Published evidence regarding association between malocclusion and orthodontic treatment on oral health is inconclusive.

ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION: Macey R, Thiruvenkatachari B, O'Brien K, Batista KBSL. Do malocclusion and orthodontic treatment impact oral health? A systematic review and meta-analysis. Am J Orthod Dentofacial Orthop. 2020;157(6):738-744.e10. doi:10.1016/j.ajodo.2020.01.015. SOURCE OF FUNDING: Government: Public Health England or the National Health Service. TYPE OF STUDY/DESIGN: Systematic review with meta-analysis of data.

Combined Orthodontic-Surgical Treatment May Be an Effective Choice to Improve Oral Health-Related Quality of Life for Individuals Affected With Severe Dentofacial Deformities.

ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION: Effect of conventional combined orthodontic-surgical treatment on oral health-related quality of life: A systematic review and meta-analysis. Yi J, Lu W, Xiao J, Li X, Li Y, Zhao Z. Am J Orthod Dentofacial Orthop 2019; 156:29-43. SOURCE OF FUNDING: Government National Natural Science Foundation of China (grant 81801018) and Orthodontic National Key Clinical Specialty Program of China, West China Hospital of Stomatology, Sichuan University. TYPE OF STUDY/DESIGN: Systematic review with meta-analysis.

Influence of Bimaxillary Surgery on Pharyngeal Airway in Class III Deformities and Effect on Sleep Apnea: A STOP-BANG Questionnaire and Cone-Beam Computed Tomography Study.

PURPOSE: To evaluate pharyngeal airway space (PAS; nasopharyngeal, oropharyngeal, and total airway) volume and the correlation of an obstructive sleep apnea (OSA) and hypopnea syndrome screening questionnaire (STOP-BANG) with various mandibular setbacks during bimaxillary surgery and compare these findings with an age- and gender-matched skeletal Class I control group. PATIENTS AND METHODS: This retrospective cohort study was composed of patients with skeletal Class III discrepancy who underwent bimaxillary jaw surgery and were assessed with STOP-BANG score, cephalometry, and cone-beam computed tomography (of the PAS). The predictor variable was bimaxillary jaw surgery and included 4-, 6-, and 8-mm setbacks. The primary outcome variables were PAS volume, body mass index, and STOP-BANG score evaluated at 1 week before surgery and after comprehensive orthodontic treatment (11.25 ± 1.95 months). Other variables were grouped into the following categories: demographic and cephalometric parameters. Statistical intragroup and intergroup differences were assessed by paired t and independent t tests (P < .05), respectively. RESULTS: The study sample was composed of 48 patients (18 to 25 yr old); group I received 4-mm setback (n = 16), group II received 6-mm setback (n = 16), and group III received 8-mm setback (n = 16) mandibular surgery, and all test groups received 4-mm maxillary advancement. The entire study group was compared with a skeletal Class I control group (n = 16). The total PAS volume after orthodontic treatment in groups I and II showed a significant decrease compared with the presurgical PAS (P < .001), but the decrease was not less than that in the control group (P > .05). In contrast, the total PAS volume in group III after orthodontic treatment (23,574 ± 1,394 mm3) was less than that in the control group (23,884 ± 1,543 mm3). CONCLUSION: After surgery, patients with Class III discrepancy exhibited a decrease in oropharynx volume; however, the STOP-BANG score showed no change in risk factors scores for OSA at 4- to 8-mm setback surgery of the mandible in bimaxillary jaw surgery.

Comparative Evaluation of the Pharyngeal Airway Space in Unilateral and Bilateral Cleft Lip and Palate Individuals With Noncleft Individuals: A Cone Beam Computed Tomography Study.

OBJECTIVE: To evaluate the pharyngeal airway space changes in complete unilateral cleft lip and palate (UCLP) and bilateral cleft lip and palate (BCLP) individuals, and compare with age and sex-matched noncleft (NC) control subjects. DESIGN: Retrospective study. SETTING: Cleft and Craniofacial Centre, KK Women's and Children's Hospital, Singapore. MATERIALS AND METHODS: Twenty UCLP (mean age: 13.4 ± 0.5 years), 18 BCLP (mean age: 13.5 ± 0.5 years) and 20 skeletal Class I subjects (mean age: 13.4 ± 0.6 years) were included in the study. Cone beam computed tomography scans were assessed for pharyngeal airway space (PAS) (oropharyngeal, nasopharyngeal, total airway space volume), and compared with PAS of age and sex-matched skeletal Class I NC individuals. RESULTS: Pharyngeal airway space showed statistically significant differences in the UCLP, BCLP, and NC control subjects. Oropharyngeal (9338 ± 1108 mm3, P < .05), nasopharyngeal (2911 ± 401 mm3, P < .05), and total airway space (12 250 ± 1185 mm3, P < .05) volumes of BCLP individuals showed significant reduction in comparison to UCLP and NC. There were no gender differences of PAS in any of the groups tested (P > .05). CONCLUSION: The pharyngeal airway space was significantly reduced in the BCLP group than were those in UCLP and control groups. This reduced PAS should be taken into account when planning treatment for these individuals.

Effective communication in the cyberage.

Gone are the days of physical data transmission with paper "hard" copies, floppy disks, compact disks, or any other storage media. Data transmission via the Internet, ranging from plain text to multi-media, is now routine. Contemporary orthodontic practice requirements integrate well with what technology has to offer. Whether it is interacting with a colleague through text, voice, or video; transferring patient records to distant locations; or submitting manuscripts to journals, the Internet is sculpting the contemporary orthodontic visage. This article describes various modalities of Internet communication, from the humble e-mail to real-time video interactions.

WiPics: wireless and beyond.

A WiPics transmitter allows wireless tranfer of images from the camera to the computer as the photos are being shot. This article describes this novel technological approach and its application in orthodontic imaging.

"Oops, I deleted it"--a solution for recovering deleted or reformatted digital images from memory cards.

Capturing patient photographs on digital flash cards rather than film has several advantages, but also a few disadvantages. Among the latter, the primary disadvantage is the possibility of accidentally deleting or corruping the files before they are downloaded from the memory card. In this article, we describe utilities that enable image recovery from deleted, reformatted, or physically damaged flash memory cards.

Influence of conventional and skeletal anchorage system supported fixed functional appliance on maxillo-mandibular complex and temporomandibular joint: A preliminary comparative cone beam computed tomography study.

AIM: Fixed functional appliance (FFA) used in the treatment of Class II malocclusion, lead to mandibular anterior teeth proclination, thus limiting the skeletal effects of the appliance. To counter this side effect, FFA is anchored in the lower anterior region of the mandible using the skeletal anchorage system. This pilot study was done to evaluate treatment and one-year post-treatment maxillo-mandibular, and temporomandibular joint (TMJ) effects of conventional fixed functional appliance (FFA) and skeletal anchorage system supported fixed functional appliance (SAS-FFA) using cone beam computed tomography (CBCT) images. MATERIAL AND METHOD: Sixteen Class II individuals were equally divided into Group I (FFA) (mean age 13.11±0.38 years) and Group II (SAS-FFA) (mean age 12.96±0.38 years). CBCT scans taken, before treatment (T0), at the end of comprehensive treatment (T1), and after one-year post-treatment (T2), were evaluated for changes in maxillo-mandibular complex and TMJ. Intraclass correlation coefficient and independent "t" test were used for repeated measures, and inter-group (mean) changes respectively. RESULTS: After one-year post-comprehensive treatment, SAS-FFA showed significant maxillary restriction (SNA, -1.93°, P<0.05) with significant increase in mandibular length (Go-Pog, 3.25mm, P<0.001) (Co-Gn, 7.87mm, P<0.001). SAS-FFA groups showed significant upward and backward increase in condylar volume (571 mm3, P<0.001) with anterior translation of glenoid fossa. FFA group showed significant lower dentition and vertical relationship relapse, along with non-significant changes at TMJ. CONCLUSION: SAS-FFA is an effective combination, which brings favourable changes on maxillo-mandibular complex and temporomandibular joint with non-significant relapse in comparison to FFA at one-year post-treatment.

The immediate effect of alternate rapid maxillary expansions and constrictions on the alveolus: a retrospective cone beam computed tomography study.

BACKGROUND: Rapid maxillary expansion reduced the expander's anchor teeth buccal alveolar bone thickness. However, the effects of alternate rapid maxillary expansions and constrictions (Alt-RAMEC) on the expander's anchor teeth alveolar thickness has not been assessed. The purpose of this retrospective study was to evaluate the effects of Alt-RAMEC on the alveolus surrounding the anchor teeth of a double-hinged expander. METHODS: Twenty-six individuals, including 12 males (11.5 ± 1.00 years) and 14 females (11.5 ± 0.90 years), who had double-hinged expander for 7 weeks of Alt-RAMEC and then 3 months of maxillary protraction, were included. Their cone beam computed tomography (CBCT) images taken 3-6 months before treatment (T0) and after 7 week of Alt-RAMEC (T1), were studied for the buccal alveolar bone thickness (BABT) and palatal alveolar bone thickness (PABT) of the expander's anchor teeth (first molars and first and second premolars) in four axial sections. The intra-class correlation coefficient, Dahlberg's formula, and paired t tests were used to analyze the method errors, and the intra-group changes of the BABT and PABT at T0-T1 were analyzed by paired t test (p < 0.05). RESULTS: The 7 weeks of Alt-RAMEC significantly reduced the BABT of the expander's anterior anchor teeth (0.54~ 70 mm, p < 0.05) and at the cervical region (0.14~ 0.25 mm, p < 0.05), but not at the apical region of the expander's posterior anchor teeth. The reduction of BABT by 7 weeks of Alt-RAMEC was within the scope of the initial BABT. On the opposite, the Alt-RAMEC significantly (p < 0.05) increased the PABT in the anterior anchor teeth and the cervical region of posterior anchor teeth. CONCLUSIONS: A 7-week protocol of Alt-RAMEC with double-hinged expander for maxillary protraction might reduce the buccal alveolar bone thickness of the expander's anchor teeth, although the reduction is within the scope of initial alveolar thickness of the expander's anchor teeth.

Implant-Retained Prosthetic Auricular Reconstruction in a Hemifacial Microsomia Individual: A Clinical Report.

Hemifacial microsomia is the second most frequently encountered congenital facial anomaly after cleft lip and palate. This case history report describes a two-implant-supported auricular prosthetic reconstruction in a young patient with an absent auricle and malpositioned lobule. The selected treatment protocol was chosen because of its superior retention when compared with alternative retention systems. Moreover, a clip-bar attachment system is more reliable and easier to use when availability of anatomical landmarks is limited, and especially in active adolescents.

Surgery-first orthognathic approach case series: Salient features and guidelines.

Conventional orthognathic surgery treatment involves a prolonged period of orthodontic treatment (pre- and post-surgery), making the total treatment period of 3-4 years too exhaustive. Surgery-first orthognathic approach (SFOA) sees orthognathic surgery being carried out first, followed by orthodontic treatment to align the teeth and occlusion. Following orthognathic surgery, a period of rapid metabolic activity within tissues ensues is known as the regional acceleratory phenomenon (RAP). By performing surgery first, RAP can be harnessed to facilitate efficient orthodontic treatment. This phenomenon is believed to be a key factor in the notable reduction in treatment duration using SFOA. This article presents two cases treated with SFOA with emphasis on "case selection, treatment strategy, merits, and limitations" of SFOA. Further, salient features comparison of "conventional orthognathic surgery" and "SFOA" with an overview of author's SFOA treatment protocol is enumerated.

Correction of an adult Class II division 2 individual using fixed functional appliance: A noncompliance approach.

This case report describes the application of fixed functional appliance in the treatment of an adult female having Class II division 2 malocclusion with retroclination of upper incisors. Fixed functional appliance was used to correct the overjet after the uprighting of upper incisors. Fixed functional appliance was fitted on a rigid rectangular arch wire. Application of fixed functional appliance achieved a good Class I molar relationship along with Class I canine relationship with normal overjet and overbite. Fixed functional appliance is effective in the treatment of Class II malocclusions, even in adult patients, and can serve as an alternate choice of treatment instead of orthognathic surgery. This is a case; wherein, fixed functional appliance was successfully used to relieve deep bite and overjet that was ensued after leveling and aligning. We demonstrate that fixed functional appliance can act as a "noncompliant corrector" and use of Class II elastics can be avoided.

Orthodontic-orthognathic interventions in orthognathic surgical cases: "Paper surgery" and "model surgery" concepts in surgical orthodontics.

Thorough planning and execution is the key for successful treatment of dentofacial deformity involving surgical orthodontics. Presurgical planning (paper surgery and model surgery) are the most essential prerequisites of orthognathic surgery, and orthodontist is the one who carries out this procedure by evaluating diagnostic aids such as crucial clinical findings and radiographic assessments. However, literature pertaining to step-by-step orthognathic surgical guidelines is limited. Hence, this article makes an attempt to provide an insight and nuances involved in the planning and execution. The diagnostic information revealed from clinical findings and radiographic assessments is integrated in the "paper surgery" to establish "surgical-plan." Furthermore, the "paper surgery" is emulated in "model surgery" such that surgical bite-wafers are created, which aid surgeon to preview the final outcome and make surgical movements that are deemed essential for the desired skeletal and dental outcomes. Skeletal complexities are corrected by performing "paper surgery" and an occlusion is set up during "model surgery" for the fabrication of surgical bite-wafers. Further, orthodontics is carried out for the proper settling and finishing of occlusion. Article describes the nuances involved in the treatment of Class III skeletal deformity individuals treated with orthognathic surgical approach and illustrates orthodontic-orthognathic step-by-step procedures from "treatment planning" to "execution" for successful management of aforementioned dentofacial deformity.

A new esthetic fiber-reinforced polymer composite resin archwire: a comparative atomic force microscope (AFM) and field-emission scanning electron microscope (FESEM) study.

BACKGROUND: Fiber-reinforced polymer composite (FRPC) archwires could provide an esthetic solution to conventional orthodontic archwires. This study was carried out with the following aims: (1) to compare the sliding friction of FRPC archwire with nickel titanium archwire using various archwire-bracket combinations and (2) to determine the correlation between surface roughness and friction of the FRPC and NiTi archwires. METHODS: Four different brackets (Gemini® (Gemini-3M Unitek, St. Paul, MN, USA), ICE® (ICE-Ormco- Orange, CA, USA), Clarity® (Clarity-3M Unitek, St. Paul, MN, USA), and SmartClip® (SmartClip-3M Unitek, St. Paul, MN, USA)) in combination with FRPC wires and NiTi wires (0.018 in) were studied for archwire friction with simulated wear and surface roughness using scanning electron microscope (SEM) and atomic force microscope (AFM), respectively. Statistical analysis of frictional wear generated and surface roughness between the various archwire and bracket groups was evaluated by one-way ANOVA at 5% level. Least significant difference (LSD) multiple comparisons were used to determine the archwire-bracket group difference. RESULTS: Gemini®-FRPC group generated the highest frictional wear (mean, 313.10; SD, 802.59) and ICE®-FRPC group produced the highest roughness values among all the groups tested (Ra = 496.13 nm, RMS = 635.49 nm). No correlation was found between frictional wear and surface roughness of the archwires of the various groups. CONCLUSIONS: FRPC archwire shows promise in its application as an esthetic aligning archwire. However, further research and refinement in its manufacture would be necessary to fully realize its potential as an esthetic archwire.

Correction of a severe skeletal Class II occlusion with a fixed functional appliance anchored on mini-implants: a patient report.

This report describes the treatment of a patient with a severe skeletal Angle Class II occlusion with a 14-mm overjet, crowding, and protrusion of the mandibular anterior teeth. The Class II relationship was caused mainly by a short corpus of the mandible. A fixed functional appliance was directly anchored on mini-implants, which were inserted in the mandible. A significant amount of mandibular advancement was achieved, with no protrusion of the mandibular anterior teeth. Facial esthetics improved considerably. This is the first patient report to demonstrate that mini-implants can be applied to anchor fixed functional appliances. The rationale to use mini-implants with fixed functional appliances and the potential benefits of this procedure are discussed.