Radiographic evaluation in three dimensions of condylar fractures with closed treatment in children and adolescents.

The study aimed at investigating a new three-dimensional classification of healing morphology in condylar fractures in children and adolescents after closed treatment, and establish its association with fracture type and clinical outcomes. The medical records of children and adolescents with condylar fracture were reviewed, retrospectively. The clinical outcomes were assessed by mandibular deviation during mouth opening, Helkimo anamnestic index (Ai), and Helkimo clinical dysfunction index (Di). The condylar healing morphology was evaluated through three-dimensional CT images after 1-2 years of follow-up. In total, 96 patients with 142 condylar fracture sites were included in the study. Condylar healing morphology was classified into three main patterns: unchanged (21.13%), spherical (62.68%), and irregular (16.19% - including the three subtypes triangular, L-shaped, and Y-shaped). There was a significant difference in the distribution of the three main healing patterns among various fracture types (p = 0.0227). Irregular patterns occurred more frequently in adolescents than in children. In unilateral fractures, no obvious association was found between condylar healing morphology and clinical outcomes, including mandibular deviation during mouth opening (p = 0.162), Ai (p = 0.0991) and Di (p = 0.25). Most patients healing in different condylar patterns reached a good clinical outcome after 1-2 years. Although the healing morphology of condylar fractures in children and adolescents remained abnormal, good clinical outcome was achieved over the 2-year follow-up. Therefore, closed treatment remains a good approach.

[Three-dimensional model analysis of obstructive sleep apnea hyponea syndrome patients with long-term treatment of oral appliances].

PURPOSE: The aim of the study was to investigate the dental changes of patients with obstructive sleep apnea hypopnea syndrome (OSAHS) with long-term treatment of oral appliances, via the method of three-dimensional model analysis. METHODS: Using Geomagic Studio 2014 software, we transferred the dental models, which were from 18 OSAHS patients before and after treatment of oral appliances, into three-dimensional models for digital analysis. Datasets obtained from pre- and after treatment were compared for accuracy via paired t test using SPSS 22.0 software package. RESULTS: Eighteen patients using oral appliances for 6.57±1.98 years, showed significant differences in some dentition values between pre-treatment and after-treatment. The total dentition changes indicated intrusion of upper premolars, buccalization of upper posterior teeth and mesialization of lower posterior teeth. Statistical analysis demonstrated decrease in upper dental arch length, increase in upper posterior arch width and decrease in upper arch depth and dramatic reduction of overjet in anterior teeth. In the same time, other values evaluated showed no significant change before and after treatment of oral appliances. CONCLUSIONS: Long-term wearing oral appliances results in changes in several variables of dental occlusion, which should not be ignored for dentists conducting this treatment plan. However, the side effect of dental occlusion changes is little on a whole, leading to high security in this aspect.