Correlation Between Cephalometric Values and Soft Tissue Profile in Class I and Class II Adult Patients based on Vertical Patterns.

Objective: To compare soft tissue profile variations between Class I and Class II adult patients due to three vertical skeletal facial patterns (normodivergent, hypodivergent and hyperdivergent) and determine which skeletal variation has the most significant impact on soft tissue profile. Methods: Retrospective soft tissue profile analysis was performed on lateral cephalograms of 131 adult patients. The analysis was divided into two categories correlated with subnasal and general soft tissue profiles. The sample was divided based on two sagittal skeletal patterns (Class I and II) and three vertical groups. In addition, comparisons were made between males and females. Viewbox 4 was used for the analysis. Descriptive, comparative, and correlation statistics were performed using SPSS software. Results: Statistically significant inter-gender differences were found at the subnasal profile level, but not at the general profile level. No significant differences were observed when comparing subnasal profiles for the sagittal groups. However, significant differences were observed at the level of the general profile, especially at the level of Z-angle, lower lip, and chin prominence. In the vertical groups, hyperdivergent facial patterns had significant differences at the level of subnasal and general profiles compared with other vertical facial patterns. Conclusion: Females had more convex subnasal profiles than males. Hyperdivergent facial patterns had an impact on both general and subnasal soft tissue profiles. The sagittal dimension affected only the general soft tissue profile. Therefore, changes in the vertical dimension had the greatest impact on facial esthetics.

Assessment of the efficacy of various maxillary molar intrusion therapies: a systematic review.

AIMS: To systematically assess the efficacy of the various interventions used to intrude maxillary molars. Furthermore, to evaluate associated root resorption, stability of intrusion, subsequent vertical movement of mandibular molars, cost effectiveness, compliance, patient reported outcomes and adverse events. METHODS: A pre-registered and comprehensive literature search of published and unpublished trials until March 22nd 2023 with no language restriction applied in PubMed/Medline, Embase, Scopus, DOSS, CENTRAL, CINAHL Plus with Full Text, Web of Science, Global Index Medicus, Dissertation and Theses Global, ClinicalTrials.gov, and Trip (PROSPERO: CRD42022310562). Randomized controlled trials involving a comparative assessment of treatment modalities used to intrude maxillary molars were included. Pre-piloted data extraction forms were used. The Cochrane Risk of Bias tool was used for risk of bias assessment, and The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was used for certainty of evidence appraisal. RESULTS: A total of 3986 records were identified through the electronic data search, of which 24 reports were sought for retrieval. Of these, 7 trials were included. One trial was judged at high risk of bias, while the others had some concerns. Based on individual small sample studies, maxillary molar intrusion was achieved using temporary anchorage devices (TADs) and rapid molar intruder appliance (RMI). It was also observed to a lesser extent with the use of open bite bionator (OBB) and posterior bite blocks. The molar intruder appliance and the posterior bite blocks (spring-loaded or magnetic) also intruded the lower molars. Root resorption was reported in two studies involving TADs. None of the identified studies involved a comparison of conventional and TAD-based treatments for intrusion of molars. No studies reported outcomes concerning stability, cost-effectiveness, compliance and patient-reported outcomes. Insufficient homogeneity between the included trials precluded quantitative synthesis. The level of evidence was very low. CONCLUSIONS: Maxillary molar intrusion can be attained with different appliances (removable and fixed) and with the use of temporary anchorage devices. Posterior bite blocks (spring-loaded or magnetic) and the RMI offer the additional advantage of intruding the mandibular molars. However, stability of the achieved maxillary molar intrusion long term is unclear. Further high-quality randomized controlled trials are needed.

Orthodontic Localization of Impacted Canines: Review of the Cutting-edge Evidence in Diagnosis and Treatment Planning Based on 3D CBCT Images.

A thorough clinical and radiographical assessment of an impacted maxillary canine's location forms the basis for proper diagnosis and successful treatment outcomes. Implementing a correct biomechanical approach for directing force application primarily relies on its precise localization. Poor biomechanical planning can resorb the roots of adjacent teeth and result in poor periodontal outcomes of the canine that has been disimpacted. Furthermore, treatment success and time strongly rely on an accurate assessment of the severity of impaction, which depends on its 3D spatial location. The evolution of cone-beam computed tomography (CBCT) radiographs provides more detailed information regarding the location of the impacted canines. In addition, the literature has shown that CBCT imaging has enhanced the quality of diagnosis and treatment planning by obtaining a more precise localization of impacted canines. This review article highlights current evidence regarding comprehensive evaluation of three-dimensional orientations of impacted canines on CBCT images for precise diagnosis and treatment planning.