Family-based GWAS for dental class I malocclusion and clefts.

BACKGROUND: Individuals born with cleft lip and/or palate who receive corrective surgery regularly have abnormal growth in the midface region such that they exhibit premaxillary hypoplasia. However, there are also genetic contributions to craniofacial morphology in the midface region, so although these individuals appear to have Class III skeletal discrepancy, their molar relationship may be Class I. Past genome-wide association studies (GWASs) on skeletal Class II and III malocclusion suggested that multiple genetic markers contribute to these phenotypes via a multifactorial inheritance model, but research has yet to examine the genetic markers associated with dental Class I malocclusion. Thus, our goal was to conduct a family based GWAS to identify genes across the genome that are associated with Class I malocclusion, as defined by molar relations, in humans with and without clefts. METHODS: Our cohort consisted of 739 individuals from 47 Filipino families originally recruited in 2006 to investigate the genetic basis of orofacial clefts. All individuals supplied blood samples for DNA extraction and genotyping, and a 5,766 single nucleotide polymorphism (SNP) custom panel was used for the analyses. We performed a transmission disequilibrium test for participants with and without clefts to identify genetic contributors potentially involved with Class I malocclusion. RESULTS: In the total cohort, 13 SNPs had associations that reached the genomic control threshold (p < 0.005), while five SNPs were associated with Class I in the cohort of participants without clefts, including four associations that were identified in the total cohort. The associations for the SNPs ABCA4 rs952499, SOX1-OT rs726455, and RORA rs877228 are of particular interest, as past research found associations between these genes and various craniofacial phenotypes, including cleft lip and/or palate. CONCLUSIONS: These findings support the multifactorial inheritance model for dental Class I malocclusion and suggest a common genetic basis for different aspects of craniofacial development.

Expansión dentoalveolar predecible en Ortodoncia con uso de alineadores. Reporte de un caso clínico / Predictable dentoalveolar expansion in orthodontics with the use of aligners. Case Report

Este artículo describe el caso clínico de una paciente de 49 años. Clínicamente se observa Clase II molar derecha, Clase I molar izquierda y Clase I canina de ambos lados. La línea media superior se encuentra desviada hacia el lado izquierdo. Ausencia de piezas 35 y 45. Estrechez de maxilar superior con apiñamiento posterior izquierdo y derecho, apiñamiento anteroinferior. Mordida invertida posterior bilateral. Corredores bucales amplios. Sonrisa consonante, media. Para su tratamiento se indica una primera etapa de 13 alineadores con movimientos de traslación a vestibular y movimientos de torque coronovestibular, donde se planifica una expansión del maxilar superior de 10,99 mm. Al cabo de ocho meses de tratamiento, se observan 5,5 mm de expansión posterior logrados en esta primera etapa. Puede afirmarse que los alineadores son una herramienta efectiva para producir expansión del arco dental. La previsibilidad resultó razonable para el movimiento de expansión con el uso de alineadores.

This article describes the clinical case of a 49 year old female patient. Clinically, right molar class II, left molar class I, and canine class I are observed on both sides. Upper midline deviated to the left side, absence of teeth 35 and 45. Narrowness of the upper jaw with left and right posterior crowding, anteroinferior crowding. Bilateral posterior reverse bite. Negative space. Consonant, medium smile. For its treatment, a first stage of 13 aligners with buccal translation movements and coronobuccal torque movements is indicated, where an expansion of the upper jaw of 10.99 mm is planned. After 8 months of treatment, we can observe 5.55 mm of posterior expansion achieved in this first stage. We can affirm that aligners are an effective tool to produce expansion of the dental arch. Predictability was reasonable for the expansion movement with the use of aligners.

Análisis bidimensional de la permeabilidad de vías aéreas con el tamaño de senos maxilares y su relación con el desarrollo de la clase esqueletal en una población mexicana / Two-dimensional analysis of airway permeability with maxillary sinus size and its relationship with the development of skeletal class in a Mexican population

Comparar la permeabilidad de las vías aéreas y el tamaño de los senos maxilares en relación con la clase esqueletal. se midieron 90 radiografías lateral de cráneo, divididas en 3 grupos, comparando las 3 clases esqueletales, las cuales se determinaron con la medida ANB de Steiner, y estas a su vez en dos subgrupos que fueron hombres y mujeres, en las cuales se utilizó el análisis de McNamara para el análisis de vías aéreas y para el área del seno maxilar se tomaron dos medidas una antero-posterior y cefálica-caudal. Al comparar los hombres con las mujeres se identificó significancia estadística en vía área superior de clase II (p=≤0.017), vía aérea inferior de clase III (p=≤0.006). Al comparar las clases esqueletales en hombres se identificó diferencias en la vía aérea superior en las clases I vs III (p=≤0.05), inferior en la clase I vs III (p=≤0,001) y II vs III (p=≤0.044). Con respecto a mujeres se identificó significancia en la vía aérea superior al comparar la clase I vs II (p=≤0,043), vía aérea inferior en la clase II vs III (p=≤0.05), longitud del seno maxilar al comparar clase I vs II (p=≤0.017). Entre la clase I esqueletal y la clase II, el tamaño de los senos maxilares resulto menor en longitud en las mujeres de clase II esqueletal. Entre la clase I y clase III esqueletal en hombres, se encontró una longitud menor en la vía aérea superior e inferior en la clase I. Las vías aéreas resultaron en menor tamaño en sujetos de clase II.

SUMMARY: To compare the airway permeability and the size of the maxillary sinuses in relation to the skeletal class. 90 lateral skull radiographs were divided into 3 groups, comparing the 3 skeletal classes, which were determined with Steiner's ANB measurement, and these were once in two subgroups that were men and women, in any McNamara analysis was used for the analysis of airways and for the maxillary sinus area measurements were made an antero-posterior and cephalic-caudal. When comparing males with females, statistical significance was identified in the upper class II route (p=≤0,017), lower class III airway (p=≤0.006). At least skeletal classes in men, differences were identified in the upper airway in classes I vs III (p=≤0.05), lower in class I vs III (p=≤0.001) and II vs III (p=≤0.044). With respect to women, significance was identified in the upper airway when comparing class I vs II (p=≤0.043), lower airway in class II vs. III (p=≤0.05), maxillary sinus length to class I vs II (p=≤0.017). Between skeletal class I and class II, maxillary sinus size was shorter in length in skeletal class II women. Between class I and skeletal class III in men, a lower length was found in the upper and lower airways in class I. The airways were found to be smaller in class II subjects.

Clinical study of different composite resin systems in Class I cavities (an 18-month randomized clinical trial) / Estudo clínico de diferentes sistemas de resina composta em cavidades de Classe I (um ensaio clínico randomizado de 18 meses)

Objective: this double-blind randomized clinical trial evaluate the clinical performance of Thermo-Viscous Bulk Fill composite, Self-Adhesive Flowable composite, and Filtek Bulk Fill Composites restorations in Class I cavities over a period of 18 months. Material and Methods: twenty individuals between the ages of 30 and 45 participated in this research. Each patient should have at least three occlusal Class I carious lesions on their molars. They were dispersed at random, with n=20 teeth representing each tested material. Group I (Futurabond M+ and VisCalor Bulk Fill which heated in a viscolar dispenser at 68 °C for 30s and placed in a 4 mm thickness), Group II (Fusio Liquid Dentin self-adhesive composite which put in a thin layer (1mm increment)), and Group III (Single Bond Universal and Filtek Bulk Fill Posterior composite which applied in 4 mm thickness without heating). Using (USPHS) criteria, all restorations were assessed clinically at baseline, 6 months, 12 months, and 18 months. Using an inverse replica, the marginal seal of the investigated restorations was further evaluated under SEM. Statistical analysis was performed with Chi-square test for all USPH parameters. Results: the three tested groups recorded a one hundred percent retention rate after 18 months follow up period. Concerning marginal adaptation, marginal discoloration, anatomical form, surface texture, and color matching, there was a significant difference (p˂0.05) between the three tested groups after 12 & 18 months. After 12 & 18 months, SEM analysis of the marginal seal revealed a statistically significant difference between the three groups. Conclusion: Bulk fill resin composite restorations showed satisfactory acceptable clinical performance after 18 months of clinical service compared to self-adhesive flowable composites, and Viscalor Bulk Fill composite demonstrated excellent results with considerable changes in marginal integrity as a consequence of thermal viscous technology and increased adaptability of restorations toward cavity walls and margins (AU)

Objetivo: este ensaio clínico randomizado duplo-cego avaliou o desempenho clínico de restaurações de resina Bulk Fill Termo-Viscosa, resina autoadesiva Flowable e Filtek Bulk Fill Composites em cavidades Classe I durante um período de 18 meses. Material e Métodos: 20 indivíduos com idade entre 30 e 45 anos participaram da pesquisa. Cada paciente deveria ter pelo menos três lesões de cárie oclusais de Classe I nos molares. Eles foram divididos aleatoriamente, com n=20 dentes representando cada material testado. Grupo I (Futurabond M+ e VisCalor Bulk Fill aquecido em dispensador viscolar a 68 °C por 30s e colocado em uma espessura de 4 mm), Grupo II (resina composta autoadesiva Fusio Liquid Dentin colocada em uma camada fina (incremento de 1 mm)) e Grupo III (resina composta Single Bond Universal e Filtek Bulk Fill Posterior aplicado em espessura de 4 mm sem aquecimento). Usando os critérios (USPHS), todas as restaurações foram avaliadas clinicamente no início, 6 meses, 12 meses e 18 meses. Usando uma réplica inversa, o selamento marginal das restaurações investigadas foi avaliado em MEV. A análise estatística foi realizada com o teste qui-quadrado para todos os parâmetros USPH. Resultados: os três grupos testados registraram uma taxa de retenção de cem por cento após um período de acompanhamento de 18 meses. Em relação à adaptação marginal, descoloração marginal, forma anatômica, textura da superfície e combinação de cores, houve uma diferença significativa (p˂0,05) entre os três grupos testados após 12 e 18 meses. Após 12 e 18 meses, a análise SEM do selamento marginal revelou uma diferença estatisticamente significativa entre os três grupos. Conclusão: as restaurações de resina composta Bulk Fill apresentaram desempenho clínico aceitável satisfatório após 18 meses de atendimento clínico em comparação com as resinas compostas fluidas autoadesivas, e a resina composta Viscalor Bulk Fill demonstrou excelentes resultados com mudanças consideráveis na integridade marginal, como consequência da tecnologia viscosa térmica e maior adaptabilidade de restaurações nas paredes e margens da cavidade (AU)

Angle class II/2nd division: is there an alignment? / Classe II/2ª divisão de Angle: existe alinhamento?

Introduction: Interdisciplinary investigative study of the stomatognathic-cervical complex, necessary to understand the structure and biomechanics of this system in Angle Class I and II / 2nd Division participants. Objective: To evaluate alignment and position of cranial cervical structures on radiographs and their functional relationship with the stomatognathic system. Material and method: Trans Oral and Profile radiographs were submitted to biomechanical analysis, considered the linear and angular measurement of Atlas and Axis through the application included in the radiogram software. Result: We observed a significant difference in the angular measurements of vertical alignment between the Skull, Axis, and the Mandible (p = <0.001), and in the left joint between the Atlas and the Axis (AE: p = 0.011; SEA: p = 0.042). Among the linear measures of the distances between the Atlas and the Axis, the AOD distance presented statistics quite close to the level of significance (p = 0.0502), but above. There was no statistically significant difference in the other measures. Conclusion: In this study, the alignment between the Atlas and Axis cervical vertebrae and the mandible and angles of the atlanto-occipital joints are altered in Class II / 2nd Division participants. There is no difference in the size and distance of the Atlas and the Axis between the Classes.

Introdução: Estudo interdisciplinar investigativo do complexo cérvico-estomatognático, necessário para compreender a estrutura e a biomecânica desse sistema em participantes Classe I e II/2ª Divisão de Angle. Objetivo: Avaliar o alinhamento e a posição das estruturas crânio cervicais nas radiografias de participantes Classe I e II/2ª Divisão de Angle e sua relação funcional com o sistema estomatognático. Material e método: As imagens digitais Trans Oral e Perfil de participantes com maloclusão Classe I e II/2ª Divisão de Angle foram submetidas à medição linear e angular do crânio, mandíbula, Atlas e do Áxis através do software Advantage Workstation 4.6 (AW4.6 ext. 04). Resultado: Houve diferença significativa nas medidas angulares de alinhamento vertical entre o Crânio, Áxis e a Mandíbula (p = <0,001), e da articulação esquerda entre o Atlas e o Áxis (AE: p = 0,011; AAE: p = 0,042). Das medidas lineares das distâncias entre o Atlas e o Áxis, a distância AOD apresentou estatística bastante próxima do nível de significância (p=0,0502), porém acima. Não houve diferença significativamente estatística nas demais medidas avaliadas. Conclusão: Neste estudo, o alinhamento entre as vértebras cervicais Atlas e Áxis e a mandíbula e os ângulos das articulações atlanto occipitais se mostraram alterados nos participantes Classe II/2ª Divisão de Angle. Não há diferença significativa no tamanho e distância do Atlas e do Áxis entre as Classes.

Prevalence and extent of Alveolar dehiscence and fenestration in Class I hyperdivergent subjects with different buccolingual inclinations of maxillary molar teeth: a CBCT study

Buccolingual position of teeth could affect the prevalence of alveolar bone defects. Presence of alveolar defects may have a deleterious effect on orthodontic treatment. The aim was to assess the prevalence and extent of dehiscence and fenestration in Class I hyperdivergent subjects and correlate it with buccolingual inclinations(BL) of maxillary first molar teeth. Methods: This retrospective study involved 80 CBCTs of class I hyperdivergent subjects divided into two groups - group A (n=33) buccolingual inclination >9º and group B (n=47) buccolingual inclination <9º. Prevalence and extent of alveolar bone dehiscence and fenestrations were measured in CBCTs using OSIRIX Lite software. Descriptive statistics, Mann Whitney U test and Spearman correlation were done for evaluating intergroup differences and correlation with Buccolingual inclination. Results: Overall prevalence of dehiscence and fenestration in maxillary first molars was 60.95% and 5% respectively. In the buccal alveolar bone, prevalence of dehiscence was highest in group A (84.6%) for 16 and in the lingual alveolar bone prevalence of dehiscence was highest in group B (71.4%) for 26 . On intergroup comparison, the extent of lingual alveolar bone dehiscence (26) in group B was significantly higher (p value <0.05) than in group A. No significant correlation between the extent of dehiscence and fenestration with buccolingual inclination of molar teeth was noted. Conclusion: Molar teeth with BL inclinations of more than 9º had higher prevalence of dehiscence on the buccal side and molar teeth with BL inclinations less than 9 degrees had more dehiscence on the lingual side. But no significant correlation of BL inclination with prevalence and extent of dehiscence and fenestration was noted

Class I and Class II Patients Treated with Damon System: A Study of Transversal, Sagittal and Torque Values Variations

ABSTRACT Objective: To analyze the transversal and anterior-posterior changes obtained in patients treated only with the Damon system. Material and Methods: 51 patients with either class I or class II division 1 sagittal relationship treated with the Damon system and the same archwire sequence were retrospectively selected. Dental casts of each patient before (T0) and after treatment (T1) were scanned and analyzed using NEMOCAST 3D software. Inter-molar, inter first-premolar, inter-second premolar and inter-canine distances were measured in both upper and lower arches. Initial and final lateral cephalograms were traced using the OrisCeph program. Pre and post-treatment measurements were compared using the t-test for repeated measurements. The Pearson Correlation Index and Linear Regression Analysis were used to determine the dependence between continuous variables. The significance level was set at 0.05. Results: Transversal diameters in the upper arch increase statistically significantly, especially in the bicuspid area. Initial intra-arch diameter was the only statistically significant variable correlated with the final expansion obtained. A linear negative correlation between the initial latero-posterior torque and the final expansion was observed in both arches. Conclusion: Using identical arches in patients with very different initial characteristics, the changes in bicuspids' diameters remain the most predominant. Patients with initial more negative torque in the posterior region had a higher expansion amount.

Assessment of Extractions of Deciduous Mandibular Canine Teeth to Correct Linguoversion Malocclusion in 17 Dogs.

A search of medical records at the Center for Veterinary Dentistry and Oral Surgery, Gaithersburg, MD was conducted to identify patients who received extractions of deciduous mandibular canine teeth to treat linguoversion. Patients were included if they were less than 5.5 months of age and had a diagnosis of deciduous class 2 or bilateral class 1 malocclusions. Treatment was considered a success if normocclusion of the permanent dentition was achieved at follow up evaluation. Seventeen patients represented 13 different breeds. No significant correlation was seen between age of treatment (mean age 3.34 months) or sex (11 males, 6 females). Six patients had class 1 malocclusions (35.29%) and eleven patients had class 2 malocclusion (64.71%). Of the six dogs treated for class 1 malocclusions, two had traumatic palatal contact and four had only minor soft tissue contact. Eleven cases of class 2 malocclusion were treated and of these there was one mild, six moderate, and four severe cases of mandibular distocclusion. All cases treated for class 1 malocclusions had a successful outcome resulting in permanent normocclusion (100%), while class 2 malocclusions had success in three of eleven cases (27.27%). The outcomes based on occlusion type were determined to be significant (p = 0.009). All participants had immediate relief of soft tissue trauma and no significant side effects of treatment were recorded. The results show that extractions of deciduous linguoverted mandibular canine teeth (LMC) can immediately improve traumatic impingement and may be a factor in providing a comfortable and functional adult occlusion. Further investigation with a larger sample size would be warranted.

A heuristic model for cephalometric diagnosis of sagittal dysplasia.

OBJECTIVE: To identify the best-suited cephalometric parameter for assessing the sagittal skeletal discrepancy in the Indian population. DESIGN: An in vitro, observational, single-blinded, retrospective study. SETTING: Department of Orthodontics and Dentofacial Orthopaedics. METHODS: A total of 94 lateral cephalograms were used in this study. The study involved one key person and two examiners. The key person collected the radiographs, coded, analysed and classified them into three groups (skeletal classes I, II and III). Subsequently, the coded radiographs were independently analysed by the two examiners. They classified the cases by matching a minimum of 6 out of 11 parameters. On completion of diagnosis by the examiners, the samples were decoded and matched with the original diagnosis given by the key person. The samples in which identification of a particular cephalometric parameter matched the original evaluation as given by the key person was regarded as correctly diagnosed. The number of correctly assessed cases was used to judge the diagnostic performance of all the parameters in all the cases. Cross-validation of the method was performed, and a diagnostic algorithm was developed for diagnosis. RESULTS: ß angle and Pi angle showed a positive predictive value of 1 in both skeletal class I and II cases. ANB angle, W angle and HBN angle showed a positive predictive value of 1 in skeletal class III cases. CONCLUSION: No single cephalometric parameter can independently be used to diagnose sagittal skeletal discrepancy in all cases. However, a conclusive diagnosis on the type of sagittal skeletal malocclusion can be made by using a simple and easy to use diagnostic algorithmic process having a combination of cephalometric parameters.

Correção da deficiência transversal maxilar utilizando o expansor de níquel-titânio LEAF Expander® com o protocolo para expansão lenta: relato de caso clínico / Correction of maxillary transverse deficiency using the LEAF Expander® nickel-titanium expander with the protocol for slow expansion: a case report

Este trabalho teve como objetivo o relato do caso clínico de uma paciente que compareceu à Faculdade de Odontologia de Araçatuba com características de classe I de Angle e deficiência maxilar transversal, no tratamento foi utilizado o expansor de níquel-titânio LEAF Expander®, fabricado pela Leone, na Itália. Trata-se aparelho que possui inúmeras vantagens por aumentar a adesão do paciente ao tratamento já que não necessita da ativação em domicílio, facilitar o andamento clínico, tendo em vista que o tratamento é menos doloroso e mais fácil que os outros expansores, aumentar a previsibilidade do tratamento, pois as forças contidas nas molas são constantes e pré-determinadas em laboratório (450g de força). Mediante a análise de modelos, documentações fotográficas e do estudo do caso clínico, concluiu-se que o tratamento realizado utilizando o protocolo padrão de expansão lenta da maxila apresentou-se como uma ferramenta inovadora e eficiente no tratamento da deficiência maxilar transversal(AU)

This study aimed to report the clinical case of a patient who attended the Faculty of Dentistry of Araçatuba with Angle class I characteristics and transverse maxillary deficiency. Leon, Italy. It is a device that has numerous advantages for increasing patient adherence to treatment since it does not require activation at home, facilitating clinical progress, given that the treatment is less painful and easier than other expanders, increasing predictability treatment, as the forces contained in the springs are constant and predetermined in the laboratory (450g of force). Through the analysis of models, photographic documentation and the study of the clinical case, it was concluded that the treatment performed using the standard protocol of slow maxillary expansion presented itself as an innovative and efficient tool in the treatment of transverse maxillary deficiency(AU)

Estudos radiográficos do osso hioide e da coluna cervical nas maloclusões Classe I e Classe II/2ª Divisão de Angle / Radiographic studies of the hyoid bone and cervical spine in Angle Class I and Class II/2nd Division malocclusions

Introduction Interdisciplinary investigative study of the stomatognathic-cervical complex, necessary to understand the structure and biomechanics of the hyoid bone and cervical spine in Class I and II / 2nd Division participants. Objective To analyze the position of the hyoid bone and the curvature of the cervical spine on lateral radiographs of participants with Class I and II/2nd Division Angle malocclusion. Material and method We evaluated the position of the hyoid bone from its alignment with the corresponding cervical vertebra. The presentation of curvature of the cervical spine was evaluated from the fourth cervical vertebra. Result There was a statistically significant difference in the position of the hyoid bone (p=0.027) between the classes, which was located at C3 in Class I and further down, between C3 and C5, in Class II/2nd Division. The cervical spine showed alterations in both classes, with an increase, rectification, and inversion of the curvature with no statistical difference between them (p=0.533). Conclusion In this study, the hyoid bone showed different positions in the malocclusions studied, however, poor posture of the cervical spine was common in both classes.

Introdução Estudo interdisciplinar investigativo do complexo estomatognático-cervical, necessário para compreender a estrutura e a biomecânica do osso hioide e coluna cervical em participantes Classe I e II/2ª Divisão de Angle. Objetivo Analisar a posição do osso hioide e da curvatura da coluna cervical nas radiografias em perfil de participantes com má oclusão Classes I e II/2ª Divisão de Angle. Material e método A posição do osso hioide foi avaliada a partir de seu alinhamento com a vértebra cervical correspondente. A apresentação da curvatura da coluna cervical foi determinada a partir da proximidade com a quarta vértebra cervical. Resultado Houve diferença estatística significativa na posição do osso hioide (p=0,027) entre as classes, que ficou situado em C3 na Classe I e mais abaixo, entre C3 e C5, na Classe II/2ª Divisão. A coluna cervical apresentou alterações em ambas as classes sem diferença estatística entre as mesmas (p=0,533), com aumento, retificação e inversão da curvatura. Conclusão Neste estudo, o osso hioide apresentou posições distintas nas más oclusões estudadas, no entanto, a má postura da coluna cervical foi comum em ambas as classes.

Ortodoncia con alineadores y odontología restauradora en el paciente adulto / Orthodontics with aligners and restorative dentistry in adult patients

En los últimos años, el tratamiento de ortodoncia con alineadores ha ido ganando la atención del paciente adulto, que acude a la consulta en busca de tratamientos no solo estéticos sino, también, confortables. Esta situación favorece, a su vez, al odontólogo rehabilitador, quien frecuentemente plantea a sus pacientes la necesidad de realizar un tratamiento de ortodoncia previo a la rehabilitación integral. En estos pacientes, un tratamiento de ortodoncia con alineadores es, generalmente, mejor aceptado que un tratamiento con aparatología fija(AU)

In recent years, the orthodontic treatment with aligners has been gaining attention of adult patients, who go to our office in search of treatments that are not only aesthetic but also comfortable. This situation in turn favors the rehabilitation dentist, who frequently raises the need for his patients to undergo an orthodontic treatment prior to comprehensive rehabilitation. In these patients, an orthodontic treatment with aligners is generally better accepted than a treatment with fixed appliances(AU)

Cephalometric comparison of dentofacial parameters between Yemeni and Caucasian adults / Comparação cefalométrica de parâmetros dentofaciais entre adultos iemenitas e caucasianos

Objective: The purposes of our research were to establish cephalometric standards for Yemeni adults and to compare them with those of the Caucasians. Material and Methods: 100 Yemeni students (fifty males, mean age of 23.6 ± 2.1 years, and fifty female, mean age of 21.5 ± 3.1 years) with normal occlusions and well-balanced faces were involved in the study. Inclusion criteria were a class I occlusion with minor or no crowding, the whole teeth is present except third molars and no previous orthodontic, orthopedic or maxillofacial surgery treatment. Five angular and eighteen linear measurements were used for the skeletal, dental and soft tissue analysis. All participant's Lateral cephalometric radiographs were evaluated. The average values and standard deviations for all the angles and linear measurements were determined. The differences for each measurement between the Yemeni and Caucasian participants were calculated using unpaired t­tests. Results: Yemeni subjects had a more retrognathic mandibular positions (P< 0.05), protrusive mandibular incisors (P< 0.01), more protruded lip positions (P < 0.01), deeper mentolabial sulci (P< 0.01) and a steeper mandibular planes (P< 0.001) compared to the Caucasians. Yemeni females had a larger lower face height than Caucasian females (P< 0.001). Conclusions The study provides specific standards for Yemeni adults and shows that the Yemenis had different skeletal and dentoalveolar cephalometric standards in comparison with Caucasians (AU)

Objetivo: O objetivo de nossa pesquisa foi estabelecer padrões cefalométricos para adultos iemenitas e compará-los com os caucasianos. Material e Métodos: Cem estudantes iemenitas (cinquenta homens, idade média de 23,6 ± 2,1 anos, e cinquenta mulheres, idade média de 21,5 ± 3,1 anos) com oclusões normais e faces bem equilibradas foram envolvidos no estudo. Os critérios de inclusão foram: oclusão de classe I com pouco ou nenhum apinhamento, todos os dentes presentes, exceto terceiros molares e sem histórico de tratamento ortodôntico, ortopédico ou cirurgia maxilo-facial prévio. Cinco medidas angulares e dezoito lineares foram utilizadas para a análise esquelética, dentária e de tecidos moles. Todas as radiografias cefalométricas laterais dos participantes foram avaliadas. Foram determinados os valores médios e desvios padrão para todos os ângulos e medidas lineares. As diferenças para cada medição entre os participantes iemenitas e caucasianos foram calculadas usando testes t não pareados. Resultados: Os indivíduos iemenitas tinham posições mandibulares mais retrognáticas (P <0,05), incisivos inferiores protrusivos (P <0,01), posições dos lábios mais protuberantes (P <0,01), sulcos mentolabiais mais profundos (P <0,01) e planos mandibulares mais inclinados (P <0,001) em comparação com os caucasianos. As mulheres iemenitas tinham uma altura facial inferior maior do que as mulheres brancas (P <0,001). Conclusão:O estudo fornece padrões específicos para adultos iemenitas e mostra que os iemenitas apresentaram padrões cefalométricos esqueléticos e dentoalveolares diferentes em comparação com os caucasianos. (AU)

Effect of Conventional Versus Passive Self-Ligating Vestibular Appliances on Torque, Tip and Transverse Dental Changes in Patients Affected by Class I Malocclusion: A Retrospective Study

ABSTRACT Objective: To evaluate the effects of passive self-ligating appliances (PSLAs) and conventional ligating appliances (CLAs) during orthodontic treatment regarding torque, tip, and transversal dental changes. Material and Methods: Dental parameters were digitally acquired from pre- and post-treatment models of each subject belonging to two groups of patients treated with PSLAs (23 patients; 11 females and 12 males with a mean age of 14.2 ± 1.6 years) and CLAs (18 patients; 10 females and 8 males with a mean age of 14.3 ± 1.9 years), respectively. All subjects had Class I or slight Class II malocclusion (= 2mm), permanent dentition and no previous orthodontic treatment. After normality of data was assumed, a paired sample t-test rejected any side differences at T0 and, therefore, the data were grouped by tooth group. Statistical analyses were performed using a linear mixed-effect framework, assuming the appliance, time, and interactions as fixed effects and the tooth type as random effects. Finally, post-hoc effect analysis was used to contrast modeled marginal effects (p<0.05). Results: For both appliances, there is a general increase of both torque and transverse values at T1, especially for PSLAs. Tip shows a general reduction in the lateral sectors for both appliances is registered. The only significant statistical difference referred to appliances' efficacy is located to mandibular intermolar width. Conclusion: Both appliances have an expansive potential for both torque and transverse dental changes. No evident differences are detectable between appliances except for the rate of the mandibular intermolar width increase.

Factors affecting the stability of maxillary extraction site closure

ABSTRACT Introduction: A side effect observed in cases treated with extractions is the instability of orthodontic space closure. Objective: The aim of this study was to investigate the influence of gingival invagination, presence of third molars and facial pattern, on the stability of orthodontic space-closure in the maxillary arch. Methods: Ninety-nine subjects (41 male and 58 female) with Class I malocclusion treated with four premolars extraction were evaluated. Extraction sites reopening and gingival invaginations were evaluated in scanned dental models in the posttreatment and 1-year posttreatment stages (mean age 16.1 years). Third molars presence was evaluated at 1-year posttreatment panoramic radiographs, and the facial pattern (SN.GoGn) was evaluated in the initial lateral headfilms. Multiple logistic regression analysis was used to estimate the influence of the aforementioned independent variables on the frequency of extraction space reopening. Results: Space reopening was observed in 20.20% of the subjects 1-year post-debonding. Gingival invaginations were present in 25.73% of quadrants after debonding and in 22.80% 1-year posttreatment. The mean pre-treatment SN.GoGn was 35.64 degrees (SD=5.26). No significant influence was observed of the three independent variables on the instability of extraction site closure. Conclusions: The presence of gingival invaginations, third molars and facial growth pattern do not seem to influence maxillary extraction sites reopening.

RESUMO Introdução: Um efeito colateral observado nos casos tratados com extrações é a instabilidade do fechamento ortodôntico do espaço. Objetivo: O objetivo do presente estudo foi investigar a influência da invaginação gengival, da presença de terceiros molares e do padrão facial na estabilidade do fechamento ortodôntico dos locais de extração na arcada superior. Métodos: Noventa e nove indivíduos (41 homens e 58 mulheres) com má oclusão de Classe I tratados com extração de quatro pré-molares foram avaliados. A reabertura dos locais de extração e as invaginações gengivais foram avaliadas nos modelos dentários digitalizados nos estágios pós-tratamento e um ano pós-tratamento (idade média de 16,1 anos). A presença dos terceiros molares foi avaliada em radiografias panorâmicas de um ano pós-tratamento, e o padrão facial (SN.GoGn) foi avaliado nas radiografias laterais iniciais. Análise de regressão logística múltipla foi utilizada para estimar a influência das variáveis independentes citadas na frequência de reabertura do espaço de extração. Resultados: A reabertura do espaço foi observada em 20,20% dos sujeitos um ano após a remoção do aparelho. Invaginações gengivais estiveram presentes em 25,73% dos quadrantes após a remoção do aparelho e em 22,80% após um ano pós-tratamento. O SN.GoGn pré-tratamento médio foi de 35,64 graus (DP = 5,26). Não foi observada influência significativa das três variáveis independentes sobre a instabilidade do fechamento do local de extração. Conclusões: A presença de invaginações gengivais, terceiros molares e padrão de crescimento facial não parece influenciar na reabertura dos locais de extração maxilar.

Anterior open bite treated with palatine crib: a case report with cephalometric, speech and electromyography analyses

This case report describes an interceptive treatment of anterior open bite (AOB) with fixed palatine grid using clinical, cephalometric, electromyographic and speech analysis data. Case report: An 8-year-old girl, Angle Class I malocclusion presenting AOB. The complete orthodontic documentation was obtained and the perioral muscles were evaluated using the electromyography during blowing, sucking and smiling activities, before and after treatment. Speech acoustic evaluation was performed through the frequencies of the formants to assess the position of the tongue. Results: The AOB was corrected in six months with reduction of vertical transpass, decrease of cephalometric Angles 1: NA and 1: NB and increase of interincisal angle. During the smile movement, it was possible to observe the decrease of the muscular activity of the superior orbicularis muscle and the increase of the muscular activity of the inferior orbicularis. In the blow movement, there was a tendency to decrease muscle activity. Opposite directions were observed at the time of installation of the grid in the frequencies of the formants. When the grid was removed, the tongue was lowered and posteriorized in relation to the installation time. When compared the final and initial moments, it was noted a predominance of tongue lower position, besides posteriorization in some vowels and anteriorization in others. Conclusion: After the use of the fixed palatine crib as an interceptive treatment for AOB, the bite was closed and it was possible to observe an harmony in the patient profile and improvement in periorbital musculature and tongue positioning.

Objetivo: Este relato de caso descreve um tratamento interceptivo da mordida aberta anterior (MAA) com grade palatina fixa usando dados clínicos, cefalométricos, eletromiográficos e de fala. Relato do caso: Menina de 8 anos de idade apresentando maloclusão Classe I de Angle e MAA. A documentação ortodôntica completa foi obtida e os músculos periorais foram avaliados pela eletromiografia durante as atividades de sopro, sucção e sorriso, antes e após o tratamento. A avaliação acústica da fala foi realizada através das frequências dos formantes para avaliar a posição da língua. Resultados: O MAA foi corrigida em seis meses com redução do transpasse vertical, diminuição dos ângulos cefalométricos 1: NA e 1: NB e aumento do ângulo interincisivo. Durante o movimento do sorriso, foi possível observar a diminuição da atividade muscular do músculo orbicular superior e o aumento da atividade muscular do orbicular inferior. No movimento do sopro, houve uma tendência a diminuir a atividade muscular. Direções opostas foram observadas no momento da instalação da grade nas frequências dos formantes. Quando a grade foi removida, a língua foi abaixada e posteriorizada em relação ao tempo de instalação inicial do aparelho. Quando comparados os momentos final e inicial, observou-se predomínio da posição inferior da língua, além de posteriorização em algumas vogais e anteriorização em outras. Conclusão: Após o uso da grade palatina fixa como tratamento interceptivo para a MAA, a mordida foi fechada e foi possível observar harmonia no perfil da paciente e melhora da musculatura periorbital e posicionamento da língua.

Simplified orthognathic surgical treatment using non-surgical asymmetric maxillary expansion: A case report.

BACKGROUND: Transverse problems can be exacerbated by highly compensated occlusion in patients with skeletal asymmetry, which makes pre-surgical decompensation harder to achieve. OBJECTIVE: This case report describes a case of combined orthognathic surgery with facial asymmetry. We used pre-orthodontic surgical simulation to visualize the goal for presurgical orthodontics, planning for a one-jaw surgical treatment option. METHODS: The planned asymmetric expansion was performed using a maxillary skeletal expander (MSE II) with surgical corticopuncture over only the left side before MSE activation. Surgery was performed to achieve mandibular left outward yaw rotation to correct the patient's facial asymmetry after the planned amount of expansion was reached. RESULTS: The results showed substantial improvement of facial aesthetics as well as skeletal symmetry. Cooperation and communication between surgeon and orthodontist ensured that the final results were satisfactory.

European College of Orthodontics. Commission of Titularisation. Clinical case No. 191101.

DATE OF BIRTH: 29/07/1993; gender: female. PRE-TREATMENT DOCUMENTS: 19 years 2 months old: 29/07/1993. DIAGNOSIS: Skeletal class II with mandibular laterognathia and retrusion, hypodivergent facial pattern; class II division 1, transverse maxillary deficiency with left unilateral posterior cross bite; missing teeth before treatment: 18 28 38 48. TREATMENT PLANNING: Orthosurgical treatment (bimaxillary surgery); Bimaxillary lingual fixed appliances. DURATION OF ACTIVE TREATMENT: 2 years. POST-TREATMENT DOCUMENTS: 22 years 5 months old; 09/01/2015. POST-RETENTION DOCUMENTS: 05/01/2016; 23 years 5 months old. RETENTION PERIOD: 3 years.

Combined orthodontic and surgical treatment supported by virtual planning in a severe mandibular asymmetry: A case report.

This article describes the complex dental treatment of a 17-year-old girl with skeletal Class I, severe mandibular asymmetry, maxillary retrusion, normodivergent pattern, left canine and molar Class II, canting of the occlusal plane, lateral left cross-bite, deep bite, upper and lower incisors retrusion and an increased curve of Spee. To achieve optimal results, a multidisciplinary approach to treatment was adopted involving orthodontics and maxillofacial surgery. The surgical phase was supported by virtual surgical planning with dedicated software. Thanks to the development of the three-dimensional radiological findings, a visualization and an accurate simulation of all the surgery-steps help to determine reproducibly and with high precision the best adjustments to do. Firstly, the excessive curve of Spee, the incisors retrusion and the deep bite were corrected with orthodontic treatment. The surgical treatment plan consisted of a palatal expansion, maxillary advancement, zygomatic grafts, bilateral sagittal osteotomy for mandibular correction and genioplasty. Orthodontic treatment was continued to finish with all the objectives achieved. After two years, the patient was satisfied with her facial and dental treatment results and with her oral function as well.

Investigation of the Relationship Between Mandibular Morphology and Upper Airway Dimensions.

INTRODUCTION: In this study, the authors aimed to perform a novel and extensive analysis, based on the most applicable correlations between the mandibular and upper airway parameters, using cone beam computed tomography across all malocclusion classes. The authors also focused on gender-dependent differences in an Iranian population. MATERIALS AND METHODS: Images were acquired from adult patients using cone beam computed tomography. The patients were classified into three groups of malocclusion classes (class I: 13 males and 27 females, class II: 13 males and 27 females, and class III: 25 males and 15 females). For each patient, 10 parameters for the mandible and 23 parameters for the pharynx, pyriform aperture, and nasal cavity were evaluated in the images. RESULTS: Pearson's correlation coefficient showed significant correlations between the mandibular morphology and upper airway dimensions in each malocclusion class. In females, the menton angle had a significant correlation with pharyngeal dimensions in all malocclusion classes. In males, the bigonial width, bicondylar width, and symphyseal height of the mandible were correlated with pharyngeal dimensions in all classes. The greatest correlation between the mandible and upper airways was observed in class III malocclusions, and the lowest correlation was observed in class I malocclusions. In addition, the mandibular parameters had relationships with the nasal cavity and pyriform aperture. CONCLUSION: It is important to consider the knowledge of the relationship between some characteristics of the mandible and airways in various clinical approaches.