Assessment of Skeletal Maturation in Nonsyndromic Cleft and Non-cleft Children-A Comparative Study.

The study aims to determine the difference in the skeletal maturation of unilateral cleft lip and palate (UCLP) and non-cleft children. This study also attempts to determine sexual dimorphism in attaining skeletal maturation between UCLP and non-cleft children. This was a retrospective, cross-sectional study. The total sample consisted of the lateral cephalogram of 131 UCLP (62 female and 71 male) children and 500 (274 female and 226 male) non-cleft children. The reviewer used the Baccetti method (2005) to review all the cephalograms for the cervical vertebrae maturation (CVM) stages. T -test was used to compare the mean chronological age and skeletal maturation of cleft and non-cleft children at each CVM stage. There was no significant difference in the mean chronological age and skeletal maturation status of UCLP and non-cleft children. There was no significant difference in skeletal maturation based on sex. The intraobserver assessment showed 80% and 85% kappa agreement, signifying absolute agreement. The correlation coefficient between chronological age and CVMIs was 0.86 ( P <0.001) in cleft children and 0.76 ( P <0.001) in non-cleft children, which was highly significant. The study indicates no significant difference in the skeletal maturation of UCLP and non-cleft children and no sex-related difference.

Effect of Fluoridated Mouthwashes on Corrosion Property of Orthodontic Appliances: A Narrative Review.

OBJECTIVE: To analyze the effects of various fluoride agents on metallic orthodontic materials. DESIGN: PubMed, Google Scholar, and Embase were searched using keyword combinations such as fluoride mouthwash and orthodontic appliance and corrosion, fluoride and fixed appliance, and metal degradation. RESULTS: Of 315 articles, 20 were selected for inclusion in the review. All types of fluoride agents, especially the acidulated form of fluoride, seemed to influence the corrosion of orthodontic metallic appliances. CONCLUSION: Since most of the studies reported suggest that fluoride ions are capable of causing corrosion of metallic orthodontic appliances, attention should be paid while prescribing fluoride agents for orthodontic patients. The degree of corrosion seems to be directly correlated with the acidity of the medium and the concentration of fluoride ions. Co-Cr brackets are resistant to corrosion by fluoride while stainless steel and Ti brackets are susceptible. CLINICAL SIGNIFICANCE: It allows making the right choice while choosing the orthodontic brackets in relation to their susceptibility to corrosion by fluoride ions.

Successful 2 phase treatment of growing skeletal Class III malocclusion based upon cephalometric prognostic factor: A case report.

Early treatment of Class III malocclusion provides an improvement in facial appearance and corrects the reverse bite. Orthopedic protraction of maxilla is considered best approach in growing Class III patients with maxillary deficiency. Present case report describes the management of a growing 10-year-old boy with skeletal Class III malocclusion using facemask therapy (Phase 1) followed by fixed orthodontic treatment (Phase 2) based upon cephalometric prognostic findings of growth treatment response vector (GTRV). With the successful orthopedic phase of maxillary protraction with facemask therapy for 7 months of period, a significant improvement in profile had been achieved along with the correction in reverse overjet. This was followed by retention with chin cup therapy for a period of 20 months. After a period of 20 months retention, a fixed orthodontic treatment was started with the objective to achieve stable functional occlusion. After 11 months of treatment with fixed appliance therapy a stable functional occlusion was achieved. The patient was placed on Hawleys retainer in maxillary arch and bonded fixed spiral wire (FSW) retainer in mandibular arch. Successful management of growing Class III patient was done using facemask and fixed orthodontic therapy based upon cephalometric prognostic findings of growth treatment response vector (GTRV).

Expression of circulating cell-free nucleic acids around miniscrew implant during orthodontic tooth movement-a prospective study.

OBJECTIVES: Literature shows that the expression of various biomarkers in peri-miniscrew crevicular fluid (PMICF) is related to the stability of miniscrew implants (MSIs). The present study investigated the role and alterations in levels of circulating cell-free nucleic acids (cfNAs) in PMICF before and after orthodontic loading. MATERIAL AND METHODS: This prospective study consisted of forty-six MSIs placed between the second premolar and first molar in the maxillary and mandibular arches. Direct loading was done after 3 weeks of MSI insertion with nickel-titanium closed coil spring exerting a force of 200 g. The PMICF sample was collected at various time intervals, and the level of cfNA was determined. Clinical parameters, including implant mobility and gingival health, were also assessed. Pre-loading and post-loading parameters were assessed using Wilcoxon's rank-sum test. RESULTS: Among 46 MSIs, 36 were stable during the study and 10 MSIs showed peri-implant inflammation and increased mobility. There was a significant rise in the cfNA concentration 24 h after implant insertion (0.4 ± 0.86 ng/µl). The level of cfNAs significantly decreased over 3 weeks and reached the baseline level (0.2 ± 0.31 ng/µl). There was also a significant rise in the levels of cfNA (0.8 ± 0.70 ng/µl) at 24 h after loading MSIs, which gradually decreased to 0.2 ± 0.24 ng/µl after 63 days. The expression of cfNAs was on the average 0.32 units more in the cases with failed implants (P = 0.05). CONCLUSIONS: cfNA levels in PMICF showed an upward trend 24 h after MSI insertion and 24 h after orthodontic loading. The expression of cfNA was more in cases with failed MSIs. Hence, the cfNAs can be considered as a prognostic biomarker of MSI stability.

Correlation between chronological age and skeletal maturity in different malocclusions: A retrospective study.

INTRODUCTION: The timing of initiation and duration of the pubertal peak is important in dentofacial orthopaedics as the mandible expresses maximum growth during the pubertal peak. The aim of the study was to compare the mean chronological age with skeletal age in three skeletal jaw relations. MATERIALS AND METHODS: The sample consisted of 787 cephalograms divided into class I, class II, and class III skeletal relationship, in which cervical vertebrae stages were assessed. Dunn test was used to compare different types of malocclusion. Pubertal peak duration was assessed by comparing the respective 95% CI. RESULTS: There was no statistically significant difference in the mean chronological age in all three malocclusion groups at CS2, CS3, CS4 and CS5. There was no significant difference in the mean age of boys and girls at each CVM stage, but class III boys have significantly delayed maturity during the pubertal spurt at CS4 (14.6 years±0.98) compared with girls (13.3 years±1.48) with P=0.02. The pubertal peak duration was 1.27 years (CI: 0.77-1.76) in the class I children, 0.96 (CI: 0.58-1.34) in the class II children and 1.15 years (CI: 0.26-2.0) in the class III children. In the class III children, the duration of the pubertal peak was higher for boys, 1.74 years (CI: 0.66-2.82) compared with girls, 0.8 years (CI: 0.42-2.82). CONCLUSIONS: There was positive correlation between chronological age and CVM stages in each skeletal jaw relation. Average time of attaining of a pubertal spurt is similar in class I, class II and class III children. Class III girls reach puberty slightly earlier than boys and puberty ends lately in class III boys. Class II boys have the shortest duration of the pubertal peak and class III boys have the longest duration of the pubertal peak.

Investigation of voltage source design's for Electrical Impedance Mammography (EIM) Systems.

According to Jossient, interesting characteristics of breast tissues mostly lie above 1MHz; therefore a wideband excitation source covering higher frequencies (i.e. above 1MHz) is required. The main objective of this research is to establish a feasible bandwidth envelope that can be used to design a constant EIM voltage source over a wide bandwidth with low output impedance for practical implementation. An excitation source is one of the major components in bio-impedance measurement systems. In any bio-impedance measurement system the excitation source can be achieved either by injecting current and measuring the resulting voltages, or by applying voltages and measuring the current developed. This paper describes three voltage source architectures and based on their bandwidth comparison; a differential voltage controlled voltage source (VCVS) is proposed, which can be used over a wide bandwidth (>15MHz). This paper describes the performance of the designed EIM voltage source for different load conditions and load capacitances reporting signal-to-noise ratio of approx 90dB at 10MHz frequency, signal phase and maximum of 4.75kΩ source output impedance at 10MHz. Optimum data obtained using Pspice® is used to demonstrate the high-bandwidth performance of the source.

How to identify patients with no risk for postextubation stridor?

The aim of this study was first, to evaluate the value of cough following tracheal tube cuff deflation, and second, to reassess the value of the cuff-leak test to predict postextubation stridor (PES). In spontaneously breathing patients, immediately before extubation, the tracheal tube was deflated and the absence of cough was monitored. The tube was then obstructed with a finger, and the absence of leak was monitored. Extubation was then performed. Four PESs were observed after 115 extubations (incidence: 3.5%). The absence of cough was more frequently observed when PES occurred than when it did not (75% v 21%, P =.04). The absence of leak was observed in 100% of PES and in 20% of PES free extubations (P =.01). The absence of both leak and cough was more frequently observed in PES (75% v 7%, P <.0001). In the absence of leak, the likelihood ratio of developing PES was 5.04 and rose to 10.4 when cough was also absent. The likelihood ratio of not developing PES in the absence of leak alone was 0. We conclude that in a population of medical intensive care unit spontaneously breathing patients, just before extubation, the presence of leaking around the endotracheal tube rules out PES, whereas the absence of cough and of leak are good predictors of PES.