Cone beam computed tomography analysis results in patients with obstructive sleep apnoea syndrome.

INTRODUCTION: The present study aimed to investigate the contribution of cone-beam computed tomography (CBCT) to the diagnosis of obstructive sleep apnoea syndrome (OSAS). METHODS: The present study investigate the relationships among body mass index (BMI), upper airway, septum deviation, nasal cavity width, airway, and the hard and soft palate width using CBCT images of 64 patients obtained in Usak University Faculty of Dentistry. The study included 31 (8 female and 23 male; mean age: 52.52 ± 10.01 years) and 33 patients (12 female and 21 male; mean age: 47.39 ± 10.27 years) with and without OSAS, respectively. Between-group comparisons of non-normally and normally distributed variables were performed using the Mann-Whitney U test and Student's t-test, respectively. Spearman's correlation analysis was used to determine the relationship between quantitative data. Statistical significance was evaluated at P < .01 and P < .05. RESULTS: There were significant differences between groups in the BMI, nasal septum position, hard and soft palate width, maxillary skeletal width, and palatal alveolar angle (P < .01). In addition it was also found that BMI was higher, the nasopharyngeal airway was longer, and the soft palate was longer and wider in males. (P = .001; P < .01). CONCLUSION: This study concluded that patients with OSAS had marked narrowing of the upper airway, nasal cavity and maxillary width, shortening and enlargement of the soft palate, and marked increase in BMI. However, to gather sufficiently reliable data for routine use in orthodontic analyses, there is a need for greater number of samples to improve the database.

Effects of the different administration frequencies of teriparatide (PTH [1-34]) on new bone formation of expanded midpalatal sutures in rats: A histomorphometric and micro-computed tomography analysis.

OBJECTIVE: The aim of the study was to evaluate the effect of 4 µg/kg teriparatide administered at intermittent and continuous frequencies on bone formation in the expanded midpalatal suture region using histomorphometric and micro-computed tomography (micro-Ct) analysis. Settings and sample population: In this study, 24 Sprague Dawley male rats were used. METHODS: The experimental animals were divided into 3 groups as follows: Group 1: only maxillary expansion, Group 2: maxillary expansion with continuous teriparatide administration (2 µg in the morning and 2 µg in the evening) and Group 3: maxillary expansion with intermittent teriparatide administration (daily 4 µg/kg). The expansion appliance was fixed to maxillary incisors of all animals within the 5-day expansion period, followed by a 12-day retention phase. Animals were sacrificed at the end of the retention period, and specimens were evaluated by micro-Ct and histomorphometric analysis respectively. RESULTS: The results of the histomorphometric analysis showed that Group 3 had the highest number of osteoblasts (1042 ± 90.76) (P < .01). In addition, the results of micro-Ct analysis revealed that Group 3 had the highest bone volume/total volume (16% ± 0), bone mineral density (173.82 ± 2.6 mgHA/cm3 ) and least midpalatal suture width (0.13 ± 0.001 mm) (P < .01). Osteoblasts number and micro-Ct analysis values of Group 2 were higher than those of Group 1 but no significant differences between them (P > .01). CONCLUSION: Intermittently administered TP (4 µg/kg once a day) was seen to enhance bone formation and mineralization. In the future, it can be used in drug studies that will increase or stimulate bone formation as well as in the midpalatal suture area.

Nasal profile changes after orthodontic tooth extraction in Class II, Division 1 malocclusion patients: A retrospective study.

INTRODUCTION: This study aimed to investigate changes in the facial soft-tissue profile, especially the nose, following fixed orthodontic treatment, with or without tooth extraction, in individuals diagnosed with dental Class II malocclusion. MATERIALS AND METHODS: Cephalometric images of 81 individuals with dental Class II malocclusion who underwent fixed orthodontic treatment were assessed before and after treatment. The participants were categorized into three groups: non-extraction; upper first premolar extraction; and four first premolar extractions. The parameters measured were: upper lip height, upper lip to E-plane, lower lip to E-plane, lower lip height, nasolabial angle, nasomental angle, facial convexity, lower anterior face height, soft-tissue facial convexity, nasal tip angle, nasal bridge length, N'-nasal bridge point, nasal bone length, nasal bone angle, nasal depth, columella convexity, and nose height. RESULTS: Within the upper two extraction group, there were significant increases at the start and end periods in nasolabial angle (P = 0.023), nasal depth Pr to Ac (P = 0.027), and nasal depth Pr to N-Prn (P = 0.040); and decreases in columella convexity (P = 0.010), upper lip to E-plane (P = 0.009), and nasomental angle (P = 0.009). There were significant results in comparisons between measurements based on the extraction status in the mean nasolabial angle (P = 0.011), mean columella convexity (P = 0.028), and mean lower lip to E-plane (P = 0.045). CONCLUSION: Orthodontic treatment involving tooth extraction may potentially affect the nasolabial angle and nasal depth. During treatment planning, it is crucial to consider the potential changes that may occur to the nose and any alterations that may be needed to achieve the desired esthetic outcome.

Is There a Relationship Between Vertical Facial Development And Nasal Cavity?

BACKGROUND: There are no studies investigating the relationship between cone beam computed tomography (CBCT) and nasal passage findings and vertical facial development. The aim of this study is to determine the relationship between nasal cavity anatomy and vertical development of patients. METHODS: A total of 60 CBCTs were examined, and Class I malocclusion individuals were divided into two groups (30 each) according to vertical facial development. All nasal cavity findings were recorded in the study. Vertical facial development, nasal septum, nasal cavity width, thickness and angle were evaluated. Mann-Whitney U Test was used, and Student's t test was used for the comparison of two groups with normal distribution. Significance was evaluated at p<0.01 and p<0.05 levels. RESULTS: Statistical analysis showed a relationship between vertical facial development and nasal cavity findings. Nasal septum deviation was mild to moderate in the hyperdivergent group, while septal deviation was absent in the hypodivergent group. A statistically significant difference was found in the width, distance (x-y) and angle of the nasal cavity from the hyperdivergent group in Class I vertical subgroups (p<0.05). CONCLUSION: When compared between low-angle and high-angle groups, statistically significant differences were observed in anterior face height, nasal passage angle, and distance between the outermost points of the nasal cavity.

Three-dimensional zygomatic changes after rapid maxillary expansion in growing patients.

PURPOSE: To assess the effects of rapid maxillary expansion (RME) treatment on the zygomatic bone complex (ZBC). METHODS: In this single-center retrospective study, pre- and posttreatment cone-beam computed tomography (CBCT) images of 38 patients treated with RME were analyzed to investigate changes in the coordinates of the ZBC landmarks. At the start of treatment (T0), the patients' mean age was 11.1 ± 3.8 years (range 8.3-14.9 years). Cohen's d test was used to evaluate statistical differences. RESULTS: There were statistically significant differences between T0 and T1 (P < 0.01) in the measurement values for the maxillary transverse width (ΔT: 3.18 ± 2.58, d: 1.23), frontozygomatic sutures (ΔT: 1.09 ± 0.56, d: 0.43), lowest point of the zygomaticomaxillary sutures (ΔT: 3.16 ± 1.78, d: 0.78), frontomaxillary angular parameter (right side ΔT: 2.81 ± 1.63, d: 1.73; left side ΔT: 2.52 ± 1.20, d: 2.10), frontozygomatic angular parameter (right side ΔT: 2.81 ± 1.63 d: 1.07; left side ΔT: 2.21 ± 2.79, d: 0.61), anterior intermaxillary distance (ΔT: 2.11 ± 1.42, d: 0.99), interzygomaticotemporal distance (ΔT: 2.00 ± 2.42, d: 0.99), and zygomatic angular parameter (right side ΔT: 2.06 ± 1.29, d: 1.6; left side ΔT: 2.02 ± 1.86, d: 1.09). CONCLUSIONS: After RME in growing patients, the zygomatic bone showed pyramidal expansion in the coronal plane and parallel palatal expansion in the axial plane. In addition, significant lateral relocation of the zygomatic bone occurred. The zygomatic bone tended to rotate outward in conjunction with the maxilla, with a typical center of rotation close to the superior side of the frontozygomatic suture. These results shed light on the patterns of skeletal expansion in the zygomatic bone associated with RME in growing patients.

Evaluation of the Possible Relationship between the Curvature and Horizontal Course of the Inferior Alveolar Canal.

OBJECTIVES: The position of the inferior alveolar canal (IAC) and its course in the mandible is crucial to prevent complications in oral surgical procedures. Therefore, the present study aims to predict the course of IAC using landmarks specific to the mandible and to correlate with cone-beam computed tomography images. METHODS: On the included panoramic radiographs (n=529), the closest point of the IAC to the inferior border of the mandible (Q) was determined, and the distances of this point to the mental (Mef) and mandibular foramen (Maf) were measured in millimeters. To determine the buccolingual course of the IAC on CBCT images (n=529), the distances from the center of the canal to the buccal and lingual cortices and between the cortices were measured at the level of the root apices of the first and second premolars and molars. Also, the positions of the Mef to adjacent premolars and molars were classified. RESULTS: The most common position of mental foramen was Type-3 (37.1%). On the coronal plane, it was also observed that as the Q point approaches the Mef, the IAC is located in the mandible's center at the second premolar level (p=0.008) and moves away from the midline at the level of the first molar (p=0.007). CONCLUSION: Based on the results, a correlation was observed between the horizontal course of the IAC and its proximity to the inferior border of the mandible. Therefore, the curvature of the IAC and its proximity to the mental foramen should be considered in oral surgeries.

Comparison of the bond strength of five different composites used in the production of clear aligner attachments.

AIM: The aims of this study were to measure and compare shear bond strength (SBS) and manipulation time (MT) among five different composite resins (CR; two flowable and three highly viscous) which are used in the production of clear aligner attachments. MATERIAL AND METHODS: This in vitro experiment study comprised of 150 extracted premolars which were divided into 5 equal groups. Predictor variables were CRs; Tetric Evo Ceram (Ivoclar VivadentAG, Liechtenstein) (Group 1), Tetric NCeram; (Ivoclar VivadentAG, Liechtenstein) (Group 2), Tetric N-Flow (GC Dental Products, Tokyo, Japan) (Group 3), G-aenial Universal Injectable (GC Dental Products, Tokyo, Japan) (Group 4), GC Aligner Connect (GC Dental Products, Tokyo, Japan) (Group 5), respectively. Outcome variables were; SBS and MT for each CR attachment in each group of teeth. Oneway ANOVA was used to compare the groups. Levene's test was used to determine variance homogeneity. In terms of variance homogeneity, Bonferroni tests were used as a post-hoc test for multiple group comparisons. RESULTS: SBS was statistically different between study groups (p < 0.001). Average SBS values ​​are found to be 16.6 ± 3.6 MPa for Tetric Evo Ceram; 20.7 ± 5.4 MPa for Tetric NCeram; 21.0 ± 4.0 MPa for Tetric N-Flow; 18.9 ± 5.0 MPa for G-aenial Universal Injectable; and 17.4 ± 3.5 MPa for GC Aligner Connect. The values ​​in the Tetric Evo Ceram group were significantly lower than the Tetric N-Ceram group (p = 0.004) and the Tetric N-Flow group (p = 0.001). Mean value of shear bond strength in the GC Aligner connect group were significantly lower than in the Tetric N-Ceram group (p = 0.047) and in the Tetric N-Flow group (p = 0.017). Flowable composite had a significantly shorter manipulation time than the high viscous one; mean 1,08 ± 0,22 min to mean 4,57 ± 0,51 min, respectively. CONCLUSION: Although SBSs of CRs tested in the study was found to be statistically different, they all quite exceeded the accepted clinically sufficient value of 6-8 MPa. Besides, flowable composite required substantially less time to manipulate than the high viscosity composite.

Analyzing the effects of tooth extraction on the lip in orthodontic treatment.

INTRODUCTION: The aim of this study was to analyze changes occurring in the lip and facial soft-tissue profile after fixed orthodontic treatment, with or without tooth extraction, in patients with dental class II malocclusion. MATERIALS AND METHODS: Measurements were made on cephalometric films of 75 individuals with dental class II malocclusion before and after fixed orthodontic treatment. The patients were divided into three groups: no extraction, extraction of upper two premolars, or extraction of four premolars. The parameters measured were: basic upper lip thickness (BULT), vermilion upper lip thickness (VULT), upper lip inclination (ULI), basic lower lip thickness (BLLT), vermilion lower lip thickness (VLLT), lower lip inclination (LLI), face axis angle (Ba-N/PtmGn), labiomental angle, facial convexity angle, and total face convexity angle. The results were analyzed statistically using the Wilcoxon, Kruskal-Wallis, and Mann-Whitney U tests. RESULTS: It was found that the VULT value in the group with no extraction was lower than the four-extraction group (P = 0.001; P < 0.05). The VULT value in the upper-two extraction group was significantly lower than that in the four-extraction group, and the Ba-N/PtmGn in the no-extraction group was lower than that in the four-extraction group (P = 0.001; P < 0.05). CONCLUSIONS: These findings suggest that tooth extraction in orthodontic treatment may affect the vermilion upper lip thickness and facial axis, but that this does not have any negative effects on the soft-tissue facial profile. Premolar tooth extraction can be performed by establishing an accurate diagnosis and treatment plan to avoid undesirable and negative effects on the facial soft-tissue profile.

Evaluation and comparison of smartphone application tracing, web based artificial intelligence tracing and conventional hand tracing methods.

AIM: The aim of this study was to compare and evaluate the reliability of three different cephalometric assessment methods: Smartphone Application Tracing Method CephNinja (SATM), Web Based Artificial Intelligence (AI) Driven Tracing Method WebCeph (WATM) and Conventional Hand Tracing Method (CHTM). METHODS: 110 lateral cephalometric radiographs were enrolled in the study and 4 linear and 7 angular parameters were traced and measured by one examiner using CephNinja, WebCeph and conventional hand tracing methods. Independent-samples Kolmogorov-Smirnov and Shapiro Wilks tests were used to compare the mean values of intra-examiner differences. Both intra-method and inter-method correlations were evaluated. RESULTS: There were statistically significant differences between the methods in terms of SNA (p:0.003; p < 0.05); SNB measurements (p:0.001; p < 0.05); SN-MP angle (p:0.001; p < 0.05); U1-SN angle (p:0.001; p < 0.05); L1-NB(mm) (p:0.007; p < 0.05) and E Line-Upper Lip(mm) measurements (p:0.013; p < 0.05). All intra-method correlation coefficients are 80% and above. In terms of inter-method coefficients the lowest coefficient of agreement is 0.170 and it is the coefficient of agreement between CHTM and SATM for measurement of U1-NA. The highest coefficient of agreement is 0.884 which is between WBTM and SATM for SNB measurement. CONCLUSIONS: The null hypothesis was rejected. There were statistically and clinically significant differences in various measurements among groups.

Evaluation of temporomandibular disorders and oral health-related quality of life with obese patients.

Objective: The aim of this study was to investigate the relationship between temporomandibular disorders and oral health impact profile in healthy, overweight, and obese patients.Methods: This study was carried out on 1528 individuals divided into three groups as healthy, overweight, and obese patients. Diagnostic Criteria for Temporomandibular Disorders, Fonseca's questionnaire, and Oral Health Impact Profile-14 (OHIP-14) forms were used.Results: Gender, classification, pain, temporomandibular joint noise, and open-lock of the jaw of healthy, overweight, and obese groups were found to be related. The differences in the Fonseca and the OHIP-14 total scores according to the groups were found to be statistically significant. The correlation between the Fonseca total score and age was positive and significant.Conclusion: In the obese patients, both total Fonseca and OHIP-14 values were found to be higher. Also, the presence of pain in the obese patients was found to be higher.

Modifications in Class I and Class II Div. 1 malocclusion during orthodontic treatment and their association with TMD problems.

Objective: To observe changes in tooth movements of patients with Class I and Class II malocclusion during the first 6 months of orthodontic treatment and to investigate the relation between TMJ problems and these changes. Methods: The sample was comprised of 63 individuals (20 control, 25 Class I malocclusion, 18 Class II Div. 1 malocclusion). Occlusion analysis was performed through T-Scan® record and chewing pattern examination before and after the 6-month period. The existence of TMD was evaluated using joint vibration analysis (JVA). Patients with malocclusion had active fixed orthodontic treatment. Results: Disclusion time reduced in the patients group during the treatment period. No association was observed between the first 6-month period of the orthodontic treatment and TMD. Discussion: It is suggested that occlusion analyses should be done before any orthodontic treatment, and disclusion time should be minimized as much as possible.

Is there a relationship of nasal septum deviation with pharyngeal airway dimension and craniocervical posture?

OBJECTIVE: This study aimed to evaluate the effects of nasal septum deviation on the pharyngeal airway and craniocervical posture measurements using cone beam computed tomography (CBCT). METHODS: This retrospective study analyzed the CBCTs of 25 patients with and without nasal septum deviation. Various parameters defining the pharyngeal airway and craniocervical and facial skeletal morphology were measured and compared between the groups after confirming intra-examiner reliability. RESULTS: Compared to the control group, the group with nasal septum deviation had a statistically significantly shorter nasopharyngeal length (p < 0.001), longer vertical airway length (p < 0.002), and larger cervical column curvature angle (p < 0.006). CONCLUSION: Children with a nasal septum deviation of 4 mm or more on their CBCT scan are susceptible to unfavorable pharyngeal airway and craniocervical postural changes.