A Novel Self-Retentive Obturator to Facilitate Feeding in an Infant with Cleft Palate: A Case Report and Literature Review.

Cleft lip and palate are common congenital defects with multifactorial complex etiology characterized by complete or incomplete cleft of lip, alveolus, and hard and soft palate. In infants, the main problem lies in the difficulty of suckling with frequent nasal regurgitation leading to respiratory and middle ear infections. This article presents a case report of an 8-day-old female with complete cleft of hard and soft palate who was given a novel self-retentive type feeding obturator. This obturator eliminated the need for supplementary aids to help in retention and has a simple design, is cost-effective, and easy to use.

Fractal analysis of mandibular trabecular pattern following protraction facemask therapy : A pilot study.

OBJECTIVE: To assess the remodeling effects of protraction facemask therapy on the trabecular pattern of the mandible and identify quantitatively the regions of the mandible undergoing maximum changes in the trabecular pattern. MATERIALS AND METHODS: The retrospective study was conducted in 30 subjects divided into two groups. The treatment group (group 1) consisted of 15 subjects with skeletal class III malocclusion treated with a facemask (mean age: 9.1 ± 2.1 years). Digital panoramic radiographs (OPG) were obtained before treatment (T0) and at the end of active facemask therapy (T1) with a mean duration of 16.1 ± 2.5 months. In all, 15 skeletal class I subjects who did not undergo any orthodontic treatment (mean age 9.1 ± 2.2 years) comprised the control group (group 2) who had two OPGs at a mean interval of 13.6 ± 2.2 months. The fractal dimensional (FD) value was calculated in three regions: angular, condylar, and corpus region. RESULTS: Intragroup comparisons revealed a significant increase in the FD values in the right condylar (T0 = 1.2 ± 0.2; T1 = 1.4 ± 0.1) and left condylar (T0 = 1.2 ± 0.1; T1 = 1.4 ± 0.1) region (p < 0.05) and in the corpus region (FD values: right T0 = 1.2 ± 0.1, T1 = 1.4 ± 0.1; left T0 = 1.2 ± 0.1, T1 = 1.4 ± 0.1; p < 0.05). The intergroup comparison demonstrated that the treatment group showed greater changes compared with the controls in the condylar process (mean difference: right = 0.19, left = 0.20; p < 0.05) and the corpus region (0.172; p < 0.05). CONCLUSION: FD analysis demonstrated that the condylar process and the corpus region underwent the most significant change in the trabecular pattern in subjects treated with protraction facemask therapy.

Association, diagnostic accuracy and optimal threshold of salivary IGF-1 and vitamin DBP levels for estimation of pubertal growth spurt: A cross sectional study.

AIM: To determine the association of salivary IGF-1 and vitamin D Binding Protein with cervical vertebral maturation index (CVMI) across the pubertal stages and to determine the diagnostic accuracy and optimal threshold of these biomarkers for estimation of pubertal growth. DESIGN: Cross-sectional observational study. SETTING: Material and methods. All patients in the age group of 8-23 years from the Outpatient Department of Orthodontics and Dentofacial orthopaedics, between the period of July 2020 to December 2020 meeting the eligibility criteria were included. Lateral cephalograms obtained from the patients were divided into pre pubertal, pubertal & post pubertal groups based on CVMI by Baccetti et al. Unstimulated whole saliva was collected by a swab-based method & analyzed with ELISA. RESULTS: Ninety-four participants were divided in three stages: prebubertal (30), pubertal (33), post pubertal (31). A significant difference was observed in the salivary IGF-1 & DBP across the three stages. Post-hoc test revealed significantly higher mean salivary IGF-1 & DBP in pubertal group than in pre & post-pubertal group. Receiver operator characteristic curve revealed excellent diagnostic accuracy for salivary IGF-1with areas under the curve (AUC) of 0.962, satisfactory for vitamin DBP with AUC of 0.831 and poor diagnostic accuracy for age with AUC of 0.536. Youden index revealed the optimal threshold to be 3.96ng/ml and 124.13pg/ml for salivary IGF-1 and vitamin DBP respectively. CONCLUSION: The levels of Salivary IGF-1 and Vitamin DBP increased during C3 and C4 stages. Compared to vitamin DBP diagnostic accuracy of salivary IGF-1 was excellent and an optimal threshold of 3.96ng/ml can be utilized to distinguish pubertal & non-pubertal participants.

Non-invasive methods for the assessment of biomarkers and their correlation with radiographic maturity indicators - a scoping review.

BACKGROUND: Detection of skeletal maturity is vital in orthodontic treatment timing and planning. Traditional methods include hand-wrist radiography and cervical vertebral maturation index (CVMI). Though the radiographic methods are well established and routinely used to assess skeletal maturation, they carry the drawback of subjective perception and low reproducibility. With evolving concepts, skeletal maturation has been assessed quantitatively through biomarkers obtained from saliva, gingival crevicular fluid (GCF), and urine. The scoping review aims to explore the various biomarkers assessed through non-invasive methods and their correlation with radiographic skeletal maturity. METHODOLOGY: The literature search was carried out on MEDLINE via Pubmed, Cochrane Library (Cochrane database of systematic reviews), Cochrane central register of controlled trials (CENTRAL), Google Scholar, Semantic Scholar, ScienceDirect, and Opengrey.eu for articles up to and including November 2020. Pertinent articles were selected based on inclusion and exclusion criteria. The results were tabulated based on the type of sample collected, the biomarker assessed, method of sample collection, and the radiographic method used. RESULTS: The literature search resulted in 12 relevant articles. Among all the studies, 10 studies showed that the concentration of biomarkers increases during the pubertal growth peak. On the contrary, 2 articles showed no significant difference between the levels of biomarkers and pubertal growth peak. CONCLUSION: It can be concluded that the level of biomarkers increases during the pubertal growth spurt and can provide a quantitative way of assessing skeletal maturity.