3D assessment of facial contours of patients wearing either complete denture or implant-supported fixed dentures.

Background: Total edentulousness leads to soft tissue changes causing esthetic problems. Being aware of the significant effects of different treatment approaches on facial soft tissue can help to obtain more satisfying esthetic results. Aim: The current study's objective was to evaluate three-dimensional facial soft tissue changes in edentulous patients rehabilitated with a complete denture (CD) and implant-supported fixed partial denture (FPD). Material and Methods: Fourteen edentulous patients, mean age of 47.6 years (42-63), were assessed before prosthetic treatments (T0), after CD (T1), and after FPD (T2). 3dMDface System (3dMD LLC) obtained the images and transferred them to 3dMD Vultus software (3dMD Vultus software Version 2.3.0.2). Nine linear, five angular, and one topographical measurement were performed for facial soft tissue analysis. For statistical analysis of facial soft tissue, ANOVA was used with a level of significance set at 5% (p <.05). Results: Significant differences were observed in lower lip height (Sto-Sl) and nasolabial angle (Prn Sn Ls) with CD. There is no significant difference with the implant-supported fixed partial dentures in these measurements when compared with pretreatment. Significant differences were observed in the lower lip angle (Chr Li Chl) with the implant-supported fixed partial dentures. There is no significant difference with CD in this measurement when compared with pretreatment. According to the paired comparisons, a significant difference was observed in philtrum height (Ls-Sn) between the treatment approaches. Conclusion: CD and implant-supported fixed partial dentures, both treatment approaches, cause facial soft tissue changes, which may help to improve the facial esthetic. The effects of these treatment methods on facial soft tissues are not significantly different, except the philtrum height.

Nasal soft tissue changes after two different approaches for surgically assisted rapid maxillary expansion.

The aim of the study was to evaluate the nasal soft tissue changes in patients who underwent surgically assisted rapid maxillary expansion (SARME) using two different surgical approaches. Thirty-two patients were included in the study, and divided into two groups according to the type of surgical approach: in group A (n=17), SARME performed with standard Le Fort I circumvestibular approach with alar base cinch and anterior nasal spine (ANS) exposure; and in group B (n=15) operations were performed with the same standard Le Fort I circumvestibular approach with only alar base cinch. Measurements of height and width of the philtrum, nasal and subnasal width, and columella width were taken from three-dimensional facial images obtained before surgery (T1), after the distraction phase (T2) and 6 months postoperatively (T3). The mean maxillary expansion was 7.3±0.7mm for group A and 7.5±1.5mm for group B, without any significant difference between groups (P=0.59). Both groups presented an increase in all vaules in T2 and T3. The approach used in group A resulted in smaller changes in the columella width. The results of the present study show that there is no need for intraoperative releasing of the soft tissues around the anterior nasal spine during SARME if columella width is sufficient. However, further randomized studies based on large patient groups are needed before final conclusions on this topic can be reached.

Intraoperative comparison of single- and double-puncture techniques in temporomandibular joint arthrocentesis.

The objective of this study was to compare techniques for temporomandibular joint (TMJ) arthrocentesis intraoperatively and to determine the ease of performance of these techniques for the physician. A total of 33 TMJ treatments were done using single-puncture arthrocentesis (SPA) type 1, SPA type 2, and double-puncture arthrocentesis (DPA) (n=11 in each treatment group) between December 2013 and December 2017. A retrospective analysis of the duration of the procedure (minutes), occurrence of complications, number of cannula relocations, and ease of the procedure was performed. Ease of the procedure was measured using a Likert-type visual analogue scale (VAS; 0-10). All measurement variables were recorded intraoperatively, and related data were analyzed statistically. Significant differences were found between SPA type 2 and the other techniques in terms of procedure duration and ease of the procedure (P<0.05). No significant differences were found in the occurrence of complications or number of cannula relocations between the techniques (P>0.05). Compared to the other TMJ arthrocentesis techniques, SPA type 2 is easier, and physicians can perform it in a shorter time.

Long-term evaluation of single-puncture temporomandibular joint arthrocentesis in patients with unilateral temporomandibular disorders.

The purpose of this study was to evaluate the long-term effects of the single-puncture arthrocentesis (SPA) technique. Forty-two patients with unilateral temporomandibular joint disorders (TMDs) were treated by SPA. Thirty-eight of these patients completed 1-24 months of follow-up (short-term group) and 21 completed 11 months or longer of follow-up (long-term group). The two groups were evaluated statistically for pain (visual analogue scale), maximum mouth opening, lateral excursion, and protrusion. Both follow-up duration groups showed significant improvements when compared to baseline levels for almost all of the outcome variables (P<0.05). Single puncture temporomandibular joint arthrocentesis is an effective treatment method over both the short and long term.

Surgical difficulties, success, and complication rates of orthodontic miniplate anchorage systems: Experience with 382 miniplates.

PURPOSE: The aim of this study was to evaluate the complications and success rates of the miniplates using both maxilla and mandible for orthodontic anchorage in growing patients. MATERIALS AND METHODS: One hundred and fifty-five consecutive patients (range 8.7-13.8 years) with Class II and III malocclusion without congenital or acquired deformities were included in this study. A total of 382 titanium miniplates were placed by the same surgeon. All miniplates were inserted under local anesthesia. Loading of the miniplates with a force of 200 g with the help of elastics or functional devices were initiated 3 weeks after surgery. RESULTS: The overall success rate of miniplate anchorage in terms of stability was 96.8%. Twenty-one patients reported irritation of the mucosa of the cheeks or lower lip after the surgery in the mandible group. Twelve miniplates needed to be removed and were successfully replaced. CONCLUSION: Skeletal anchorage miniplates is effective for correcting malocclusions. Success depends on proper presurgical patient counseling, minimally invasive surgery, good postsurgical instructions, and orthodontic follow-up.

Evaluation of lip force in patients with unilateral and bilateral cleft lip.

Our aim was to investigate the differences in the dynamics of lip force between a group of participants with repaired cleft lips and a group of patients the same age but without clefts. We evaluated 101 children between the ages of 10 to 15 years (unilateral clefts n=35, bilateral clefts n=15, class I malocclusion n=25, and class III malocclusion n=26). Maximum and minimum forces required to close the lips were evaluated with the Lip De Cum® device (Cosmos Instruments Co Ltd, Tokyo, Japan) for the all groups. We found no significant differences between the maximum and minimum values between boys and girls within the groups, whereas the mean maximum and minimum lip force of the boys was higher than those of the girls in all the groups. This study showed that maximum and minimum lip closing force values were statistically similar in all groups. We conclude, therefore, that patients with bilateral cleft lip have reduced maximum and minimum lip force.

Surgical acrylic guide for distractor positioning.

Internal maxillary distraction with the Le Fort I osteotomy is a technique that can provide simultaneous skeletal advancement and gradual expansion of the soft tissue. For calibrating the vectors of the internal distractors and transferring the desired vectors to the patient, surgical guides may be fabricated before surgery on a stereolithographic model. The anterior nasal spine may be used as a critical anatomical landmark for applying this type of surgical guide.