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.

Evaluation of Facial Appearance among Patients With Repaired Unilateral Cleft Lip and Palate: Comparison of Patient- and Clinician-Ratings of Satisfaction.

The objective of this study was to determine the levels of patient-satisfaction on facial and dental appearance compared with clinician ratings. Participants included 61 patients with repaired unilateral cleft lip and palate (UCLP), aged 14-25 years. Raters comprised three cleft team clinicians. A Likert scale was used to assess the levels of satisfaction of the patients themselves and the clinicians. The results revealed that the patients were moderately satisfied with their appearance. Nose was the least satisfactory feature, followed by lip appearance. When compared to the clinician ratings, the patients were less satisfied with their own nose and lip, but more satisfied with teeth. Concerning age, self-assessment did not differ between adolescents and young adults. Females were less likely to be satisfied compared to males, but the difference was not statistically significant. In conclusion, patients with repaired UCLP were moderately satisfied with their facial and dental appearance. Clinician- and patient-opinions were different in some aspects. This study highlights the importance of patient satisfaction as a meaningful treatment outcome assessment, which could lead to an improvement in cleft care to meet the patient expectations.

In vitro resorbability and granular characteristics of 3D-printed hydroxyapatite granules versus allograft, xenograft, and alloplast for alveolar cleft surgery applications.

Three-dimensionally printed hydroxyapatite (3DP HA) was investigated in regards to its functional properties supporting bone regeneration and tooth movement in alveolar cleft applications. Commercially available bovine xenograft (BXG), biphasic calcium phosphate alloplast (BCP), and two types of freeze-dried bone allograft granules (FDBA and FDBA-CMC) were employed as control samples. Degradability was studied by submerging the samples in pH 7.4 buffered solution at 37°C for 28 days and determining subsequent weight loss percentage. The wicking property and granular agglomeration were evaluated by putting the granules in contact with deionized water, blood, and phosphate-buffered saline (PBS). Both of FDBA and FDBA-CMC showed the greatest weight loss at 28 days followed by 3DP HA. In contrast, 3DP HA showed significantly greater wicking ability than other samples for all liquid types. FDBA-CMC exhibited the greatest granular agglomeration for all liquid types followed by 3DP HA. 3DP HA was found to be a favorable candidate for bone grafting in alveolar cleft treatment.

Decoronation as a treatment option for replacement root resorption following severe intrusive trauma: a case report.

This article reports a clinical case of a 13-year-old girl, who was referred with chief complaint of a non-esthetic maxillary central incisors position. Five years ago, her maxillary right and left central incisors and left lateral incisor intruded into the maxilla. The intruded teeth were splinted for a month. After splint removal, the patient lost follow up. The aim of this work is to report the successful conservative management of severe intrusion in developing dentition.

Evaluation of alveolar bone grafting in unilateral cleft lip and palate patients using a computer-aided diagnosis system.

PURPOSE: This study aimed to evaluate the trabecular bone changes after alveolar bone grafting in unilateral cleft lip and palate (UCLP) patients using a computer-aided diagnosis (CAD) system. MATERIALS AND METHODS: The occlusal radiographs taken from 50 UCLP patients were surveyed retrospectively. The images were categorized as: 50 images in group 0 (before bone grafting), 33 images in group 1 (one month after bone grafting), 24 images in group 2 (2-4 months after bone grafting), 15 images in group 3 (5-7 months after bone grafting), and 21 images in group 4 (8 or more months after bone grafting). Each image was grouped as either "non-cleft side" or "cleft side". The CAD system was used five times for each side to calculate the pixel area based on the mathematical morphology. Significant differences were found using a Wilcoxon signed ranks test or paired samples t test. RESULTS: The pixel area showed a significant difference between the "non-cleft side" and "cleft side" in group 0 (404.27±103.72/117.73±92.25; p=0.00), group 1 (434.29±86.70/388.31±109.51; p=0.01), and group 4 (430.98±98.11/366.71±154.59; p=0.02). No significant differences were found in group 2 (423.57±98.12/383.47±135.88; p=0.06) or group 3 (433.02±116.07/384.16±146.55; p=0.19). CONCLUSION: Based on the design of this study, alveolar bone grafting was similar to normal bone within 2-7 months postoperatively.