Facial recognition by cloud-based APIs following surgically assisted rapid maxillary expansion.

INTRODUCTION: This study aimed to investigate whether the facial soft tissue changes of individuals who had undergone surgically assisted rapid maxillary expansion (SARME) would be detected by three different well-known facial biometric recognition applications. METHODS: To calculate similarity scores, the pre- and postsurgical photographs of 22 patients who had undergone SARME treatment were examined using three prominent cloud computing-based facial recognition application programming interfaces (APIs): AWS Rekognition (Amazon Web Services, Seattle, WA, USA), Microsoft Azure Cognitive (Microsoft, Redmond, WA, USA), and Face++ (Megvii, Beijing, China). The pre- and post-SARME photographs of the patients (relaxed, smiling, profile, and semiprofile) were used to calculate similarity scores using the APIs. Friedman's two-way analysis of variance and the Wilcoxon signed-rank test were used to compare the similarity scores obtained from the photographs of the different aspects of the face before and after surgery using the different programs. The relationship between measurements on lateral and posteroanterior cephalograms and the similarity scores was evaluated using the Spearman rank correlation. RESULTS: The similarity scores were found to be lower with the Face++ program. When looking at the photo types, it was observed that the similarity scores were higher in the smiling photos. A statistically significant difference in the similarity scores (P < 0.05) was found between the relaxed and smiling photographs using the different programs. The correlation between the cephalometric and posteroanterior measurements and the similarity scores was not significant (P > 0.05). CONCLUSION: SARME treatment caused a significant change in the similarity scores calculated with the help of three different facial recognition programs. The highest similarity scores were found in the smiling photographs, whereas the lowest scores were found in the profile photographs.

Does YouTube offer high-quality information? Evaluation of patient experience videos after orthognathic surgery.

OBJECTIVES: To evaluate the content, reliability, and quality of videos of patient experiences after orthognathic surgery on YouTube. MATERIALS AND METHODS: Fifty videos that met the inclusion criteria were analyzed. The demographic characteristics of the videos were determined, and 13 points were used to classify poor and rich-content videos. The quality of the videos was evaluated using the Video Information and Quality Index (VIQI), Global Quality Score (GQS), and DISCERN. The Mann-Whitney U-test, Spearman correlation, and linear regression analysis were used for statistical analysis. RESULTS: When poor- and rich-content videos were evaluated, there were statistically significant differences in video duration, number of likes, number of comments, and interaction index (P < .05). Compared to the poor-content video group, the GQS score, DISCERN, total content, and VIQI score of the rich-content video group were significantly higher. The interaction index and video duration and video information content quality showed a positive relationship. CONCLUSIONS: Although the quality of the videos shared by patients on YouTube was generally moderate, the content of the information was generally poor. Nevertheless, it should be considered that YouTube videos can be a source of information for patients who want to have surgery, which can affect the process.

Face comparison analysis of patients with orthognathic surgery treatment using cloud computing-based face recognition application programming interfaces.

INTRODUCTION: This study aimed to investigate whether the postoperative change in patients after orthognathic surgery, whose facial aesthetics was affected, led to detectable differences using Microsoft Azure, Amazon Web Services Rekognition, and Face++, which were commercially available face recognition systems. METHODS: Photographs of 35 patients after orthognathic surgery were analyzed using 3 well-known cloud computing-based facial recognition application programming interfaces to compute similarity scores between preoperative and postoperative photographs. The preoperative, relaxed, smiling, profile, and semiprofile photographs of the patients were compared separately to validate the relevant application programming interfaces. Patient characteristics and type of surgery were recorded for statistical analysis. Kruskal-Wallis rank sum tests were performed to analyze the relationship between patient characteristics and similarity scores. Multiple-comparison Wilcoxon rank sum tests were performed on the statistically significant characteristics. RESULTS: The similarity scores in the Face++ program were lower than those in the Microsoft Azure and Amazon Web Services Rekognition. In addition, the similarity scores were higher in smiling photographs. A statistically significant difference was found in similarity scores between relaxed and smiling photographs according to different programs (P <0.05). For all 3 facial recognition programs, comparable similarity scores were found in all photographs taken before and after surgery across sex, type of surgery, and type of surgical approach. The type of surgery and surgical approach, sex, and amount of surgical movement did not significantly affect similarity scores in any facial recognition programs (P >0.05). CONCLUSIONS: The similarity scores between the photographs before and after orthognathic surgery were high, suggesting that the software algorithms might value measurements on the basis of upper-face landmarks more than lower-face measurements.

Correction of late adolescent skeletal Class III using the Alt-RAMEC protocol and skeletal anchorage.

This case report describes skeletal anchorage-supported maxillary protraction performed with the Alternate Rapid Maxillary Expansion and Constriction (Alt-RAMEC) protocol over a treatment duration of 14 months in a 16-year-old female patient who was in the late growth-development period. Miniplates were applied to the patient's aperture piriformis area to apply force from the protraction appliance. After 9 weeks of following the Alt-RAMEC protocol, miniplates were used to transfer a unilateral 500-g protraction force to a Petit-type face mask. A significant improvement was observed in the soft tissue profile in measurements made both cephalometrically and in three dimensional photographs. Subsequently, the second phase of fixed orthodontic treatment was started and the treatment was completed with the retention phase. Following treatment completion, occlusion, smile esthetics, and soft tissue profile improved significantly in response to orthopedic and orthodontic treatment.

A novel approach to radiographic detection of growth development period with hand-wrist radiographs: A preliminary study with ImageJ imaging software.

OBJECTIVE: The purpose of this study is to determine whether or not the ImageJ program can be used to automatically determine the growth period of the hand and wrist which have different growth-development periods according to the density values in the phalanges in radiographs. SETTING AND SAMPLE POPULATION: Our study included hands-wrist radiographs of 270 individuals aged 8-17 years. MATERIAL AND METHODS: The study's participants were classified into 7 groups according to their skeletal maturation stage (PP2=, MP3=, MP3cap, DP3u, PP3u, MP3u, and Ru) which included pre-peak, peak, and post-peak periods. The total density values (TDV) and pure density values (PDV) in the distal, medial, and proximal phalanges were calculated using each radiograph in the ImageJ program. Analysis of variance (ANOVA) was used to evaluate the density values and chronological age, and pairwise comparisons were made using the post-hoc LSD test. RESULTS: The total density value was graphically zigzagged in the mesial, distal, and proximal phalanges. However, the pure density value increased continuously until the post-peak period and decreased after the DP3u period until the Ru period. While no significant difference in total density values was observed between the growth periods for all three phalanges, a significant difference in pure density values was observed. CONCLUSION: It has been demonstrated in the ImageJ program that the peak growth period can be distinguished using the pure density values obtained from all phalanges of the third finger and that this method can be used as an alternative to the growth period detection through artificial intelligence.

Effect of distance learning on the quality of life, anxiety and stress levels of dental students during the COVID-19 pandemic.

BACKGROUND: The long-term psychological effects of COVID-19 on dental students are unclear. The aim of this cross-sectional online study was to investigate the psychological effects of the COVID-19 pandemic on dental students. METHOD: The Quality of Life Scale (WHOQOL-BREF) was sent to all dental students through Google Forms to evaluate their quality of life (QoL), and the DASS-21 scale was used to evaluate their psychosocial status due to distance learning during the COVID-19 pandemic. The answers were analyzed both on the basis of year of education and type of education (online versus classroom learning). One-way ANOVA was used for comparison of students in the different years of education; post hoc LSD test was used for pairwise comparisons. Sample t-test was used to compare the two groups separated as classroom/face-to-face learning and distance/online learning. RESULT: The questionnaire was completed by 580 students with a response rate of 87.74%. According to the QoL scale results, there was no significant difference between the groups regarding general health, physical health, and psychology, both between different years and learning methods (p > 0.05). According to the results of the DASS-21 scale, anxiety and depression in the 3rd year students were significantly higher than the other years. The stress level of the 2nd year students was statistically significantly different from the other years (p < 0.05). Evaluation of anxiety, stress and the QoL showed an overall detrimental effect of distance learning on the dental students, although the evaluation did not reach statistical significance. CONCLUSION: Anxiety, stress and factors affecting the quality of life negatively affected dental students who received online/distance learning, although the difference did not reach statistical significance when compared to students who received in-classroom learning.

Shear bond strength of orthodontic molar tubes to composite restoration bonded with particular adhesives after different surface pre-treatments.

OBJECTIVE: To evaluate in vitro the shear bond strength of orthodontic molar tubes to composite restoration bonded with particular adhesives after different surface pre-treatments. SETTING AND SAMPLE POPULATION: The sample population is 60 extracted molars. MATERIALS AND METHODS: After the teeth were thermocycled, they were randomly divided into six groups according to the adhesive and various surface pre-treatments that had been applied. The surface pre-treatments included sandblasting with 50-µm aluminium oxide particles and roughening with diamond bur and 37% phosphoric acid. Transbond XT Adhesive Primer (3M Unitek) (TXT) and Assure Plus (Reliance Orthodontic Products) adhesives were used in the study. Following the application of the adhesives, the brackets were bonded to the surfaces of the teeth. Shear bond strength was measured using a universal testing machine. Data were analysed with one-way ANOVA and LSD tests (P = .05). The adhesive remnant index (ARI) was determined using a stereomicroscope. Data from the ARI scores were submitted to Pearson's chi-squared test (P = .05). RESULTS: The highest shear bond strengths were obtained in the Assure Plus group 15.05 ± 3.72 MPa after sandblasting (P < .05). The lowest shear bond strengths were found in the TXT group (7.52 ± 2.89 MPa; P < .05). Sandblasting and bur pre-treatment for TXT and Assure Plus adhesives increased shear bond strength in both of them. There were no significant differences in the ARI scores between the groups (P > .05). CONCLUSION: Sandblasting and roughening pre-treatment can increase the bond strength of teeth with composite restoration. Assure Plus is also more effective than conventional adhesive systems.

Correction to: Evaluation of pharyngeal airway dimensions and hyoid bone position in children after adenoidectomy or adenotonsillectomy: A cephalometric study.

[This corrects the article DOI: 10.34172/joddd.2022.013.].

Evaluation of pharyngeal airway dimensions and hyoid bone position according to craniofacial growth pattern.

OBJECTIVE: To compare pharyngeal airway dimensions and hyoid bone position in different craniofacial growth patterns. METHODS: In total, 611 patients divided into 9 subgroups were compared according to malocclusion classification and vertical growth pattern, and these subgroups were compared in terms of pharyngeal airway and hyoid measurements. A two-way ANOVA test was used to compare the findings of the subgroups. RESULTS: No significant difference was found for the pharyngeal measurements between the groups (p>0.05). The vertical airway length (PNS-Ep) was significantly shorter in the Class III malocclusion group (p<0.05) and in the hypodivergent group (p<0.05). No statistically significant difference was found between any subgroups in any measurements of the position of the hyoid bone (p>0.05). CONCLUSION: The pharyngeal airway dimensions and hyoid bone position are similar among individuals in the sagittal direction. The vertical airway length is significantly shorter in Class III and hypodivergent individuals.

Comparison of psychosocial and aesthetic features of class III malocclusion after orthognathic surgery: Conventional approach versus surgery-first approach.

The aim of this study is to investigate and compare the changes in psychosocial status, self-esteem, and quality of life in patients treated with conventional and SF approaches. 14 patients (mean age 23.04±3.36; 9 male and 5 female) who met the inclusion criteria were included in the SF group; 18 patients with class III malocclusion (mean age 29.27±3.78; 9 male and 9 female) were included in the COS group. In the research protocol, the first questionnaires were carried out 2 weeks before surgery (T0); second survey approximately 4 weeks after surgery (T1); and the third one was done to patients after the treatment was completed (debonding) (T2). In our study, Orthognathic Quality of Life Questionnaire (OQLQ), Pyschosocial Impact of Dental Aesthetics Questionnaire (PIDAQ), Oral Health Impact Profile (OHIP-14), Beck Depression Inventory second edition (BDI-II) and Rosenberg Self-Esteem Scale (RSES), surveys were conducted. No statistically significant difference was observed in all of the PIDAQ parameters and most of the OQLQ parameters within the COS and SF groups (P>0.05). When the BDI-II results were examined, different trends in scores were observed between the two groups, and this difference was found to be statistically significant (P<0.05). In the SF approach, progressive improvement was detected in the patients in terms of psychosocial and quality of life in the early period of treatment. The greater improvement in psychological and social characteristics in the SF approach compared to conventional orthognathic surgery may also be associated with a shorter treatment time.

A novel approach to radiographic detection of bucco-palatal/lingual dilacerations: A preliminary study with ImageJ.

The purpose of our study is to determine whether bucco-palatal/lingual (BPL) root dilacerations (RD), especially in single root teeth, can be determined using the ImageJ program through only one periapical radiography. Extracted teeth without any RD (n = 8) were determined as the control group (Group 1) and with RD in apical 1/3 part at least 20° with the longitudinal axis in the BPL direction (n = 8) as the study group (Group 2). With the help of a simple holder system prepared, digital periapical radiographs of all teeth were taken in an anteroposterior position. Histogram analysis of all periapical radiographs was performed using the spectrum feature of ImageJ software. It was aimed to make a dilaceration analysis by comparing the groups using mean, standard deviation, minimum, maximum, and bin width values. As a result of the Mann-Whitney U test, all mean and maximum values showed a statistically significant difference between the study and control groups (p < 0.05). This pilot study revealed that the ImageJ software can be used to diagnose BPL dilaceration in the apical 1/3 part of the root. It is important for dentists and patients that it can contribute to limiting the radiation dose to which patients will be exposed.

Effects of different types of maxillary protraction on maxilla with finite element analysis.

OBJECTIVE: To compare two different skeletal anchorage methods with finite element analysis in the treatment of Class III patients with maxillary retrognathia. MATERIAL AND METHODS: Two different treatment scenarios were performed on skull model obtained from computerized tomography images of skeletal Class III patients with maxillary retrognathia and finite element analysis was performed. In the first group; mini plates were simulated on infra zygomatic crest. A unilateral 500 g protraction force was applied to the face-mask. In the second group; mini plates were simulated in infrazygomatic crest and mandibular symphysis. Then, 500g protraction force was applied with Class III elastic between the miniplates. Von Misses stresses and displacement values were evaluated comparatively. RESULTS: In Class III elastic group, maximum Von Misses stress occurred around infra zygomatic crest and symphysis anchored with 0.078 MPa. The maxillary posterior region and paranasal regions were the areas showing the highest Von Misses tension after infra zygomatic crest and symphysis. In the face-mask group, the most common site of Von Misses stress in nasomaxillary complex and alveolar structures were infra zygomatic area where plaques were applied, followed by pterygomaxillary suture. Tensile forces are reduced especially in these two areas by spreading to surrounding structures. CONCLUSIONS: In both methods, it was determined that the amount of force transmitted to circumaxillary sutures was sufficient to induce the formation of osteogenesis in these regions.

Cephalometric Evaluation of Nasopharyngeal Airway and Hyoid Bone Position in Subgroups of Class II Malocclusions / Evaluación cefalométrica de la vía área nasofaríngea y posición del hueso hioides en subgrupos de maloclusión clase II

Abstract The aim of the study is to evaluate pharyngeal airway dimensions and hyoid bone position according to different Class II malocclusion types in Turkish population. Materials and Methods: The retrospective clinical study consisted of patients divided into 3 subgroups with skeletal Class II malocclusion. A total of 221 individuals (131 females and 90 males) were included in the study. Individuals with skeletal Class II malocclusion were divided into three subgroups as maxillary prognathia, mandibular retrognathia and combined. In the cephalometric analysis; 8 nasopharyngeal, 7 oropharyngeal, 2 hypopharyngeal, 9 hyoid measurements and 4 area measurements were used. The distribution of sex and growth-development stages of the patients were compared with the Pearson chi-square test. One-way ANOVA was used to evaluate patients. Tukey Post-Hoc tests were used for bilateral comparisons for significant parameters. SPSS package program was used for data analysis. Results were considered statistically significant at p0.05). When the position of the hyoid bone was evaluated, a statistically significant difference was found between the three groups in the measurements of Hy-Pg (mm) (p<0.05). Conclusion: Linear and areal nasopharyngeal airway dimensions are similar in subgroups of Class II malocclusions, while the distance of the hyoid bone from the pogonion is less in the mandibular retrognathia group.

Resumen El objetivo del estudio es evaluar las dimensiones de las vías respiratorias faríngeas y la posición del hueso hioides según los diferentes tipos de maloclusión de clase II en la población turca. Materiales y métodos: El estudio clínico retrospectivo consistió en pacientes divididos en 3 subgrupos con maloclusión esquelética de Clase II. Un total de 221 individuos (131 mujeres y 90 hombres) fueron incluidos en el estudio. Los individuos con maloclusión esquelética de Clase II fueron divididos en tres subgrupos como prognatismo maxilar, retrognatismo mandibular y combinados. En el análisis cefalométrico se utilizaron 8 medidas nasofaríngeas, 7 orofaríngeas, 2 hipofaríngeas, 9 medidas hioides y 4 medidas de área. La distribución del sexo y las etapas de desarrollo del crecimiento de los pacientes se compararon con la prueba de chi cuadrado de Pearson. Se utilizó un ANOVA unidireccional para evaluar a los pacientes. Las pruebas Tukey Post-Hoc se usaron para comparaciones bilaterales de parámetros significativos. El programa del paquete SPSS se usó para el análisis de datos. Los resultados se consideraron estadísticamente significativos a un nivel de significación p0.05). Cuando se evaluó la posición del hueso hioides, se encontró una diferencia estadísticamente significativa entre los tres grupos en las mediciones de Hy-Pg (mm) (p<0.05). Conclusión: Las dimensiones de las vías respiratorias nasofaríngeas lineales y areales son similares en los subgrupos de maloclusiones de Clase II, mientras que la distancia del hueso hioides al pogonion es menor en el grupo de retrognacia mandibular.

Determining the short-term effects of different maxillary protraction methods on pharyngeal airway dimensions.

OBJECTIVE: This study sought to evaluate the effects of different maxillary protraction methods on the pharyngeal airway in Class III patients with maxillary retrognathia. SETTING AND SAMPLE POPULATION: A total of 59 individuals (31 females and 28 males) with a mean age of 11.38 ± 1.24 years were included in this study. MATERIAL AND METHODS: Fifty-nine treated maxillary retrognathic patients who underwent different protraction methods were evaluated. Twenty patients treated with RME (Rapid Maxillary Expansion) made up the first group, and 20 patients treated with 5-week Alt-RAMEC (Alternate Rapid Maxillary Expansion and Constriction) protocol comprised the second group. Lastly, 19 patients on whom face masks with miniplates were applied were included in the skeletal anchorage (SA) group. Sixteen linear and four areal pharyngeal airway measurements were made on lateral cephalograms before and after treatment. Differences between the groups were assessed using analysis of variance (ANOVA) tests. RESULTS: The mean maxillary protraction levels were determined as 2.7, 3.69 and 4.01 mm in the RME, Alt-RAMEC and SA groups, respectively. In the nasopharynx, AD1-PNS, AD2-PNS, PNS-Ba and PNS-Ho measurements revealed a significant increase in the SA group compared to the other groups (P < .05). In the oropharynx, PNS-Ep measurement increased significantly in the RME group (P < .05). In the total pharyngeal airway area, an increase was detected in the SA, Alt-RAMEC, and RME groups. CONCLUSION: The most effective protraction method in terms of pharyngeal airway dimensions, especially in the nasopharynx, is the application of the face mask with skeletal anchorage. A greater increase in vertical airway length (PNS-Ep) was observed with RME.

Skeletal and Dental Effects of Twin-Block Appliances in Patients Treated With or Without Expansion.

OBJECTIVE: To compare the skeletal and dental effects of twin-block appliances with or without expansion. METHODS: From our archives, patients using twin-block appliances were selected. A total of 20 patients with expansion screws were classified as group 1 (10 male, 10 female; mean age 12.48 ± 1.38 years), and 18 patients without screws as group 2 (8 male, 10 female; mean age 12.81 ± 1.16 years). Cephalometric radiographs at pre-and post-treatment were used to evaluate skeletal and dentoalveolar parametric changes; study models and posteroanterior radiographs were used for transverse evaluation. The initial measurements and the treatment-related mean changes within the study groups were analyzed using the Student's t-test. RESULTS: Changes in maxillary skeletal measurements were not statistically significantly different between groups except for A-VRL (P > .05). Mandibular measurements showed an increase in SNB (º) and Co-Gn distance in both groups. However, these changes were similar for both groups (P > .05). The maxillary measurements showed that incisors were proclined in the expansion group and retroclined in the non-expansion group. No significant difference was found between the groups in terms of changes in the skeletal transversal measurements (P > .05). On the study models, the changes in maxillary intercanine and intermolar widths, and in arch length differed to a statistically significant degree between groups (P < .05). CONCLUSION: The skeletal effects of 2 different types of twin-block appliances in the transversal direction were similar; it was determined that dental expansion was obtained in the maxilla by adding screws to the twin-block appliances.

External root resorption in root-filled and vital teeth after extraction and non-extraction orthodontic treatments: a split-mouth retrospective study.

OBJECTIVE: This study aimed to compare the amounts of external root resorption (ERR) during different modalities of orthodontic treatment (OT) in root-filled teeth (RFT) and their contralateral teeth with vital pulp (VPT) in the same patient. MATERIAL AND METHODS: The study sample consisted of 69 patients in two groups: 35 patients in the non-extraction group (18 female, 17 male; 18.16 ± 3.79 years), and 34 patients in the extraction group (19 female, 15 male; 17.72 ± 2.78 years). Digital panoramic radiographs of each patient taken before and after OT were used to measure the tooth length and root surface area. The amounts of ERR in RFT and contralateral VPT were evaluated pre- and post-OT in mandibular molars. The data were statistically analyzed with the paired t-test, independent t-test, and analysis of covariance (ANCOVA) (p < .05). RESULTS: A statistically significant difference was observed in both the orthodontic treatment groups when RFT and VPT were compared in terms of ERR (p < .05). A significant difference was observed between RFT and VPT in extraction treatments when the reduction in the root area between the two sides in the groups was compared (p < .05). CONCLUSIONS: RFT are more resistant to ERR than VPT. The ERR in RFT may not be a significant matter for the planning of OT.

Comparison of three-dimensional soft-tissue evaluations between skeletal and pseudo-class III malocclusions.

The aim of our study was to compare soft tissue measurements with 3D imaging methods in individuals with untreated skeletal and pseudo-Class III malocclusions. The study sample consisted of 75 patients (38 males, 37 females, mean age 12.41 ± 2.35 years) with pseudo- and true skeletal Class III malocclusions and skeletal Class I malocclusions. Soft tissue evaluations of all patients were performed using 3D stereophotogrammetric facial images. In our study, 26 landmarks, 17 linear measurements, 13 angular measurements, and 5 volume measurements were made using the 3dMD Vultus software. The significance was determined to be p < 0.05 in ANOVA, Tukey tests. No significant differences were found among the groups in terms of demographic data (p > 0.05). The skeletal Class I control group had a significantly more extended upper lip and vermillion length as compared to the Class III groups. The soft tissue convexity angle and upper nasal angle were found to be wider in the Class III malocclusion group compared to those in the Class I control group. While the pseudo-Class III group had a significantly lower midface volume, chin volume was significantly higher in the skeletal class group. Upper lip volume was significantly higher in the Class I group. Using 3dMD for guiding clinicians in the differential soft and hard tissue diagnosis of pseudo-Class III malocclusions, differences were revealed in Class I patients in the middle part of the face. In the differential diagnosis of true Class III malocclusions, chin volume was found to be different from that of Class I patients.

Comparison of treatment effects of different maxillary protraction methods in skeletal class III patients.

OBJECTIVE: The aim of this study was to compare treatment outcomes with different maxillary protraction methods in patients with skeletal Class III malocclusion resulting from maxillary retrognathia. SETTING AND SAMPLE POPULATION: A total of 55 individuals consisting of 29 females and 26 males with a mean age of 11.4 ± 1.06 years were included in this study. MATERIAL AND METHODS: Fifty-five treated maxillary retrognathic patients who underwent different protraction facemask methods were evaluated. Eighteen patients treated with RME were in the first group, and 19 patients treated with a modified Alt-RAMEC protocol were in the second group; eighteen patients on whom face masks with miniplates were applied were included in the skeletal anchorage (SA) group. Thirty measurements were made on lateral cephalometric radiographs before and after treatment. Differences between the groups were assessed with the ANOVA test. RESULTS: The mean age was higher in the SA group (11.96 ± 0.92 years) compared with the other groups. The mean ANB angle increased by 2.96°, 4.91° and 3.86° in the RME, Alt-RAMEC and SA groups, respectively. The forward movement of the maxilla was similar between the groups. However, while the rate of protraction was higher in the modified Alt-RAMEC group, a greater skeletal effect was found in the SA group. CONCLUSION: The most effective method in terms of skeletal effect is the application of the face mask with skeletal anchorage; the modified Alt-RAMEC protocol can be applied before face mask to obtain faster protraction.

Evaluation of Changes in Nasal Projection After Surgically Assisted Rapid Maxillary Expansion With 3dMD Face System.

The most appropriate treatment option for maxillary expansion in adulthood due to increased cyanosis in sutures is surgically assisted maxillary expansion (SARME). Skeletal and dental changes are observed with SARME. Three-dimensional imaging techniques are gaining importance with the developing technology in evaluating the changes that occur as a result of the treatments applied. The aim of study was to evaluate the soft tissue changes occurring in the nasal projection after SARME in 3-dimensional analyzes during the expansion and post-retention processes. The study sample consisted of 19 patients with a transverse maxillary deficiency of more than 5 mm (11 female and 8 male). 3dMD Vultus software was used for measuring height and width of the philtrum, superior alar, nasal and subnasal width; nasal length, nasal projection, nasal bridge width, nasal tip protrusion and upper face height) before surgery (T0), after the expansion phase (T1), and 6 months postoperatively (T2). A significant difference was found only subnasal width between pre-treatment and post-retention values. Surgically assisted maxillary expansion operations alter the nasal projection and this study certified these results with 3dMD face system. 3dMD face technique is an effective imaging technique for evaluating the soft tissues changes after orthognathic surgeries.

Alternate Rapid Maxillary Expansion and Constriction (Alt-RAMEC) protocol: A Comprehensive Literature Review.

The aim of this comprehensive review is to introduce clinicians to the increasingly popularity Alt-RAMEC procedure, a method commonly used in the treatment of class III malocclusion in the last 15 years. Another application of the literature to enhance the skeletal effects of Class III treatment on the maxillae is the Alternative Rapid Maxillary Expansion and Constriction (Alt-RAMEC) procedure introduced by Liou, which improves the effectiveness of the maxillae relative to the surrounding sutures and the enhancement of the maxillae. In the Alt-RAMEC protocol, maxillae will be enlarged to be 1 mm per day, first enlarged to 7 mm, and then the 1 mm screw is closed. In other weeks, in this order the screw of the expansion device is turned on for one week and then closed for one week, completing the Alt-RAMEC protocol at the end of the 9-week process. In this review, we will discuss the advantages and disadvantages of the studies, which include successful treatments by applying this protocol, differences with other methods, its effect on the airway, and its advantages and disadvantages.