Assessment of the occlusal outcomes in patients treated with orthognathic surgery and clear aligners.

OBJECTIVE: This retrospective two-centre study aimed to evaluate the occlusal outcomes in patients undergoing orthognathic surgery with clear aligners. METHODS: A retrospective chart review and occlusal outcomes for 15 patients (10 females and five males) with different types of dentofacial deformities in the anteroposterior, vertical and transverse dimensions, who underwent orthognathic surgery in conjunction with clear aligners were evaluated. Weighed Peer Assessment Rating (PAR) index scores of the pre-treatment and post-treatment digital models were used to assess initial complexity, final occlusal outcomes and degree of improvement with surgery and clear aligners. RESULTS: The mean post-treatment PAR score was 3.5 ± 2.54, which was a statistically significant improvement from the pre-treatment PAR score of 27.63 ± 12.09, an 87% improvement was achieved. All subcategories of the PAR index showed statistically significant improvement except for midline assessment component. CONCLUSIONS: Occlusal outcomes with aligners showed great improvement as indicated with the PAR index scores. Orthognathic surgical cases can be treated efficiently with aligners and future studies should compare occlusal outcomes between orthognathic surgical patients treated with clear aligners and those treated with fixed appliances.

Intraoral Infection and Oral Health in the Surgical Patient: Need for Concern During the Perioperative Period?

A patient's intraoral health condition is not typically a chief perioperative concern of surgical health care providers and preoperative dental evaluation/therapy is often left unattended prior to elective surgery. Consequently, patients for surgery may possess untreated dental caries, intraoral infection(s), and/or periodontal disease. Individuals who have not had a dental evaluation or examination for the previous several years may be harboring a quiescent and potent oral infection. Deleterious effects of an intraoral infection may not only compromise surgical outcome, but lead to an increased need for additional interventional therapy(s) along with associated expenses. This article will review known connection(s) between oral health, systemic disease, and treatment concerns for bacterial endocarditis. Some of the barriers that exist with improving oral health prior to surgical procedures will also be examined. Augmenting recognition of perioperative dental considerations may result in interventional measures that can minimize use of additional healthcare related resources and optimize patient care.

Selective oxoammonium salt oxidations of alcohols to aldehydes and aldehydes to carboxylic acids.

The oxidation of alcohols to aldehydes using stoichiometric 4-acetamido-2,2,6,6-tetramethylpiperidine-1-oxoammonium tetrafluoroborate (1) in CH(2)Cl(2) at room temperature is a highly selective process favoring reaction at the carbinol center best able to accommodate a positive charge. The oxidation of aldehydes to carboxylic acids by 1 in wet acetonitrile is also selective; the rate of the process correlates with the concentration of aldehyde hydrate. A convenient and high yield method for oxidation of alcohols directly to carboxylic acids has been developed.