dentists, facilitating accurate diagnosis, appropriate referrals, and the provision of anticipatory guidance to patients striving to achieve optimal oral health across various age groups.