Impacts of mandibular setback with or without maxillary advancement for class III skeletal correction on sleep-related respiratory parameters: A systematic review and meta-analysis.

A systematic review and meta-analysis was conducted to evaluate the impacts of mandibular setback with or without maxillary advancement for class III skeletal correction on respiratory parameters measured by polysomnography (PSG) and to compare these respiratory parameters between these procedures for class III skeletal correction. Six electronic databases were searched up to June 2023. Studies comparing PSG parameters before and after orthognathic surgery for skeletal class III patients were selected for further analysis. The outcomes of interest were apnoea-hypopnea index (AHI), respiratory disturbance index (RDI), the lowest oxygen saturation (lowest SpO2), the average oxygen saturation (mean SpO2), and the 3% oxygen desaturation index (3% ODI). Data extraction, methodological quality assessment, risk of bias assessment, meta-analysis, and subgroup analysis were performed. Sixteen studies with a total of 476 patients who underwent orthognathic surgery for class III skeletal correction were included for meta-analysis. The risk of bias level was moderate for most studies. All PSG parameters before and after orthognathic surgery were not significantly different. The different surgical procedures also did not significantly affect post-operative PSG parameters. 5.8% of patients developed post-operative obstructive sleep apnoea (OSA). Most of them underwent a large distance of mandibular setback. There is a moderate level of evidence that mandibular setback with or without maxillary advancement for class III skeletal correction does not pre-dispose young and healthy patients to obstructive sleep apnoea when evaluated in the short term after surgery. However, post-operatively developed OSA was found in several isolated cases that underwent a large amount of mandibular setback with or without maxillary advancement.

Effects of nasoalveolar molding on nasolabial aesthetics in patients with cleft lip and palate during pre-adolescence: A systematic review and meta-analysis of retrospective studies.

This study aims to analyze long-term effects of nasoalveolar molding (NAM) as a part of cleft primary management protocols on nasolabial aesthetics for patients with non-syndromic cleft lip and palate by conducting a systematic review and meta-analysis. Six electronic databases and two journals were searched up to July 2023. Studies comparing nasolabial outcomes between NAM and non-NAM protocols were selected for further analysis. Nasolabial aesthetics were the outcome of interest. Data extraction, methodological quality assessment, risk of bias assessment, meta-analysis and subgroup analysis were performed. Seven retrospective cohort studies were selected for a qualitative review and four for a quantitative analysis. The risk of bias assessment was moderate for most studies. Only studies utilizing the Asher-McDade rating (AMR) were included for meta-analyses. The protocols with NAM exhibited a significantly lower AMR score for vermillion border than other protocols. AMR scores for nasal form and nasal symmetry from protocols with NAM were significantly lower than protocols without any pre-surgical infant orthopaedics (PSIO) but not significantly different from protocols with other PSIO techniques. The AMR score for nasolabial profile from protocols with NAM was not significantly different from other protocols. However, subgroup analysis demonstrated that protocol combining NAM and primary rhinoplasty significantly lowered AMR scores for nasal form, nasal symmetry and nasolabial profile. For patients with unilateral cleft lip with or without palate (UCLP), this study found that a protocol combining NAM and primary rhinoplasty improved nasolabial outcomes while a protocol with NAM alone offered only limited benefits. For patients with BCLP, the available evidence remains inconclusive. Performing NAM in combination with primary rhinoplasty improves nasolabial aesthetics in patients with UCLP. PROSPERO (CRD4202128384).

Development and validation of the Thai Halitosis Associated Life-Quality Test (T-HALT): an evaluation of psychometric properties.

BACKGROUND: Halitosis appears to have significant impacts on quality of life, necessitating reliable assessment tools. The Halitosis Associated Life-Quality Test (HALT) has been validated in various populations, but not among Thai people. While HALT provides a valuable foundation, there is a need for a culturally adapted and expanded instrument for the Thai context. Consequently, this study aimed to develop and validate a comprehensive questionnaire for assessing halitosis-related quality of life in Thai populations, incorporating a Thai version of HALT (T-HALT) as a core component. MATERIALS AND METHODS: This cross-sectional study involved 200 dental patients at Mahidol University. The original HALT was translated into Thai using forward-backward translation. Cultural adaptation and psychometric properties of T-HALT were evaluated through multiple approaches. Content validity was ensured through expert reviews, while face validity was assessed by patient feedback. Reliability was examined via test-retest and internal consistency measures. Criterion and discriminant validity was evaluated by correlating T-HALT scores with self-perceived halitosis and volatile sulfur compound (VSC) measurements, respectively. VSCs were quantified using the OralChroma™ device, which analyzes breath samples collected directly from patients' mouths. Construct validity was assessed through exploratory (EFA) and confirmatory factor analysis (CFA), providing insights into the questionnaire's underlying structure. RESULTS: T-HALT demonstrated excellent internal consistency (Cronbach's alphas = 0.940-0.943) and test-retest reliability (ICC = 0.886). Criterion validity was supported by a significant correlation between T-HALT scores and self-perceived halitosis (r = 0.503, P < 0.001). Discriminant validity was confirmed by the absence of a significant correlation between T-HALT scores and VSC levels (r = 0.071, P = 0.32). EFA revealed a four-factor structure, which was subsequently confirmed by CFA. However, Items 1 and 7 were excluded due to poor standardized factor loadings. CONCLUSION: T-HALT demonstrates good reliability and validity for assessing halitosis-related quality of life in Thai populations. It performs well as a unidimensional measure, but its multidimensional application requires modifications. Future research should validate a modified version excluding Items 1 and 7 across diverse Thai populations, potentially enhancing its cultural specificity.

Association between nasal septum deviation and transverse maxillary development: A retrospective cross-sectional study.

INTRODUCTION: The few studies investigating the relationship between nasal septum deviation (NSD) and maxillary development, using different assessment methods and the age of subjects, reported contradicting results. METHODS: The association between NSD and transverse maxillary parameters was analyzed using 141 preorthodontic full-skull cone-beam computed tomography scans (mean age, 27.4 ± 9.01 years). Six maxillary, 2 nasal, and 3 dentoalveolar landmarks were measured. The intraclass correlation coefficient was used to assess intrarater and interrater reliability. The correlation between NSD and transverse maxillary parameters was analyzed using the Pearson correlation coefficient. Each transverse maxillary parameter was compared among 3 groups of different degrees of severity using the analysis of variance test. Transverse maxillary parameters were also compared between the more and less deviated nasal septum sides using the independent t test. RESULTS: A correlation between deviated septal width and palatal arch depth (r = 0.2, P <0.013) and significant differences in palatal arch depth (P <0.05) among 3 NSD severity groups classified with deviated septal width was noted. There was no correlation between septal deviated angle and transverse maxillary parameters and no significant difference for transverse maxillary parameters among the 3 groups of NSD severity classified by septal deviated angle. No significant difference in transverse maxillary parameters was found when comparing the more and the less deviated sides. CONCLUSIONS: This study suggests that NSD can affect palatal vault morphology. The magnitude of NSD may be a factor associated with transverse maxillary growth disturbance.

A Comparison of Tooth Size and Arch Dimensions Among Measurements Taken Intraorally with 3D-Printed and Digital Models Obtained from Intraoral Scans.

Background: To compare measurements of tooth size and arch dimensions among those taken directly intraorally with those made on digital and 3D printed models produced by intraoral scanning. Material and Methods: Sixty-six participants were recruited. Intraoral tooth size and arch measurements were taken intraorally with a digital caliper. Digital impressions were taken with an iTero® intraoral scanner. The three-dimensional digital models were measured using a 3D diagnostics tool (OrthoCAD software). The same digital models were used to fabricate physical models using a resin 3D printer (Elegoo Saturn). The measurements were repeated on 3D printed models by using the digital caliper. The recorded parameters included mesiodistal tooth widths, transverse, and antero-posterior dimensions. All measurements were repeated to assess intra- and inter- examiner reliability. The validity of each measurement method was assessed by repeated measures ANOVA with post-hoc pairwise comparisons (p<0.5). Results: The mean differences among three methods for all parameters were statistically significant (p<.05) but were considered to be clinically insignificant, except for the upper intercanine width. Direct intraoral measurements tend to be smaller than the digital and 3D printed models. The ICCs values indicated excellent intra- and inter-examiner reliability which demonstrates high reproducibility for all measurements on all model types. Conclusions: Direct intraoral measurements tend to be smaller than the digital and 3D printed models. However, the accuracy of measurements made directly intraorally, and on digital and 3D models from intraoral scans is clinically acceptable, except for the upper intercanine width. Key words:Tooth measurements, Accuracy, Dental models, 3D printing, Digital model.

Classification of cervical vertebral maturation stages with machine learning models: leveraging datasets with high inter- and intra-observer agreement.

OBJECTIVES: This study aimed to assess the accuracy of machine learning (ML) models with feature selection technique in classifying cervical vertebral maturation stages (CVMS). Consensus-based datasets were used for models training and evaluation for their model generalization capabilities on unseen datasets. METHODS: Three clinicians independently rated CVMS on 1380 lateral cephalograms, resulting in the creation of five datasets: two consensus-based datasets (Complete Agreement and Majority Voting), and three datasets based on a single rater's evaluations. Additionally, landmarks annotation of the second to fourth cervical vertebrae and patients' information underwent a feature selection process. These datasets were used to train various ML models and identify the top-performing model for each dataset. These models were subsequently tested on their generalization capabilities. RESULTS: Features that considered significant in the consensus-based datasets were consistent with a CVMS guideline. The Support Vector Machine model on the Complete Agreement dataset achieved the highest accuracy (77.4%), followed by the Multi-Layer Perceptron model on the Majority Voting dataset (69.6%). Models from individual ratings showed lower accuracies (60.4-67.9%). The consensus-based training models also exhibited lower coefficient of variation (CV), indicating superior generalization capability compared to models from single raters. CONCLUSION: ML models trained on consensus-based datasets for CVMS classification exhibited the highest accuracy, with significant features consistent with the original CVMS guidelines. These models also showed robust generalization capabilities, underscoring the importance of dataset quality.

Occlusal stimuli regulate interleukin-1 beta and FGF-2 expression in rat periodontal ligament.

While many studies reported the structural changes in the periodontal ligament (PDL) under hypofunctional conditions, the associations of cytokine growth factors are still unclear. They are known to take part in inflammation, and may affect the biological properties of hypofunctional tooth. To investigate the hypofunctional PDL and the recovery from this condition, we focused on interleukin-1 beta (IL-1beta) and basic fibroblast growth factor (FGF-2). Male Wistar rats were divided into occluded, non-occluded, and recovery groups. An anterior bite plate was used to eliminate the occlusal contact of molars in the non-occluded group, and was then removed for the recovery group. After occlusal stimuli were eliminated for 7 and 14 days, and after 3 and 7 days of recovery from 7 days in the hypofunctional condition, the PDLs of the lower first molars were investigated immunohistochemically. The lack of occlusal stimuli caused atrophic changes in the PDL with the upregulation of IL-1beta and decreased expression of FGF-2, while decreased IL-1beta and enhanced FGF-2 expression were observed in the recovery process. These results suggest that occlusal stimuli regulate IL-1beta and FGF-2 expression, and the nature of this regulation may differ from that in the healing process of an inflammatory reaction.