Relationship between Cephalometric and Ultrasonic Airway Parameters in Adults with High Risk of Obstructive Sleep Apnea.

Background/Objectives: Polysomnography and cephalometry have been used for studying obstructive sleep apnea (OSA) etiology. The association between craniofacial skeleton and OSA severity remains controversial. To study OSA's etiology, cephalometry, fiberoptic pharyngoscopy, polysomnography, and sleep endoscopy have been used; however, airway obstructions cannot be located. Recent research suggested ultrasonography for OSA screening and upper airway obstruction localization. Thus, this study aims to investigate the relationship between specific craniofacial cephalometric and ultrasonic airway parameters in adults at high risk of OSA. Methods: To assess craniofacial structure, lateral cephalograms were taken from thirty-three adults over 18 with a STOP-Bang questionnaire score of three or higher and a waist-to-height ratio (WHtR) of 0.5 or higher. Airway parameters were assessed through submental ultrasound. Results: NSBA correlated with tongue base airspace width, while MP-H correlated with oropharynx, tongue base, and epiglottis airspace width. SNA, SNB, and NSBA correlated with tongue width at the oropharynx. At tongue base, ANB and MP-H correlated with tongue width. SNB and NSBA were associated with deep tissue thickness at the oropharynx, while MP-H correlated with superficial tissue thickness at velum and oropharynx. Conclusions: Cephalometric parameters (SNA, SNB, ANB, NSBA, and MP-H) were correlated with ultrasonic parameters in the velum, oropharynx, tongue base, and epiglottis.

Shear Bond Strength of Polypropylene Fiber in Orthodontic Adhesive on Glazed Monolithic Zirconia.

This study aims to compare shear bond strength (SBS) and mode of failure (MOF) between ceramic and metal orthodontic brackets on glazed monolithic zirconia using non-woven polypropylene fiber adhesive. Sixty glazed and sintered zirconia blocks were divided into six groups and attached with orthodontic brackets as follows: CS, ceramic bracket with silane; CB, ceramic bracket with bonding agent; CBS, ceramic bracket with bonding agent and silane; MS, metal bracket with silane; MB, metal bracket with bonding agent; and MBS, metal bracket with bonding agent and silane. There was a statistically significant difference in mean SBS values (p < 0.001). The CS group showed the highest SBS value (23.42 ± 3.88 MPa). On the other hand, the lowest was found in the MB group, which was not statistically different from the CB group (3.26 ± 0.76 and 5.09 ± 1.50 MPa, respectively). The MS, MBS, and CBS groups showed no statistical difference compared to each other (15.57 ± 4.01, 13.23 ± 5.47, and 12.77 ± 4.43 MPa, respectively). SBS is highest when a ceramic bracket with silane is bonded to glazed monolithic zirconia.

Shear Bond Strength and Mode of Failure of Polypropylene Fibers in Orthodontic Flash-Free Adhesive.

The purpose of this research is to evaluate the effects of magnetostrictive and piezoelectric scalers on the shear bond strength (SBS), failure mode of the polypropylene fiber adhesive brackets, and the load of both scaler tips. The adhesive precoated (APC) Flash-Free brackets were placed on the buccal surfaces of sixty maxillary first premolars, which were divided into three equal groups of 20 specimens each, following the control group (no scaling), the magnetostrictive group, and the piezoelectric group. All specimens were measured for SBS value by using a universal testing machine at a crosshead speed of 0.75 mm/minute. The mode of failure was examined under a×10 magnification light microscope digital camera and scores for the adhesive remnant index (ARI) were recorded and measured load between the magnetostrictive and piezoelectric groups. For statistical analysis, ANOVA and multiple comparison, as well as unpaired t-test and chi-square tests, at the 0.05 significance level were used. The results showed that the average SBS value of the control group was greater than that of the magnetostrictive group and the piezoelectric group. However, the SBS was not significantly influenced by ultrasonic instruments (p > 0.05). The ARI score and load showed no significant differences among the groups (p > 0.05). In conclusion, the SBS of the APC Flash-Free bracket wasn't affected by using ultrasonic instrumentation around the base of the bracket.

Oral Microbiome in Orthodontic Acrylic Retainer.

The oral microbiome can be shifted if the patients wear the acrylic retainers for a lengthy period. It is essential to understand the components of the plaque in order to forestall the development of dental caries and gingivitis. The aim of this study is to report the bacterial communities that adhere to the acrylic retainers by full-length nanopore 16S sequencing. Six healthy participants were allocated into 2 groups (chemical tablet and brushing groups). Plaque samples were collected from the acrylic retainer surfaces before and after cleaning. The bacterial communities were reported using full-length nanopore 16S sequencing. The results showed that 7 distinct phyla were identified by sequencing. The most prevalent of these was the Firmicutes. We found a total of 72 genera. The most common microorganism across all samples was Streptococcus, followed by Neisseria, Rothia, and Gemella. The beta diversity showed a significant difference between before and after cleaning (p < 0.05). This study revealed the novel finding that a combination of chemical and mechanical cleaning methods was the most effective method of eliminating retainer biofilms. Moreover, retainer cleaning tablets did not alter the homeostatic balance of the bacterial communities adhering to the acrylic retainers.

Comparison of Various Antimicrobial Agents for Thermoplastic Polymeric Retainers.

The thermoplastic retainers indicated a rising incidence of cariogenic bacteria such as Streptococcus mutans. A report suggested the case of a patient with severe gingival inflammation and dental caries as a result of inadequate appliance cleaning. This study aims to compare the various antimicrobial agents for thermoplastic polymeric retainers. A minimum bactericidal concentration (MBC) of acetic acid was determined. Streptococcus mutans biofilm was formed on punched 4-mm copolyester (Essix ACE®) and polyurethane (Vivera®) retainers after they were submerged in 0.12% chlorhexidine (CHX group), acetic acid (AA group), Polident Denture Cleanser® (PD group), and Polident Pro Guard & Retainer® (PR group). A crystal violet (CV) test was performed. The biofilm imaging was assessed by confocal laser scanning microscopy (CLSM). The results showed that all chemical disinfectants exhibited statistically significant differences (p < 0.05) compared to the positive control. This novel finding elucidated that 0.625% acetic acid is effective for antimicrobial in both copolyester and polyurethane retainers. However, only the CHX, PD, and PR groups could reduce biofilm mass. In addition, the CV assay cannot provide information about the actual number of living and dead bacteria. Furthermore, the LIVE/DEAD BacLight assay was able to show the bacterial viability.

A Comparative Assessment of the Upper Pharyngeal Airway Dimensions among Different Anteroposterior Skeletal Patterns in 7-14-Year-Old Children: A Cephalometric Study.

BACKGROUND: The pharyngeal airway is a crucial part of the respiratory system's function. Assessing the pharyngeal airway dimensions in different skeletal types is important in the orthodontic treatment of growing patients. The aim of this study was to compare the upper pharyngeal airway dimensions of 7-14-year-old children with different skeletal types. METHODS: Three-hundred-sixty-one lateral cephalometric radiographs were grouped based on their skeletal patterns determined by the ANB angle as skeletal type I (n = 123), type II (n = 121), and type III (n = 117). The radiographs were divided into 4 groups: 7/8 YO (7-8 years old), 9/10 YO, 11/12 YO, and 13/14 YO. The cephalometric measurements comprised SNA, SNB, ANB, Ad1-PNS, Ad2-PNS, McUP, and McLP. An ANOVA was used to compare the group results. RESULTS: Significant differences in Ad1-PNS, Ad2-PNS, McUP, and McLP in skeletal types II and III were found between age groups. Most upper pharyngeal airway dimensions in skeletal types II and III children were significantly wider in the 13/14 YO group than in the other age groups. CONCLUSION: The upper pharyngeal airway dimensions increased age-dependently in 7-14-year-old children, especially in skeletal types II and III. The upper pharyngeal airway dimensions could serve as a guide in differentiating the different skeletal classes in clinical settings.

Antimicrobial Activity of Various Disinfectants to Clean Thermoplastic Polymeric Appliances in Orthodontics.

There is a lack of research evidence on the risk-benefits of the various disinfectants in cleaning products and cleansing regimens. This systematic review compared the antimicrobial activity of various chemical disinfectants to disinfect the thermoplastic polymeric appliances in orthodontics. The study was carried out using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Cochrane Handbook of Systematic Reviews of Interventions. An electronic search was conducted on Pubmed, Google Scholar, Scopus, ScienceDirect, and Springer. Two authors independently investigated the risk of bias in duplication. A total of 225 articles were collected. After removing duplicates, 221 articles remained, and after filtering their titles and abstracts, 11 articles met eligibility qualifications remained. Finally, nine articles that met the criteria were selected. It showed that both over-the-counter orthodontic appliance cleaners and applied-chemical disinfectants were effective against bacteria. The duration and frequency of usage guidelines cannot be concluded.

Effects of different types of tooth movement and force magnitudes on the amount of tooth movement and root resorption in rats.

OBJECTIVE: To investigate differences in the amount of tooth movement and root resorption that occurred after tipping and bodily movement of the maxillary first molar in rats. MATERIALS AND METHODS: Ten-week-old female Wistar rats were divided into two groups according to type of tooth movement and subdivided into four subgroups according to the magnitude of applied force. Nickel-titanium closed-coil springs exerting forces of 10, 25, 50, or 100 g were applied to the maxillary left first molars to induce mesial tooth movement. We designed a novel orthodontic appliance for bodily tooth movement. Tooth movement distance and root resorption were measured using microcomputed tomography and scanning electron and scanning laser microscopy. RESULTS: The amount of tooth movement in the bodily tooth movement group was less than half that in the tipping tooth movement group. The greatest amount of tooth movement occurred in the 10-g tipping and 50-g bodily tooth movement subgroups, and the amount of tooth movement decreased with the application of an excessive magnitude of force. Conversely, root resorption increased when the heavier orthodontic force was applied in both groups. Root resorption in the tipping tooth movement group was approximately twice that in the bodily tooth movement group. CONCLUSIONS: Root resorption in the tipping tooth movement group was more pronounced than that in the bodily tooth movement group. Although the amount of tooth movement decreased when extremely heavy forces were applied, root resorption increased in both the tipping and bodily tooth movement groups in rats.

Assessment of three-dimensional nasolabial response to Le Fort I advancement.

BACKGROUND: Le Fort I advancement induces soft tissue changes to the nasolabial region. The correlation of sagittal skeletal movement to soft tissue alteration has been studied using 2D methods. However, the influence of maxillary advancement has not been adequately assessed using three-dimensional means. The purpose of this study is to analyze nasolabial changes following Le Fort I advancement using 3D photometric measurements. METHODS: Patient demographic information and their amount of advancement were tabulated. Pre- and postoperative 3D photographs (3D VECTRA photosystem, Canfield, Fairfield, NJ) were recorded. Nasolabial anthropometric measurements were performed using the corresponding 3D post-processing software (Mirror). Six month minimum follow-up elapsed before final evaluation. RESULTS: Forty-four 3D photo data sets were included. Mean maxillary advancement was 5.5 (±1.9) mm. Male/female ratio was 0.7 with a mean age of 16.7 years. Significant increases (p < 0.0001) were seen in the alar base, alar widths, nostril width, and in the soft triangle and lateral alar angles. Significant decreases (p < 0.0001) were noted in the nasofrontal angle and in nostril height. A significant (p < 0.05) increase of the nasal tip, columella and upper lip projection was seen. Philtral height showed no significant changes (p > 0.05) after maxillary advancement. No significant correlation (p > 0.05) between the degree of soft tissue changes and the amount of maxillary advancement was found. CONCLUSION: Le Fort I advancement significantly impacts the nasolabial soft tissue envelope. The 3D soft tissue changes are predictable and similar for any advancement up to 10 mm.

The effect of bone morphometric changes on orthodontic tooth movement in an osteoporotic animal model.

OBJECTIVE: To elucidate the effect of bone morphometric changes on orthodontic tooth movement (OTM) in zoledronic acid-treated ovariectomized rats. MATERIALS AND METHODS: Twenty-one 10-week-old female Wistar rats were divided into ovariectomy (OVX), OVX with zoledronic acid administration (OVX + ZOL), and sham operation (control) groups. Two weeks after OVX, ZOL administration was initiated. Twelve weeks after OVX, a nickel-titanium closed-coil spring of 25-g force was applied mesially to the maxillary left first molar. In vivo micro-computed tomography (CT) of the left proximal tibia was performed for bone morphometric analysis every 2 weeks after OVX. In addition, OTM was investigated using micro-CT at 0, 12, and 14 weeks after OVX. RESULTS: There were significant differences in the bone mineral content (BMC), bone volume (BV), BMC to tissue volume ratio (BMC/TV), and BV to TV ratio of trabecular bone between the control and OVX groups and also between the OVX + ZOL and OVX groups. In the OVX + ZOL group, increased BMC and BV in the cortical bone and increased bone mineral density (BMD) in the trabecular bone were observed. Interestingly, OTM in the OVX group was almost two times more than that in the control and OVX + ZOL groups. Moreover, OTM was correlated with BMD, BMC, BV, and BMC/TV in the trabecular bone. CONCLUSIONS: OVX accelerated OTM, while ZOL suppressed it. OTM demonstrated a significant negative relationship with trabecular bone mass.

Orthodontic tooth movement and root resorption in ovariectomized rats treated by systemic administration of zoledronic acid.

INTRODUCTION: The effect of zoledronic acid, a potent and novel bisphosphonate, on tooth movement and orthodontically induced root resorption in osteoporotic animals systemically treated with zoledronic acid as similarly used in postmenopausal patients has not been elucidated. Therefore, this study was undertaken. METHODS: Fifteen 10-week-old female Wistar rats were divided into 3 groups: ovariectomy, ovariectomy + zoledronic acid, and control. Only the ovariectomy and ovariectomy + zoledronic acid groups underwent ovariectomies. Two weeks after the ovariectomy, zoledronic acid was administered only to the ovariectomy + zoledronic acid group. Four weeks after the ovariectomy, 25-g nickel-titanium closed-coil springs were applied to observe tooth movement and orthodontically induced root resorption. RESULTS: There were significant differences in the amounts of tooth movement and orthodontically induced root resorption between the ovariectomy and the control groups, and also between the ovariectomy and the ovariectomy + zoledronic acid groups. There was no statistically significant difference in tooth movement and orthodontically induced root resorption between the ovariectomy + zoledronic acid and the control groups. Zoledronic acid inhibited significantly more tooth movement and significantly reduced the severity of orthodontically induced root resorption in the ovariectomized rats. The ovariectomy + zoledronic acid group showed almost the same results as did the control group in both tooth movement and orthodontically induced root resorption. CONCLUSIONS: Zoledronic acid inhibits excessive orthodontic tooth movement and also reduces the risk of severe orthodontically induced root resorption in ovariectomized rats.

Tooth movement and root resorption; the effect of ovariectomy on orthodontic force application in rats.

OBJECTIVE: To quantify the amount of tooth movement and orthodontically induced root resorption (OIRR) in ovariectomized rats. MATERIALS AND METHODS: Five 10-week-old female Wistar rats undergoing ovariectomy (OVX) were investigated as the experimental group, and the other five without ovariectomy served as the control group. Four weeks after ovariectomy, 25-g nickel-titanium closed-coil springs were applied mesially to the maxillary left first molars. Micro-computed tomography was taken at day 0, 1, 3, 7, 14, 21, and 28. At day 28, the molars were extracted. The surface area of root resorption craters, depth, and volume were measured using electron and laser scanning microscopes. RESULTS: Tooth movement gradually increased with time throughout 28 days. There was a significant difference in the amount of tooth movement between the control group and the OVX group. For OIRR, the OVX group showed wide and shallow root resorption craters scattered on the mesial root. The deep resorption craters were observed on the distal roots distributed in the cervical, middle, and apical thirds of the roots. Statistically significant differences were found between the control and the OVX groups in the depth and the volume of root resorption craters in the distal roots and the total volume of root resorption craters in all three roots. CONCLUSION: Ovariectomy affected not only tooth movement but also OIRR. Tooth movement in the OVX group was more rapid than the control group. Furthermore, the amount of OIRR in the OVX group was more severe than the control group.