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1.
Artigo em Inglês | MEDLINE | ID: mdl-33845549

RESUMO

Background: Spinal epidural hematoma is rare condition that can rapidly develop into severe neurologic deficits. The pathophysiology of this development remains unclear. There are several case reports of emergency hematoma evacuations after epidural steroid injection. Case: We report on two patients who developed acute, large amounts of epidural hematoma without neurological deficits after transforaminal epidural steroid injection. After fluoroscopy guided aspiration for epidural hematoma was performed, neurological defects did not progress and the hematoma was shown to be absorbed on magnetic resonance imaging. Conclusions: These reports are believed to be the first of treating epidural hematoma occurring after transforaminal epidural steroid injection through non-surgical hematoma aspiration. If large amounts of epidural hematoma are not causing neurological issues, it can be aspirated until it is absorbed.

2.
J Korean Med Sci ; 36(14): e93, 2021 Apr 12.
Artigo em Inglês | MEDLINE | ID: mdl-33847083

RESUMO

BACKGROUND: In accordance with the guidelines for the expectant management of women exposed to previable preterm premature rupture of membrane, we compared neonatal outcomes according to the latent period from membrane rupture to delivery among extremely preterm infants exposed to maternal preterm premature rupture of membrane using the Korean Neonatal Network database. METHODS: Of the 3,305 extremely preterm infants born at 23-27 weeks' gestation between 2014 and 2017 who were registered in the Korean Neonatal Network, 1,464 infants were born to pregnant women who were exposed to preterm premature rupture of membrane. The short latency group was defined as infants born with a latent period between membrane rupture and delivery < 7 days (n = 450), whereas the prolonged latency group was defined as infants born with a latent period of ≥ 7 days (n = 434). Using well-established risk factors for adverse short-term outcomes, multivariate logistic regression analysis was performed to assess a prolonged latent period in preterm premature rupture of membrane as an independent risk factor for neonatal outcomes in extremely preterm infants exposed to preterm premature rupture of membrane. RESULTS: The mean gestational age at membrane rupture in the prolonged latency group was significantly lower than that in the short latency group (22.7 ± 2.5 vs. 25.4 ± 1.3 weeks, P < 0.001). Nevertheless, the mean gestational age at delivery and birth weight were not significantly different between the two groups. The incidence of oligohydramnios and histologic chorioamnionitis in the prolonged latency group was significantly higher than that in the short latency group (38.7 [155/401] vs. 26.1 [105/403], 69.8 [270/384] vs. 61.0 [242/397], respectively, P < 0.05). The survival rate in the prolonged latency group did not differ from that in the short latency group (71.2 [309/434] vs. 73.3 [330/450], P = 0.478). Although the prolonged latency group was not associated with mortality during hospitalization in the multivariate logistic regression analysis, the prolonged latency group's early pulmonary hypertension and bronchopulmonary dysplasia rates were increased by 1.8 and 1.5 times, respectively. CONCLUSION: A prolonged latent period of 7 days or more does not affect the survival rate but increases the risk of bronchopulmonary dysplasia occurrence among extremely preterm infants who are exposed to maternal preterm premature rupture of membrane.

3.
J World Fed Orthod ; 10(1): 9-13, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33642260

RESUMO

Recent advances in technology, growing patient demand, and the need for social distancing due to Coronavirus Disease 2019 has expedited adoption of teledentistry in orthodontics as a means of consulting and monitoring a patient without an in-office visit. However, a lack of computer literacy and knowledge of software choices, and concerns regarding patient safety and potential infringement of regulations can make venturing into this new technology intimidating. In this article, various types of teledentistry systems for orthodontic practices, implementation guidelines, and important regulatory considerations on the use of teledentistry for orthodontic purposes are discussed. A thorough evaluation of the intended use of the software should precede commitment to a service. Selected service should be Health Insurance Portability and Accountability Act compliant at minimum and a Business Associate Agreement should be in place for protection of privacy. Ensuring the compatibility of the designated clinic computer with the system's requirements and installation of all safeguards must follow. Appointments should be documented in the same manner as in-office visits and teledentistry patients must be located within the clinician's statutory license boundary. Informed consent forms should include teledentistry or a supplemental teledentistry consent form should be used. Malpractice insurance covers everything usual and customary under the provider's license but the need for cyber liability insurance increases with teledentistry.


Assuntos
/epidemiologia , Ortodontia , Telemedicina/métodos , Inteligência Artificial , Health Insurance Portability and Accountability Act , Humanos , Pandemias , Pneumonia Viral/epidemiologia , Privacidade/legislação & jurisprudência , Estados Unidos
4.
Orthod Craniofac Res ; 24 Suppl 1: 31-38, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33652500

RESUMO

INTRODUCTION: The purpose of this study was to evaluate the long-term position of erupted third molars after maxillary total arch distalization using modified C-palatal plates (MCPPs) in adolescents and to identify factors associated with these positions. SETTING AND SAMPLE POPULATION: Sixty-two third molars (male: 20, female: 42) in Class II patients treated with MCPPs and thirty-nine teeth for the Control group (male: 22, female: 17). MATERIALS AND METHODS: Samples were analyzed using panoramic radiographs taken initially (T0), after treatment (T1) and after >3 years retention (T2). Third molars were classified as downward (Group A, N = 31; males: 12, females: 19) and upward (Group B, N = 31; males: 8, females: 23) based on their vertical position after treatment. Analysis of variance and multiple logistic regression analysis were performed. RESULTS: The vertical position of the third molars of Group A, Group B, and the Control showed a 2.2, 3.5 and 2.7 mm downward movement at T2. However, there was no difference in the amount of third molar eruption among the groups. Regarding factors affecting the vertical distance of the third molar, Age, C8-OP, ∠8-OP and D7-T at the initial affected vertical position of the third molars after molar distalization (P < .05). CONCLUSIONS: Group A and B showed no difference in the third molar eruption during retention after total arch distalization. This study suggests that it might be unnecessary to extract the developing third molar before molar distalization in Class II adolescents.


Assuntos
Má Oclusão de Angle Classe II , Dente Serotino , Adolescente , Cefalometria , Feminino , Humanos , Masculino , Maxila/diagnóstico por imagem , Dente Molar/diagnóstico por imagem , Dente Serotino/diagnóstico por imagem , Dente Serotino/cirurgia , Técnicas de Movimentação Dentária
5.
Artigo em Inglês | MEDLINE | ID: mdl-33762139

RESUMO

INTRODUCTION: C-expanders are tissue- and bone-borne maxillary expanders that are anchored by 6 orthodontic miniscrews, 3 on each side of the palate. The purpose of the study was to investigate the effect of C-expanders on the circummaxillary sutures and bucco-palatal axis of teeth in 3-dimensional finite element analyses when anchor screw vectors are different. METHODS: Five expansion models were studied on the basis of the vertical positions of anchor screws on the palate. Anchor screws for models A, B, and C were placed symmetrically at 4 mm, 7 mm, and 15 mm below the cementoenamel junction (CEJ), respectively. Anchor screws for models D and E were placed asymmetrically at 4 mm and 15 mm below CEJ and 7 mm and 15 mm below CEJ, respectively. Stress, displacement, and angular changes of the bone and teeth were measured in elastoplastic behavior models using a static-nonlinear simulation in an implicit method. RESULTS: Symmetrical and asymmetrical anchor screw placement with different vertical vectors were compared using finite element analyses on 5 models. CONCLUSIONS: Using different vectors of anchor screws for C-expanders does change the pattern of palatal expansion (null hypothesis was rejected). The current investigation presents a promising future of controlled asymmetric skeletal maxillary expansion when asymmetric maxillary architecture needs to be corrected for successful orthodontic outcomes without involving orthognathic surgeries.

6.
Artigo em Inglês | MEDLINE | ID: mdl-33736907

RESUMO

INTRODUCTION: The purpose of this study was to analyze and clarify tooth movement during mesialization of the whole maxillary dentition with various force angulations (FAs). METHODS: A finite element method was used to simulate the long-term orthodontic movement of the maxillary dentition by accumulating the initial displacement of teeth produced by elastic deformation of the periodontal ligament. A mesial force of 3 N was applied to the maxillary second molar at 5 different FAs (-30°, -15°, 0°, 15°, and 30°) to the occlusal plane. RESULTS: At an FA of 28°, the line of action of the force passed through the center of resistance of the maxillary whole dentition. With all FAs, the central incisors and molars tipped labially and mesially, respectively. The tipping angles gradually decreased as the FAs shifted from -30° to 30°. The molars tipped lingually with FAs of -30° and -15°, whereas they tipped buccally with FAs of 0°, 15°, and 30°. The molars tended to rotate mesiolingually more as the angle of force increased toward an FA of 30°. The occlusal plane rotated counterclockwise with FAs of -30°, -15°, and 0°, whereas it rotated clockwise with FAs of 15° and 30°. With an FA of 30°, buccal tipping and mesiolingual rotation of the molars, and the change in the occlusal plane angle decreased when the transpalatal arch (TPA) was fixed to the first molars and decreased, even more when the TPA was fixed to the second molars rather than the first molars, when a thicker TPA was used, and when the TPA was fixed to both molars rather than a single molar. CONCLUSIONS: There was a correlation between tooth movement during mesialization of the whole maxillary dentition and the angle at which the force was applied.

7.
Proc Natl Acad Sci U S A ; 118(13)2021 Mar 30.
Artigo em Inglês | MEDLINE | ID: mdl-33753488

RESUMO

Chloride ion-pumping rhodopsin (ClR) in some marine bacteria utilizes light energy to actively transport Cl- into cells. How the ClR initiates the transport is elusive. Here, we show the dynamics of ion transport observed with time-resolved serial femtosecond (fs) crystallography using the Linac Coherent Light Source. X-ray pulses captured structural changes in ClR upon flash illumination with a 550 nm fs-pumping laser. High-resolution structures for five time points (dark to 100 ps after flashing) reveal complex and coordinated dynamics comprising retinal isomerization, water molecule rearrangement, and conformational changes of various residues. Combining data from time-resolved spectroscopy experiments and molecular dynamics simulations, this study reveals that the chloride ion close to the Schiff base undergoes a dissociation-diffusion process upon light-triggered retinal isomerization.

8.
J Clin Pediatr Dent ; 45(1): 48-53, 2021 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-33690830

RESUMO

Technology has transformed almost every aspect of our lives. Smartphones enable patients to request, receive, and transmit information irrespective of the time and place. The global pandemic has forced healthcare providers to employ technology to aid in 'flattening the curve. The Novel Coronavirus, which is responsible for COVID-19, is transmitted primarily through person-to-person contact but may also be spread through aerosol generating procedures, so many clinics have severely limited interpersonal interactions. The purpose of this article is to provide helpful information for those orthodontists considering some form of remote practice. Various HIPAA-compliant telecommunication or teledentistry systems that can be used for orthodontic treatment are introduced and discussed. Detailed information about each platform that can potentially be used for orthodontics is provided in Figure 1. The authors do not endorse any of the products listed and the included software is not all inclusive but instead is a glimpse into the options available.


Assuntos
Ortodontia , Assistência Odontológica , Humanos , Pandemias
9.
Ann Surg Oncol ; 2021 Mar 06.
Artigo em Inglês | MEDLINE | ID: mdl-33677764

RESUMO

BACKGROUND: This study investigated the optimal timing to initiate assessment of the response to initial therapy during the early postoperative period in patients with differentiated thyroid carcinoma (DTC) using dynamic risk stratification (DRS). METHODS: This historical cohort study included 510 patients with DTC who underwent a total thyroidectomy followed by radioactive iodine (RAI) remnant ablation. DRS for these patients was categorized into subgroups according to the time into the follow-up period at which the response to initial therapy was assessed. The ability of each DRS subgroup to predict the long-term structural recurrence of cancer was compared using the proportion of variance explained (PVE) from logistic regression models. RESULTS: The median follow-up period was 108 months. Structural recurrence occurred in 7.6% of patients (n = 39/510). The PVE for long-term structural recurrence was higher among DRS subgroups (28.8-34.19%) compared with the American Joint Committee on Cancer/Union for International Cancer Control tumor-node-metastasis staging system (both the 7th and 8th editions; 4.01% and 6.13%, respectively) and the American Thyroid Association initial risk estimate (4.59%). Among the DRS subgroups, DRS assessed between 2 and 3 years after the initial surgery was associated with the highest PVE (34.19%). CONCLUSIONS: The first assessment of DRS optimally predicts long-term structural recurrence in patients with DTC who underwent a total thyroidectomy and subsequent RAI remnant ablation at that 2- to 3-year postoperative period.

10.
Am J Orthod Dentofacial Orthop ; 159(4): 470-479, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33558030

RESUMO

INTRODUCTION: The aims of this study were to evaluate the long-term skeletodental effects, the volume of maxillary tuberosity, and airway space changes after maxillary molar distalization using modified C-palatal plate (MCPP) in adolescents with Class II malocclusion. METHODS: The sample consisted of 20 adolescent patients (MCPP group; mean age, 12.9 ± 1.0 year) who underwent bilateral distalization of their maxillary dentition and 20 subjects as a control group. In the MCPP group, cone-beam computed tomography images were taken before distalization, at the end of the treatment, and during retention with a minimum of a 3-year posttreatment follow up period. Repeated measures ANOVA followed by post-hoc analysis with the Bonferroni test were used to identify significant differences between time points. RESULTS: After the long-term observation period, sagittal skeletal and dental relationships were maintained (there were no significant changes in ANB, occlusal plane angle, and overjet postretention). The vertical skeletal dimension did not change during treatment and was stable at the long-term follow-up (the mandibular plane angle and ANS-Me were relatively well maintained). The volume of the maxillary tuberosity showed no significant change during long-term retention. However, the volume was significantly smaller in the treatment group than in the control group (P <0.0001). There were no significant airway space changes after distalization and the postretention period. In addition, there was no significant difference between the MCPP and control groups. CONCLUSIONS: Improved sagittal skeletal and dental relationships because of treatment were maintained in the long-term evaluation. There was no negative long-term effect on airway space associated with the maxillary arch distalization. Therefore, these findings might be beneficial for clinicians in diagnosis and treatment planning for Class II malocclusion in adolescents.


Assuntos
Má Oclusão de Angle Classe II , Técnicas de Movimentação Dentária , Adolescente , Cefalometria , Criança , Tomografia Computadorizada de Feixe Cônico , Humanos , Má Oclusão de Angle Classe II/diagnóstico por imagem , Má Oclusão de Angle Classe II/terapia , Maxila/diagnóstico por imagem , Desenho de Aparelho Ortodôntico
11.
Sci Rep ; 11(1): 4743, 2021 Feb 26.
Artigo em Inglês | MEDLINE | ID: mdl-33637826

RESUMO

We aimed to evaluate the efficacy of using airway ultrasonography to select the correct tracheal tube size and insertion depth in pediatric patients who underwent cleft repair surgery as a way to decrease airway complications and adverse events during perioperative periods. Fifty-one patients (age < 28 months) were consecutively divided into conventional (n = 28) and ultrasound (n = 23) groups. Tracheal tube size and insertion depth were determined using the age-based formula and auscultation in the conventional group, whereas using ultrasonographic measurement of subglottic diameter with auscultation and lung ultrasonography in the ultrasound group. We evaluated the initially selected tube size, insertion depth, ventilatory indices, and the incidence of airway complications and adverse events. Tube insertion depth (median [interquartile range]) was significantly greater in the ultrasound group than in the conventional group (13.5 cm [12.5-14.0] vs 13.0 cm [11.8-13.0], P = 0.045). The number of complications and adverse events was significantly higher in the conventional group than in the ultrasound group (32.1% vs 4.3%, P = 0.013). Airway ultrasound application could reduce airway-related complications and adverse events by determining the appropriate tracheal tube size and insertion depth.

12.
Am J Orthod Dentofacial Orthop ; 159(2): 234-245, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33546828

RESUMO

Autotransplantation of a mature premolar in adults can be a treatment of choice for tooth replacement when combined with well-planned orthodontic treatment. This case report describes the successful treatment of a 39-year-old patient with severe crowding and a hopelessly fractured tooth on the maxillary left side. Maxillary dental crowding was relieved by extraction of a premolar on the right side, and this extracted tooth was autotransplanted to replace the fractured tooth. A mandibular incisor was extracted to correct anterior crossbite. The total treatment period was 20 months. The treatment results showed a good long-term prognosis after transplantation of a mature premolar with normal surrounding alveolar bone level for over 6 years of follow-up. Occlusion and periodontal health were excellent in the long term.


Assuntos
Fraturas dos Dentes , Adulto , Dente Pré-Molar/cirurgia , Humanos , Incisivo , Mandíbula , Maxila , Fraturas dos Dentes/diagnóstico por imagem , Fraturas dos Dentes/cirurgia , Transplante Autólogo
13.
Orthod Craniofac Res ; 24 Suppl 1: 103-112, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33484608

RESUMO

OBJECTIVES: The aim of this systematic review is to assess the treatment effects (amount of distalization, distal tipping and vertical movement) of buccally versus palatally placed temporary skeletal anchorage devices (TSADs) on maxillary first molars during distalization. MATERIALS AND METHODS: Medline and Scopus databases were searched up to September 2020 for randomized controlled trials (RCTs) and non-randomized prospective cohort studies on maxillary molar distalization using TSADs in patients with Class II malocclusion. After study selection, data extraction and risk of bias assessment, meta-analyses were performed for the amount of distalization, distal tipping and intrusion of first molars. RESULTS: Nine studies (2 RCTs and 7 prospective studies) were included. The risk of bias of the RCTs was low to unclear. The non-randomized studies were of moderate quality. In five studies, the TSADs were placed in the infrazygomatic process while in two studies, they were placed in the buccal inter-radicular spaces, and in two studies, they were placed in the midpalatal region. The first molar distalization was 2.75 mm when buccal inter-radicular TSADs were used, but 4.07 and 4.17 mm with palatal and infrazgomatic TSADs. The palatal appliances were associated with 11.17° of distal tipping of the first molar while infrazygomatic and buccal inter-radicular TSADs resulted in 3.99° and 1.70° of tipping, respectively. CONCLUSIONS: Inter-radicular TSADs resulted in less distal tipping but also in less distalization. Palatal TSAD-supported appliances showed the greatest amount of distal tipping. Further RCTs or prospective studies on the effect of various designs of TSAD-supported distalization are warranted.


Assuntos
Má Oclusão de Angle Classe II , Procedimentos de Ancoragem Ortodôntica , Cefalometria , Humanos , Maxila , Dente Molar , Desenho de Aparelho Ortodôntico , Aparelhos Ortodônticos , Técnicas de Movimentação Dentária
14.
Am J Orthod Dentofacial Orthop ; 159(4): 502-511, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33495061

RESUMO

INTRODUCTION: The objectives of this study were to evaluate the effects of bicortical engagement by microimplants with maxillary skeletal expanders on pterygopalatine sutures opening and to analyze the postexpansion skeletal changes associated with it. METHODS: Eighteen subjects treated with maxillary skeletal expanders were examined for pterygopalatine suture openings. Eight subjects who showed no evidence of the suture opening were assigned to the nonsplit group (NG), whereas 10 subjects with opened sutures were assigned to the split group (SG). Preexpansion and postexpansion cone-beam computed tomography images were superimposed for each group, and the changes in the 2 groups were compared. Finally, cone-beam computed tomography volumes were reoriented along the axis of each microimplant to check the bicortical engagement of the 4 microimplants. RESULTS: There was a significant correlation between the bicortical engagement of the orthodontic microimplants and the pterygopalatine suture opening (P = 0.0003). In the NG, the average amount of transverse expansion measured at the center of resistance of the maxillary first molars, anterior nasal spine, and posterior nasal spine (PNS) was 4.33 mm, 2.22 mm, and 1.58 mm, respectively, whereas the transverse expansion in the SG was 5.29 mm, 2.21 mm, and 2.46 mm, respectively. The magnitude of transverse expansion at PNS was significantly higher in the SG than in the NG (P = 0.036). The PNS also showed a significant anterior displacement in the SG (0.89 mm) compared with the NG (0.06 mm) (P = 0.033). CONCLUSIONS: Bicortical microimplant anchorage is essential for pterygopalatine suture opening in microimplant-assisted maxillary skeletal expansion, which may result in further skeletal expansion and forward movement in the posterior part of the palatomaxillary complex.


Assuntos
Maxila , Técnica de Expansão Palatina , Tomografia Computadorizada de Feixe Cônico , Humanos , Maxila/diagnóstico por imagem , Maxila/cirurgia , Dente Molar , Suturas
15.
Am J Orthod Dentofacial Orthop ; 159(3): 373-388, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33485717

RESUMO

Orthodontists often have trouble treating patients who have temporomandibular joint disorders because occlusion changes depend on the position of unstable condyles. This characteristic means the patients do not have definite criteria with which to make an accurate orthodontic diagnosis, so clinicians are unable to establish a reliable treatment plan. This article reports on the treatment of a patient with skeletal Class II relationship and condylar resorption. A stabilization splint was used before any active orthodontic tooth movement to stabilize her condylar position. Although the patient exhibited dramatically increased open bite and a retruded mandibular position after splint therapy, her occlusion and facial esthetics were resolved by orthodontic camouflage treatment with appropriate orthodontic mechanics after extraction of 4 premolars.


Assuntos
Mordida Aberta , Transtornos da Articulação Temporomandibular , Cefalometria , Feminino , Humanos , Mandíbula , Côndilo Mandibular , Articulação Temporomandibular , Transtornos da Articulação Temporomandibular/terapia
16.
Angle Orthod ; 91(1): 22-29, 2021 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-33339047

RESUMO

OBJECTIVES: To compare the dental and skeletal treatment effects after total arch distalization using modified C-palatal plates (MCPPs) on adolescent patients with hypo- and hyperdivergent Class II malocclusion. MATERIALS AND METHODS: The study group included 40 patients with Class II malocclusion (18 boys and 22 girls, mean age = 12.2 ± 1.4 years) treated with MCPPs. Fixed orthodontic treatment started with the distalizing process in both groups. Participants were divided into hypo- or hyperdivergent groups based on their pretreatment Frankfort mandibular plane angle (FMA) ≤22° or ≥28°, respectively. Pre- and posttreatment lateral cephalograms were digitized, and 23 variables were measured and compared for both groups using paired and independent t-tests. RESULTS: The hyper- and hypodivergent groups showed 2.7 mm and 4.3 mm of first molar crown distalizing movement, respectively (P < .001). The hypodivergent group had a slight 2.2° crown distal tipping of first molars compared with 0.3° in the hyperdivergent group. After distalization, the FMA increased 3.1° and 0.3°, in the hypodivergent and hyperdivergent groups, respectively (P < .001). SNA decreased in the hypodivergent group, while other skeletal variables presented no statistically significant differences in the changes between the groups. CONCLUSIONS: The hypodivergent group showed more distal and tipping movement of the maxillary first molar and increased FMA than the hyperdivergent group. Therefore, clinicians must consider vertical facial types when distalizing molars using MCPPs in Class II nonextraction treatment.


Assuntos
Má Oclusão de Angle Classe II , Desenho de Aparelho Ortodôntico , Adolescente , Cefalometria , Feminino , Humanos , Masculino , Má Oclusão de Angle Classe II/diagnóstico por imagem , Má Oclusão de Angle Classe II/terapia , Maxila , Técnicas de Movimentação Dentária
17.
Prog Orthod ; 21(1): 44, 2020 Dec 07.
Artigo em Inglês | MEDLINE | ID: mdl-33283252

RESUMO

BACKGROUND: The purpose of this study is to investigate the heritability of total rotation, matrix rotation, and intramatrix rotation of the mandible in Korean monozygotic (MZ) twins, dizygotic (DZ) twins, and their siblings. MATERIALS AND METHODS: The samples consisted of 75 pairs of Korean twins (39.7 + 9.26 years; MZ group, 36 pairs; DZ group, 13 pairs; sibling group, 26 pairs). Lateral cephalograms were taken, and 13 variables related to internal and external mandible rotation were measured. Three types of occlusal planes (bisected occlusal plane, functional occlusal plane, and the MM bisector occlusal plane) were used to evaluate genetic influence on the occlusal plane. Heritability (h2) was calculated by using the intraclass correlation coefficient (ICC) and Falconer's method. RESULTS: With regard to mandibular rotation, the MZ twin group showed significantly higher ICC values compared to the DZ twin and sibling groups. The ICC mean values for 13 cephalometric measurements were 0.85 (MZ), 0.62 (DZ), and 0.52 (siblings) respectively. The heritability of the total rotation (0.48) and matrix rotation (0.5) between the MZ and DZ groups was higher than that of the intramatrix rotation (- 0.14). All of the three types of occlusal plane showed high heritability, and among the three types, the functional occlusal plane showed the highest heritability (h2 = 0.76). CONCLUSION: Based on these findings that showed a strong genetic effect on total rotation and matrix rotation, maintaining these rotations should be carefully considered in the orthodontic treatment plan, while the lower border of the mandible may be responsive to various treatments. Occlusal plane change, especially with regard to the functional occlusal plane, may not be stable due to strong genetic influences.

18.
Angle Orthod ; 2020 Oct 14.
Artigo em Inglês | MEDLINE | ID: mdl-33289781

RESUMO

OBJECTIVES: To compare the dental and skeletal treatment effects after total arch distalization using modified C-palatal plates (MCPPs) on adolescent patients with hypo- and hyperdivergent Class II malocclusion. MATERIALS AND METHODS: The study group included 40 patients with Class II malocclusion (18 boys and 22 girls, mean age = 12.2 ± 1.4 years) treated with MCPPs. Fixed orthodontic treatment started with the distalizing process in both groups. Participants were divided into hypo- or hyperdivergent groups based on their pretreatment Frankfort mandibular plane angle (FMA) ≤22° or ≥28°, respectively. Pre- and posttreatment lateral cephalograms were digitized, and 23 variables were measured and compared for both groups using paired and independent t-tests. RESULTS: The hyper- and hypodivergent groups showed 2.7 mm and 4.3 mm of first molar crown distalizing movement, respectively (P < .001). The hypodivergent group had a slight 2.2° crown distal tipping of first molars compared with 0.3° in the hyperdivergent group. After distalization, the FMA increased 3.1° and 0.3°, in the hypodivergent and hyperdivergent groups, respectively (P < .001). SNA decreased in the hypodivergent group, while other skeletal variables presented no statistically significant differences in the changes between the groups. CONCLUSIONS: The hypodivergent group showed more distal and tipping movement of the maxillary first molar and increased FMA than the hyperdivergent group. Therefore, clinicians must consider vertical facial types when distalizing molars using MCPPs in Class II nonextraction treatment.

19.
Orthod Craniofac Res ; 2020 Dec 04.
Artigo em Inglês | MEDLINE | ID: mdl-33277824

RESUMO

OBJECTIVE: To systematically review the effects of cortical bone thickness (CBT) and bone mass density (BMD) on miniscrew success rates. METHODS: MEDLINE, the Cochrane Library, and Scopus were searched up to June 2020. Of a total of 5734 articles, seven studies were finally selected for the review. RESULTS: The overall mean success rate weighted by the number of miniscrews was 87.21% (89.87% in the maxilla and 79.24% in the mandible). There was a significantly higher success rate for miniscrews placed in the maxilla compared with those in the mandible (P < .05). CBT showed a small positive effect on the success rate of the miniscrews although it failed to reach a statistical significance. The cortical BMD had a minimal effect on the success of the miniscrews. The cancellous BMD demonstrated a very strong effect on the success of the miniscrews in the maxilla, whereas, it showed a moderate negative effect in the mandible. LIMITATIONS: Because of the small number and clinical heterogeneity of the included studies, the results should be interpreted with caution. Further randomized clinical studies with a large sample size are recommended.

20.
Invest Ophthalmol Vis Sci ; 61(14): 14, 2020 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-33315053

RESUMO

Purpose: We sought to assess the relationship between retinal nonperfusion area (NPA) on ultra-widefield fluorescein angiography (UWFA) and renal function in type 2 diabetes mellitus (DM) patients with diabetic retinopathy (DR) and nephropathy. Methods: UWFA was performed in 248 eyes (124 patients) with DR, comprising 94 eyes from patients with chronic kidney disease (CKD) caused by diabetes and 154 eyes without CKD (non-CKD). Serum creatinine level (Cr), estimated glomerular filtration rate (eGFR), urine albumin/creatinine ratio (UACR), and urine protein/creatinine ratio (UPCR) were collected. On UWFA, retinal NPA was measured in an automated manner. The correlation between NPA and renal function was analyzed. Results: The mean NPA value of the total eye was 33.11 ± 45.77-disc diameter (DA) in non-CKD and 100.57 ± 69.52 in CKD (P < 0.001). NPA of posterior pole was 1.21 ± 3.28 DA in non-CKD and 7.99 ± 6.75 in CKD group (P < 0.001). The NPA values of both the total eye and posterior pole were significantly correlated with Cr (r = 0.585 and 0.483), eGFR (r = -0.572 and -0.524), UACR (r = 0.541 and 0.482), and UPCR (r = 0.509 and 0.529, respectively) (all P ≤ 0.001). Linear modeling encompassing all clinical factors and relative clinical factors suggested eGFR as the most important predictor for NPAs of the total eye and posterior pole. Conclusions: Larger retinal NPA on UWFA is associated with worse renal function in DM patients. Renal function can be used to predict retinal NPA in type 2 DM patients with nephropathy and DR.

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