Porous NiTi Dental Implant Fabricated by a Metal Injection Molding: An in Vivo Biocompatibility Evaluation in an Animal Model.

This study assessed the corrosion resistance, intracutaneous reactivity, acute systemic toxicity, and in situ tissue effect of the implantation of porous NiTi fabricated by metal injection molding in animal models. For the intracutaneous reactivity study, five intracutaneous injections were administered per site with and without the tested extract in polar and nonpolar solutions. The extract was also delivered via intravenous and intraperitoneal routes for acute systemic toxicity. TiAl6 V4 (control) and porous NiTi were implanted in rabbit femora for a period of 13 weeks to evaluate the in situ tissue response. Corrosion was evaluated through open and cyclic polarization in PBS, while biocompatibility was investigated by assessing the general conditions, skin irritation score (edema and erythema), and histopathology. No active dissolution or hysteresis loop was observed in the corrosion study. None of the animals exhibited death, moribundity, impending death, severe pain, self-mutilation, or overgrooming. No edema was observed at injection sites. Only the positive control showed an erythematous reaction at 24, 48, and 72 h observations (p < 0.001). Porous NiTi showed a low in situ biological response for inflammation, neovascularization, and fibrosis in comparison to the control implant (p = 0.247, 0.005, and 0.011, respectively). Porous NiTi also demonstrated high pitting corrosion resistance while causing no acute hypersensitivity or acute systemic toxicity. The study concludes that porous NiTi implants were unlikely to cause local sensitization, acute systemic toxicity, or chronic inflammatory reactions in an animal model. Porous NiTi also exhibited osseointegration equivalent to Ti6AI4 V of known biocompatibility.

SURVIVAL AND COMPLICATION RATES OF RESIN COMPOSITE LAMINATE VENEERS: A SYSTEMATIC REVIEW AND META-ANALYSIS.

OBJECTIVES: The aim of this systematic review was to evaluate the survival and complication rates of resin composite laminate veneers. METHODS: Randomized controlled trials and cohort studies with a minimum 2-year follow-up assessing survival and complication rates of resin composite laminate veneers on permanent dentition from 1998 to May 2022. Literature searches were conducted in MEDLINE (PubMed), Scopus, and the Cochrane Central Register of Controlled Trials electronic databases. References cited in the related reviews and included full-text articles were also hand-searched to further identify potentially relevant studies. RESULTS: A total of 827 articles were identified. Twenty-two studies were considered for full-text review after the title and abstract screening stage. After exclusion, 7 studies (3 randomized controlled trials and 4 cohort studies) were included in the systematic review. Three published scales were adopted for the quality and risk of bias assessment. At the survival rate threshold, the overall heterogeneity (I2) for randomized controlled trials was 50.5% (P = .108). The overall pooled survival rate of the randomized controlled trials was 88% (95% CI: 81%-94%), with the mean follow-up time ranging from 24 to 97 months. Surface roughness, color mismatch, and marginal discoloration were the most reported complications. CONCLUSION: Resin composite laminate veneers demonstrated moderately high survival rates for the entire sample and the direct laminate veneer group demonstrated higher survival rates than the indirect approach. Most of the complications were regarded as clinically acceptable with or without reintervention.

Does 3-dimensional facial attractiveness relate to golden ratio, neoclassical canons, 'ideal' ratios and 'ideal' angles?

BACKGROUND: The established recommendations and guidelines regarding ideal measurements for an attractive face are mostly based on data gathered among Caucasian population. The aim of this study was to examine the relationship between perception of 3-dimensional facial attractiveness and golden ratio, neoclassical canons, 'ideal' ratios and 'ideal' angles in Hong Kong Chinese. METHODS: Thirty 3-D photographs (15 males and 15 females) were shown to 101 laypersons and 60 patients seeking orthognathic treatment. The photographs were rated based on a 100 mm visual analogue scale (VAS) from 0 (very unattractive) to 100 (very attractive). RESULTS: More than half of the measurements (42/77) in females and thirty-two measurements in males were found to be significantly different from the ideal target value (p < 0.05) upon the comparison of the attractive faces with golden ratio, neoclassical canons, 'ideal' ratios and 'ideal' angles. Meanwhile, correlation tests between VAS scores and the parameters detected significant results (p < 0.05) in only six ratios, eight angles, one neoclassical canon and one proportion. CONCLUSIONS: Despite several renowned 'ideal' parameters of attractive faces that have been recommended in the literature, only a few of them were found to be significantly correlated with attractive faces in Hong Kong Chinese.

Facial profile study using 3-dimensional photographs to assess esthetic preferences of Hong Kong Chinese orthognathic patients and laypersons.

INTRODUCTION: This study was conducted to investigate and compare esthetic perceptions of different facial profiles among Hong Kong Chinese laypersons and patients scheduled for orthognathic treatment. METHODS: Two sets of 3-dimensional facial photographs (1 male and 1 female) each comprised 7 images that showed different dentoskeletal relations (ie, Class I, bimaxillary protrusion, bimaxillary retrusion, maxillary protrusion, maxillary retrusion, mandibular protrusion, and mandibular retrusion). The sets of photographs were shown to 101 laypersons (age, 28.87 ± 6.22 years) and 60 patients seeking orthognathic treatment (age, 27.12 ± 6.07 years). They rated their esthetic perceptions of the photographs on the basis of a 100 mm visual analog scale (VAS) from 0 (very unattractive) to 100 (very attractive). RESULTS: The dentoskeletal Class I facial profile was ranked as the most attractive profile. Female orthognathic judges selected the retrusive maxilla while male orthognathic judges and male and female laypersons ranked the mandibular protrusion profile as the least attractive profile for both females and males. A bimaxillary protrusive female profile was viewed as more attractive by the orthognathic male (P = 0.006) and female (P = 0.006) judges, compared with female layperson judges. After adjustment for age, no statistically significant interaction between sex and judges (P >0.10) for all VAS scores were detected. For the female bimaxillary protrusive profile, orthognathic patient judges assigned a mean VAS score of 9.174 points higher than layperson judges (95% confidence interval, 3.11-15.24; P = 0.003). CONCLUSION: Dentoskeletal Class I facial profile was generally considered the most attractive profile in both sexes; male and female orthognathic patients preferred a bimaxillary protrusive female profile. A concave facial profile was perceived as least attractive in both sexes.

Patient's satisfaction with facial appearance and psycho-social wellness after orthognathic surgery among Hong Kong Chinese using the FACE-Q.

PURPOSE: To assess and compare the changes in satisfaction with facial appearance and psycho-social well-being in dento-skeletal class II and III patients after orthognathic surgery with the FACE-Q among Hong Kong Chinese. METHODS: The questionnaires for thirteen orthognathic-relevant FACE-Q scales, translated into Cantonese and validated, were administered to Hong Kong Chinese patients before and after orthognathic surgery in the short- and long-term, respectively. The assessed scales were categorized into four main domains: satisfaction with facial appearance, quality of life, patient's experience of care, and adverse effects. RESULTS: Generally, highly significant (p < 0.001) improved FACE-Q scores were found in the long-term in the scales investigating the satisfaction with overall facial appearance, lower face and jawline, and chin. Although dento-skeletal class III patients demonstrated significantly improved satisfaction with their post-surgical nostril appearance (p = 0.003), this was not evident in dento-skeletal class II patients (p = 0.231). Nonetheless, both class II and class III subjects have also revealed significantly improved psychological well-being (0.003; <0.001) and social function (0.001; <0.001) in the long-term. Age was not found to be correlated with all scales for satisfaction of facial appearance. CONCLUSION: Previously validated Face-Q scales are valuable instruments to measure clinical outcomes, psychological well-being and social function in Cantonese speaking patients. Both Class II and Class III patients showed significantly improved satisfaction with facial appearance, psychological well-being and social function after orthognathic surgery regardless of skeletal pattern and gender, confirming findings in other ethnicities.

Three-Dimensional Pharyngeal Airway Changes After 2-Jaw Orthognathic Surgery With Segmentation in Dento-Skeletal Class III Patients.

PURPOSE: To investigate short- and long-term three-dimensional changes of pharyngeal airway morphology and hyoid bone position in dento-skeletal class III deformity patients after 2-jaw orthognathic surgery with segmentation. METHODS: A retrospective analysis has been performed on patients with dento-skeletal class III deformity who had undergone orthognathic 2-jaw surgery with segmentations, presenting both pre- and post-surgical cone-beam computed tomographys. Three-dimensional skeletal movements, pharyngeal airway changes and hyoid bone position were measured and correlated. RESULTS: The mean short term postsurgical review period for all included 47 patients was 5.8 ±â€Š2.2 months. Thirteen patients among them provided a mean long term period of 26.4 ±â€Š3.4 months. The mean postsurgical maxillary movement was 2.29 ±â€Š2.49 mm in vertical, 2.02 ±â€Š3.45 mm in horizontal direction, respectively, while the mandibular movement was 6.49 ±â€Š4.58 mm in vertical, and -5.85 ±â€Š6.13 mm in horizontal direction. In short-term, the vertical length of nasopharynx was found to be reduced (P = 0.005) but increased for the oropharynx (P < 0.001). Furthermore, the oropharyngeal minimum cross-sectional area has decreased significantly (P = 0.013). The hyoid bone moved posterosuperiorly, however, with only its horizontal movement found to be significant (P = 0.043). No significant result was detected in long-term analyses, neither in postsurgical pharyngeal airway changes nor the hyoid bone movement. There were no significant differences in pharyngeal airway measurements (P > 0.05) detected between patients with and without genioplasty advancement. CONCLUSION: Two-jaw orthognathic surgery in dento-skeletal class III patients led to a statistically non-significant reduction of the post-surgical airway volume in both short- and long-term. Although the post-surgical oropharyneal minimum cross-sectional area was decreased significantly in the short term, this finding did not persist in the long term.

Effects of mandibular setback with or without maxillary advancement osteotomies on pharyngeal airways: An overview of systematic reviews.

BACKGROUND: Mandibular setback osteotomies potentially lead to narrowing of the pharyngeal airways, subsequently resulting in post-surgical obstructive sleep apnea (OSA). OBJECTIVE: To summarize current evidence from systematic reviews that has evaluated pharyngeal airway changes after mandibular setback with or without concomitant upper jaw osteotomies. METHODOLOGY: PubMed, EMBASE, Web of Science, and Cochrane Library databases were searched with no restriction of language or date. Systematic reviews studying changes in pharyngeal airway dimensions and respiratory parameters after mandibular setback with or without concomitant upper jaw osteotomies have been identified, screened for eligibility, included and analyzed in this study. RESULTS: Six systematic reviews have been included. While isolated mandibular setback osteotomies result in reduced oropharyngeal airway dimensions, the reduction is lesser in cases with concomitant upper jaw osteotomies. Only scarce evidence exists currently to what happens to naso- and hypo-pharyngeal airways. There is no evidence for post-surgical OSA, even though some studies reported reduced respiratory parameters after single-jaw mandibular setback with or without concomitant upper jaw osteotomies. CONCLUSION: Although mandibular setback osteotomies reduce pharyngeal airway dimensions, evidence confirming post-surgical OSA was not found. Nevertheless, potential post-surgical OSA should be taken into serious consideration during the treatment planning of particular orthognathic cases. As moderate evidence exists that double-jaw surgeries lead to less compromised post-surgical pharyngeal airways, they should be considered as the method of choice especially in cases with severe dentoskeletal Class III deformity. STUDY REGISTRATION: PROSPERO (registration number: CRD42016046484).

How does mandibular advancement with or without maxillary procedures affect pharyngeal airways? An overview of systematic reviews.

BACKGROUND: Mandibular advancement surgery may positively affect pharyngeal airways and therefore potentially beneficial to obstructive sleep apnea (OSA). OBJECTIVE: To collect evidence from published systematic reviews that have evaluated pharyngeal airway changes related to mandibular advancement with or without maxillary procedures. METHODOLOGY: PubMed, EMBASE, Web of Science, and Cochrane Library were searched without limiting language or timeline. Eligible systematic reviews evaluating changes in pharyngeal airway dimensions and respiratory parameters after mandibular advancement with or without maxillary surgery were identified and included. RESULTS: This overview has included eleven systematic reviews. Maxillomandibular advancement (MMA) increases linear, cross-sectional plane and volumetric measurements of pharyngeal airways significantly (p<0.0001), while reducing the apnea-hypopnea index (AHI) and the respiratory disturbance index (RDI) significantly (p<0.0001). Two systematic reviews included primary studies that have evaluated single-jaw mandibular advancement, but did not discuss their effect onto pharyngeal airways. Based on the included primary studies of those systematic reviews, single-jaw mandibular advancement was reported to significantly increase pharyngeal airway dimensions (p<0.05); however, conclusive long-term results were lacking. CONCLUSION: MMA increases pharyngeal airway dimensions and is beneficial to patients suffering from OSA. However, more evidence is still needed to draw definite conclusion related to the effect of single-jaw mandibular advancement osteotomies on pharyngeal airways.

Orthognathic Relevant Scales of FACE-Q: Translation and Validation for Hong Kong Chinese Patients.

BACKGROUND: A validated questionnaire is needed to study a more holistic outcome assessment including postsurgical aesthetic satisfaction and psychosocial changes in orthognathic patients. The aim of this study was to determine the reliability and validity of 9 orthognathically relevant translated FACE-Q scales among Hong Kong Chinese orthognathic patients. METHODS: Two hundred fifty adult Cantonese-speaking patients of 18 years or older who underwent orthognathic treatment were recruited in the Prince Philip Dental Hospital of Hong Kong. Nine of an overall of 40 independent FACE-Q scales were selected and translated into Hong Kong Chinese. The reliability, validity, and test-retest reliability were examined using Cronbach's alpha, paired t test and Pearson's correlation coefficients. RESULTS: The Hong Kong Chinese version of the 9 FACE-Q scales was obtained by forward-backward translation. One hundred eight male (mean age, 25.57 ± 4.49) and 142 female (mean age, 24.61 ± 4.54) patients were recruited for the reliability and validation process. The internal consistency (0.89-0.97) and the test-retest reliability (0.73-0.90) were found to be high. The validity of the translated questionnaires was comparable with that of the original FACE-Q. CONCLUSION: The results presented here prove that the 9 translated FACE-Q scales are reliable and valid instruments for research and clinical purposes in Hong Kong Chinese orthognathic patients.

DNA methylation profiling revealed promoter hypermethylation-induced silencing of p16, DDAH2 and DUSP1 in primary oral squamous cell carcinoma.

BACKGROUND: Hypermethylation in promoter regions of genes might lead to altered gene functions and result in malignant cellular transformation. Thus, biomarker identification for hypermethylated genes would be very useful for early diagnosis, prognosis, and therapeutic treatment of oral squamous cell carcinoma (OSCC). The objectives of this study were to screen and validate differentially hypermethylated genes in OSCC and correlate the hypermethylation-induced genes with demographic, clinocopathological characteristics and survival rate of OSCC. METHODS: DNA methylation profiling was utilized to screen the differentially hypermethylated genes in OSCC. Three selected differentially-hypermethylated genes of p16, DDAH2 and DUSP1 were further validated for methylation status and protein expression. The correlation between demographic, clinicopathological characteristics, and survival rate of OSCC patients with hypermethylation of p16, DDAH2 and DUSP1 genes were analysed in the study. RESULTS: Methylation profiling demonstrated 33 promoter hypermethylated genes in OSCC. The differentially-hypermethylated genes of p16, DDAH2 and DUSP1 revealed positivity of 78%, 80% and 88% in methylation-specific polymerase chain reaction and 24% and 22% of immunoreactivity in DDAH2 and DUSP1 genes, respectively. Promoter hypermethylation of p16 gene was found significantly associated with tumour site of buccal, gum, tongue and lip (P=0.001). In addition, DDAH2 methylation level was correlated significantly with patients' age (P=0.050). In this study, overall five-year survival rate was 38.1% for OSCC patients and was influenced by sex difference. CONCLUSIONS: The study has identified 33 promoter hypermethylated genes that were significantly silenced in OSCC, which might be involved in an important mechanism in oral carcinogenesis. Our approaches revealed signature candidates of differentially hypermethylated genes of DDAH2 and DUSP1 which can be further developed as potential biomarkers for OSCC as diagnostic, prognostic and therapeutic targets in the future.

Perioperative antibiotic prophylaxis in orthognathic surgery: a systematic review and meta-analysis of clinical trials.

OBJECTIVE: The aim of this study was to investigate whether the use of antibiotic prophylaxis in orthognathic surgery can effectively reduce the postoperative infection rate. STUDY DESIGN: Electronic databases were searched and reference lists checked. Full articles meeting the inclusion criteria were retrieved. Study details and outcome data of these reports were statistically analyzed. There was no language limitation. RESULTS: Five randomized clinical trials were included in the final review process: 4 articles compared the period of prophylactic antibiotic usage, and 1 compared the infection prevention effect of different types of antibiotics with placebo. Although a significantly higher infection rate was found in the placebo group, no significant difference could be found related to infection prevention between short- and long-term antibiotic regimen. CONCLUSIONS: Prophylactic antibiotic regimen is considered to be useful for infection prevention in orthognathic surgery. A single-dose regimen is recommended; application for extended postoperative period is not advocated.