Dual CXCR4/IL-10 Gene-Edited Human Amniotic Mesenchymal Stem Cells Exhibit Robust Therapeutic Properties in Chronic Wound Healing.

Although stem cells have attracted attention as a novel therapeutic solution for tissue regeneration, their minimal efficacy remains controversial. In the present study, we aimed to investigate the enhanced therapeutic property of CXCR4/IL-10 dual angiogenic/anti-inflammatory gene knock-in amniotic mesenchymal stem cells (AMM) in a wound-healing model. Dual CXCR4 and IL-10 genes were inserted into the AMM genome using transcription-activator-like effector nuclease (TALEN). Matrigel tube formation and anti-inflammatory effects were assessed in vitro, and efficacy was tested in vivo in a diabetic wound-healing model. CXCR4/IL-10-expressing amniotic MSCs (AMM/CI) strongly expressed CXCR4 and IL-10 genes and robustly promoted tube formation and anti-inflammatory potential. AMM/CI transplantation resulted in accelerated wound healing, as well as high engraftment and re-epithelialization potential. Transplanted AMM/CI also exhibited high angiogenic and decreased pro-inflammatory gene expression in the wound tissue, indicating direct therapeutic effects on wound healing. Taken together, these data indicate that dual angiogenic/anti-inflammatory gene knock-in may be a novel approach to enhance the therapeutic effects of stem cells, and transplantation of AMM/CI can be an alternative therapeutic option in chronic wound healing.

Correction of an adult Class III malocclusion through regaining of orthodontic space and an implant restoration.

This case report describes the interdisciplinary treatment of a 23-year-old female with Class III malocclusion and a missing maxillary left second premolar. Treatment alternatives were discussed, and the selected treatment plan was presented to illustrate a way to gain space for the premolar implant restoration and correct Class III relationship through maxillary molar retraction followed by maxillary total arch protraction with a palatal temporary skeletal anchorage device. Esthetic anterior alignment and functional occlusal rehabilitation was achieved, and facial balance was maintained at the end of treatment. CLINICAL SIGNIFICANCE: Implant restoration in conjunction with regaining orthodontic space by a team of multidisciplinary dental specialists presents an effective treatment solution to permanent tooth agenesis. Class III malocclusion can be treated with a combination of maxillary protraction and mandibular retraction using temporary skeletal anchorage devices. The versatility of modified palatal C-plates presents greater clinical application when related side effects are controlled with solid understanding of their biomechanics.

Group IV Transition Metal (M = Zr, Hf) Precursors for High-κ Metal Oxide Thin Films.

This paper describes the synthesis of eight novel zirconium and hafnium complexes containing N-alkoxy carboxamidate-type ligands, as potential precursors for metal oxides and atomic layer deposition (ALD) for HfO2. A series of ligands, viz., N-ethoxy-2,2-dimethylpropanamide (edpaH), N-ethoxy-2-methylpropanamide (empaH), and N-methoxy-2,2-dimethylpropanamide (mdpaH), were used to afford complexes Zr(edpa)4 (1), Hf(edpa)4 (2), Zr(empa)4 (3), Hf(empa)4 (4), Zr(mdpa)4 (5), Hf(mdpa)4 (6), ZrCp(edpa)3 (7), and HfCp(edpa)3 (8). Thermogravimetric analysis curves assessed for the evaporation characteristics of complexes 1-8 revealed single-step weight losses with low residues, except for the mdpa-containing complexes. Single-crystal X-ray diffraction studies of 1, 2, 5, and 6 revealed that all the complexes have monomeric molecular structures, with the central metal ion surrounded by eight oxygen atoms from the four bidentate alkoxyalkoxide ligands. Among the complexes prepared, 8 exhibited a low melting point (64 °C), good volatility (1 Torr at 112 °C), high thermal stability, and excellent endurance over 6 weeks at 120 °C. Therefore, an ALD process for the growth of HfO2 was developed using HfCp(edpa)3 (8) as a novel precursor. Furthermore, the HfO2 film exhibited a low capacitance equivalent oxide thickness of ∼1.5 nm, with Jg as low as ∼3 × 10-4 A/cm2 at Vg -1 V in a metal-insulator-semiconductor capacitor (Au/HfO2/p-Si).

Growth patterns and overbite depth indicators of long and short faces in Korean adolescents: Revisited through mixed-effects analysis.

OBJECTIVE: The purpose was to evaluate skeletal factors related to the growth of subjects with skeletal open and deep bites based on lateral cephalographs from 9 years of pure longitudinal data using mixed effect analysis. SETTING AND SAMPLE POPULATION: Fifty-one children with extreme lower anterior facial height to total anterior facial height (LAFH/TAFH) ratio values at the age of 14 were assigned to either skeletal open bite or skeletal deep bite groups from a total of 223 subjects. MATERIAL & METHODS: The palatal plane angle (PPA), mandibular plane angle (MPA), gonial angle (GA), palatomandibular plane angle (PMA), upper gonial angle (UGA), lower gonial angle (LGA), occlusal plane angle (OPA) and overbite depth indicator (ODI) were measured and analysed. Mixed-effects regression model analysis was used for the interpretation of data with random effects. RESULTS: Morphological differences were evident from the beginning and became more pronounced with age in MPA, GA, PMA, ODI and LGA. The initial values of all variables were statistically significant. Annual increases with age were statistically significant in GA, OPA, ODI and UGA. The morphological differences in the annual increases in MPA, GA, PMA and UGA were also statistically significant. CONCLUSIONS: Morphologically different growth patterns were mainly contributed by lower anterior facial height dimensions. The extent of individual variations mandates judicious decision-making in clinical situations.

Germanium Compounds Containing Ge═E Double Bonds (E = S, Se, Te) as Single-Source Precursors for Germanium Chalcogenide Materials.

New germanium chalcogenide precursors, S═Ge(dmamp)2 (3), S═Ge(dmampS)2 (4), Se═Ge(dmamp)2 (5), Se═Ge(dmampS)2 (6), Te═Ge(dmamp)2 (7), and Te═Ge(dmampS)2 (8), were synthesized from Ge(dmamp)2 (1) and Ge(dmampS)2 (2) using sulfur, selenium, and tellurium powders (dmamp = 1-dimethylamino-2-methyl-2-propanolate, dmampS = 1-dimethylamino-2-methylpropane-2-thiolate). Complexes 1 and 2 were synthesized from metathesis reactions of GeCl2·dioxane with 2 equiv of aminoalkoxide or aminothiolate ligands. Thermogravimetric analysis of complex 1 displayed good thermal stability and volatility. The molecular structures of complexes 2-8 from X-ray single crystallography showed distorted trigonal bipyramidal geometry at the germanium centers. Germanium chalcogenide materials (GeSe and GeTe) were obtained from the thermal decomposition of complexes 5, 6, and 8 in hexadecane. X-ray diffraction patterns exhibited that GeSe and GeTe had orthorhombic and rhombohedral phases, respectively. This study affords a facile method to easily prepare germanium chalcogenide materials using well-designed and stable complexes by thermal decomposition of single-source precursors in solution.

Submorphotypes of the maxillary first molar and their effects on alignment and rotation.

INTRODUCTION: The aim of this study was to explore the shape differences in maxillary first molars with orthographic measurements using 3-dimensional virtual models to assess whether there is variability in morphology that could affect the alignment results when treated by straight-wire appliance systems. METHODS: A total of 175 maxillary first molars with 4 cusps were selected for classification. With 3-dimensional laser scanning and reconstruction software, virtual casts were constructed. After performing several linear and angular measurements on the virtual occlusal plane, the teeth were clustered into 2 groups by the method of partitioning around medoids. To visualize the 2 groups, occlusal polygons were constructed using the average data of these groups. RESULTS: The resultant 2 clusters showed statistically significant differences in the measurements describing the cusp locations and the buccal and lingual outlines. The rotation along the centers made the 2 cluster polygons look similar, but there was a difference in the direction of the midsagittal lines. CONCLUSIONS: There was considerable variability in morphology according to 2 clusters in the population of this study. The occlusal polygons showed that the outlines of the 2 clusters were similar, but the midsagittal line directions and inner geometries were different. The difference between the morphologies of the 2 clusters could result in occlusal contact differences, which might be considered for better alignment of the maxillary posterior segment.

Patterns of vertical facial growth in Korean adolescents analyzed with mixed-effects regression analysis.

INTRODUCTION: To understand the growth patterns of skeletal open bite and deepbite, we present observations from 9 years of pure longitudinal data based on lateral cephalometric radiographs using mixed-effects regression model analysis. METHODS: In total, 51 children (14 years old) with extreme values for the ratio of lower anterior facial height to total anterior facial height were assigned to 1 of 2 groups: a skeletal open-bite group (11 boys, 14 girls) or a skeletal deepbite group (14 boys, 12 girls). Measurements of total anterior facial height, upper anterior facial height, lower anterior facial height, total posterior facial height, ramus height, and ratio of lower anterior facial height to total anterior facial height were obtained for all subjects. All data were analyzed and interpreted using a mixed-effects regression model analysis with random effects. RESULTS: From these 4 groups at 14 years old, statistically significant differences were observed between the groups when subjects of the same sex were compared; however, statistical significance was not reached between subjects of opposite sexes in each group. Morphologic differences were clearly evident from the start and became more pronounced with age. There were statistical significances in the initial values and increases with age in all 6 variables except for increases with age in the ratio of lower anterior facial height to total anterior facial height. Statistical significance was also reached for morphologic differences between the annual increases in the ratio of lower anterior facial height to total anterior facial height and lower anterior facial height. In general, individual random variability was high in all variables when compared with the annual changes over time. CONCLUSIONS: Divergent patterns were established early and became more pronounced with age, with anterior facial height dimensions primarily contributing to these differences. Individual variations were so pronounced that caution is recommended for all clinical decisions.

Different mandibular first molar shapes according to groove and cusp configuration in relation to suggested bracket position.

The aim of this study was to explore the shape differences in the mandibular first molars through orthographic measurements using three-dimensional (3D) virtual models, and study the possibility of new morphologic categories that require more than subjective visual inspection. A total of 164 mandibular first molars with five cusps were selected for classification. Using 3D laser scanning and reconstruction software, virtual casts were constructed. After several linear and angular measurements on the virtual occlusal plane, the teeth were clustered using the partitioning around medoids methods-an unsupervised classification. The cluster analysis presented two clusters that showed statistically significant differences in the measurements over the cusp locations and groove configurations. However, gender differences were not shown in the angular groove and cusp configurations. Two clusters were found in the population of the present study, and this result suggested the existence of a diverse morphologic trait in the mandibular molar even in the same origin and could be considered in positioning orthodontic brackets that have built-in prescriptions.

Evaluation of dental and basal arch forms using cone-beam CT and 3D virtual models of normal occlusion.

UNLABELLED: OBIECTIVES: To evaluate the relationship between the mandibular dental and basal arches using CBCT, and to assess the correlation between basal arch dimensions derived from CBCT and 3-dimensional (3D) virtual models in a cohort sample exhibiting normal occlusions. METHODS: The facial axis (FA) and root centre (RC) points of mandibular teeth were identified on 32 CBCT images. FA and WALA points were digitised on 3D models of 28 mandibular casts from the same sample. The relationships between dental and basal arch dimensions, and between the two basal depth dimensions derived from RC and WALA points were statistically assessed by Pearson's correlation. RESULTS: Strong correlations were found between dental and basal intercanine and intermolar arch widths. Also, the basal intercanine width showed a moderate correlation with dental intermolar width and depth. The basal intercanine and intermolar widths measured on 3D models showed moderate correlations with those measurements on CBCT, whereas the basal canine and molar depths showed no correlations. CONCLUSIONS: The dental and basal anterior and posterior arch widths were strongly correlated in normal occlusion. No correlations were found between the arch depths measured from WALA points and RC points. Hence, RC points may represent more useable landmarks compared to WALA points in the evaluation of basal arch forms. It is recommended that the relationship between the dental and basal arches is evaluated during treatment planning in order to improve arch co-ordination.

A growth mechanism of porous film formed on Al in 0.6 M oxalic acid electrolyte.

Understanding of mechanism of porous film formation is of fundamental importance for anodizing in general because, the onset of pore initiation terminates the barrier film growth process over the macroscopic metal surface. Several mechanisms have been proposed to explain pore formation. They include direct injection of aluminum ions into electrolyte and a field-assisted dissolution mechanism. High-resolution scanning electron microscopy of anodized surfaces and direct TEM of ion beam thinned films and ultrarmicrotomed film sections have been employed to gain further insight into the mechanism of initial porous film growth in 0.6 M oxalic acid. From detailed examination of the behavior of the xenon-tagged layer in the film during pore initiation and development in oxalic acid, the film structure of the barrier layer is found to be unstable during pore initiation and the instability of the film structure is possibly related to the field-assisted structure modification process.

Efficacy of combination colonoscopy using modified cap-assisted and water-exchange colonoscopy with prone position for detection of colorectal adenomas.

The efficacy of cap-assisted and water-exchange colonoscopy, individually or in combination for adenoma detection is well documented. Moreover, prone positioning colonoscopy may also improve adenoma detection by decreasing loop formation. However, the efficacy of triple-combination colonoscopy using the above methods for adenoma detection is unclear. This study aimed to compare the effectiveness of combining modified cap-assisted and water-exchange colonoscopy with prone position (CWP) and conventional colonoscopy (CC) for adenoma detection. A total of 746 patients who underwent either CWP or CC, performed by 2 board-certified gastroenterologists between December 2019 and March 2020, were investigated retrospectively. Cap-assisted colonoscopy was modified using hooking and dragging maneuver. We evaluated the polyp detection rate (PDR), adenoma detection rate (ADR), and the mean number of adenomas detected per procedure (MAP). There was no significant difference in sex, age, the indication of colonoscopy and quality of bowel preparation between the 2 groups. PDR, ADR, and proximal colon MAP were significantly higher in the CWP group than in the CC group (PDR: 84.9% vs 59.8%, P < .01; ADR: 70.1%, vs 49.2%, P < .01; proximal colon MAP: 1.24 vs 0.55, P < .01). CWP is more effective than CC for PDR, ADR, and proximal colon MAP. Although it may facilitate adenoma detection, further studies assessing the synergistic or complementary effects of combining these methods are needed.

Novel Heteroleptic Tin(II) Complexes Capable of Forming SnO and SnO2 Thin Films Depending on Conditions Using Chemical Solution Deposition.

A new heteroleptic complex series of tin was synthesized by the salt metathesis reaction of SnX2 (X = Cl, Br, and I) with aminoalkoxide and various N-alkoxy-functionalized carboxamide ligands. The complexes, [ClSn(dmamp)]2 (1), [BrSn(dmamp)]2 (2), and [ISn(dmamp)]2 (3), were prepared from the salt metathesis reaction of SnX2 with one equivalent of dmamp; [Sn(dmamp)(empa)]2 (4), [Sn(dmamp)(mdpa)]2 (5), and [Sn(dmamp)(edpa)]2 (6) were prepared via the salt metathesis reaction using complex 2 with one equivalent of N-alkoxy-functionalized carboxamide ligand. Complexes 1-5 displayed dimeric molecular structures with tin metal centers interconnected by µ2-O bonding via the alkoxy oxygen atom. The molecular structures of complexes 1-5 showed distorted trigonal bipyramidal geometries with lone pair electrons in the equatorial position. Using complex 6 as a tin precursor, SnO x films were deposited by chemical solution deposition (CSD) and subsequent post-deposition annealing (PDA) at high temperatures. SnO and SnO2 films were selectively obtained under controlled PDA atmospheres of argon and oxygen, respectively. The SnO films featured a tetragonal romarchite structure with high crystallinity and a preferred growth orientation along the (101) plane. They also exhibited a lower transmittance of >52% at 400 nm due to an optical band gap of 2.9 eV. In contrast, the SnO2 films exhibited a tetragonal cassiterite crystal structure and an extremely high transmittance of >97% at 400 nm was observed with an optical band gap of 3.6 eV.

Comparison of overjet among 3 arch types in normal occlusion.

INTRODUCTION: The purposes of this study were to examine the amounts of overjet in the anterior and posterior segments of 3 arch forms by using facial axis points on 3-dimensional virtual models and to verify the minimum posterior extension required for classification of the arch form in normal occlusions. METHODS: Facial axis points were digitized on 97 virtual models with normal occlusion, classified into 20 tapered, 25 ovoid, and 52 square arch forms. Intercanine and intermolar arch widths and depths were measured. The best-fitting curves were created, and overjet was measured at each facial axis point. Two-way analysis of variance (ANOVA) was performed to assess the relationship between arch form and overjet in different areas. The minimum posterior extension to determine arch type was analyzed with the chi-square test. RESULTS: Subjects with a tapered arch form had larger overjet compared with those with ovoid and square forms, except at the central incisor. A significant difference in overjet among different areas was found in subjects with a square arch form (P <0.0001). No significant difference (P = 0.864) was found among the first and second premolar and the first molar groups for classifying arch-form types. CONCLUSIONS: A significant difference was found in anterior and posterior overjet according to arch types. The extension to the first premolar was sufficient to classify arch form type. It might be beneficial to consider more coordinated preformed superelastic archwires according to variations in overjet of different arch types.

New clinical classification of dental arch form using facial axis points derived from three-dimensional models.

INTRODUCTION: The purpose of the present study was to use facial axis (FA) points to classify dental arch form generated from an analysis of 3-D virtual models of a sample of normal occlusions. A secondary aim was to introduce a new arch form template based on this classification for clinical application. METHODS: One hundred and twenty five plaster models of Class I occlusions were 3-D scanned (Orapix Co., Ltd, Seoul, Korea) and FA points digitized on the virtual models using Rapidform 2006 software (INUS Technology Inc., Seoul, Korea). Following intercanine and intermolar arch width and depth measurements, K-means cluster analysis was applied on 77 cases (Dataset 1) to classify the sample into arch form types. A curve of best fit of the mean arch form of each type was generated. The remaining 48 cases (Dataset 2) were mapped into the clusters and a multivariate test was performed to assess the differences among the clusters. RESULTS: Classification into five clusters demonstrated maximum inter-cluster distance in the arch parameters and produced the most homogeneous cluster size. The differences between the 5 cluster types were statistically but not clinically significant and so they were recombined to form three clusters representing 'narrow', 'moderate' and 'wide' arch forms. CONCLUSIONS: A template with three arch form types based on anterior and posterior dimensions has been proposed through 3-D analysis of FA points for more accurate arch form identification and arch wire selection.

CO2 Curing Efficiency for Cement Paste and Mortars Produced by a Low Water-to-Cement Ratio.

Curing by CO2 is a way to utilize CO2 to reduce greenhouse gas emissions. Placing early-age cement paste in a CO2 chamber or pressure vessel accelerates its strength development. Cement carbonation is attributed to the quickened strength development, and CO2 uptake can be quantitatively evaluated by measuring CO2 gas pressure loss in the pressure vessel. A decrease in CO2 gas pressure is observed with all cement pastes and mortar samples regardless of the mix proportion and the casting method; one method involves compacting a low water-to-cement ratio mix, and the other method comprises a normal mix consolidated in a mold. The efficiency of the CO2 curing is superior when a 20% concentration of CO2 gas is supplied at a relative humidity of 75%. CO2 uptake in specimens with the same CO2 curing condition is different for each specimen size. As the specimen scale is larger, the depth of carbonation is smaller. Incorporating colloidal silica enhances the carbonation as well as the hydration of cement, which results in contributing to the increase in the 28-day strength.

Validation Study of Korean Translated Systemic Clinical Outcome Routine Evaluation-15 as Self-Report Family Assessment Measure: Focusing on Adolescent in Daegu and North Gyeongsang Province.

BACKGROUND: Systemic Clinic Outcome and Routine Evaluation (SCORE-15) is a compact scale that contains the most critical family function assessment tools including assessments of the strengths, adaptability, and communication among family members. It has been translated into other languages in the United States and Europe. This study aimed to verify the reliability and validity of SCORE-15 with a small research population and justify its applicability in Korea. METHODS: SCORE-15 is a self-reporting family function measurement tool for each family member over the age of 11 years. This study used the Family Communication Scale (FCS) included in the Family Adaptability and Cohesion Evaluation Scales (FACES) IV package and FACES in FACES-III to verify the validity of the Korean-translated SCORE-15. Cronbach's α value was calculated to check the reliability of SCORE-15. Data were analyzed using STATA ver. 15.0 (Stata Corp., College Station, TX, USA). RESULTS: The study analyzed the correlation between FACES-III and SCORE-15 and FCS and SCORE-15 so that there was a significant static correlation in both comparisons (r=0.72 and r=0.81, respectively). Also, the research compared each subscale to analyze the correlation and the range was 0.47 to 0.95. The total SCORE-15 Cronbach's α value was 0.92 and those values of the subscales for family strengths, family communication, and family difficulty were 0.89, 0.73, and 0.87, respectively (P<0.001). CONCLUSION: Our study was the first to validate the Korean SCORE-15, which can be used as an appropriate shortform indicator for evaluating family function and changes in detecting therapeutic improvements in Korea.

Synthesis and characterization of novel zinc precursors for ZnO thin film deposition by atomic layer deposition.

A novel series of zinc complexes, [EtZn(dab)]2 (1), [EtZn(damb)]2 (2), [EtZn(damp)]2 (3), and [EtZn(dadb)]2 (4), were prepared via single-step substitution. Further, these were analyzed by nuclear magnetic resonance (NMR), Fourier transform infrared spectroscopy (FT-IR), elemental analysis, single crystal X-ray diffraction analysis, and thermogravimetric analysis (TGA). The X-ray crystallography analysis revealed that all complexes exist as dimeric structures with distorted tetrahedral geometry having zinc centers that are interconnected via µ2-O bonding of the aminoalkoxy oxygen atom. TGA and thermal analysis of the complexes showed high volatilities and stabilities at sublimation temperatures of 70, 95, 90, and 105 °C at 0.5 Torr for the respective compounds. Precursor 3 was successfully used for ZnO thin film deposition by ALD. A growth rate per cycle (GPC) of 0.125 nm per cycle was obtained at 200 °C and XPS analysis confirmed the growth of highly pure ZnO films without carbon and nitrogen impurities, while XRD analysis revealed the deposition of reasonably crystalline films. Additionally, the high transmittance and wide bandgap of the films are suitable for optoelectronic applications.

Effects of CO2 Curing on Alkali-Activated Slag Paste Cured in Different Curing Conditions.

The effect of CO2 curing on alkali-activated slag paste activated by a mixture of sodium hydroxide and sodium silicate solutions is reported in this paper. The paste samples after demolding were cured in three different curing environments as follows: (1) environmental chamber maintained at 85% relative humidity (RH) and 25 °C; (2) 3-bar CO2 pressure vessel; and (3) CO2 chamber maintained at 20% CO2 concentration, 70% RH and 25 °C. The hardened samples were then subjected to compressive strength measurement, X-ray diffraction analysis, and thermogravimetry. All curing conditions used in this study were beneficial for the strength development of the alkali-activated slag paste samples. Among the curing environments, the 20% CO2 chamber was the most effective on compressive strength development; this is attributed to the simultaneous supply of moisture and CO2 within the chamber. The results of X-ray diffraction and thermogravimetry show that the alkali-activated slag cured in the 20% CO2 chamber received a higher amount of calcium silicate hydrate (C-S-H), while calcite formed at an early age was consumed with time. C-S-H was formed by associating the calcite generated by CO2 curing with the silica gel dissolved from alkali-activated slag.

High-Performance Thin-Film Transistors of Quaternary Indium-Zinc-Tin Oxide Films Grown by Atomic Layer Deposition.

A new deposition technique is required to grow the active oxide semiconductor layer for emerging oxide electronics beyond the conventional sputtering technique. Atomic layer deposition (ALD) has the benefits of versatile composition control, low defect density in films, and conformal growth over a complex structure, which can hardly be obtained with sputtering. This study demonstrates the feasibility of growing amorphous In-Zn-Sn-O (a-IZTO) through ALD for oxide thin-film transistor (TFT) applications. In the ALD of the a-IZTO film, the growth behavior indicates that there exists a growth correlation between the precursor molecules and the film surface where the ALD reaction occurs. This provides a detailed understanding of the ALD process that is required for precise composition control. The a-IZTO film with In/Zn/Sn = 10:70:20 was chosen for high-performance TFTs, among other compositions, regarding the field-effect mobility (µFE), turn-on voltage ( Von), and subthreshold swing (SS) voltage. The optimized TFT device with the a-IZTO film thickness of 8 nm revealed a high performance with a µFE of 22 cm2 V-1 s-1, Von of 0.8 V, and SS of 0.15 V dec-1 after annealing at 400 °C for 30 min. Furthermore, an emerging device such as a vertical channel TFT was demonstrated. Thus, the a-IZTO ALD process could offer promising opportunities for a variety of emerging oxide electronics beyond planar TFTs.

Displacement and stress distribution of the maxillofacial complex during maxillary protraction using palatal plates: A three-dimensional finite element analysis.

OBJECTIVE: The purpose of this study was to analyze initial displacement and stress distribution of the maxillofacial complex during dentoskeletal maxillary protraction with various appliance designs placed on the palatal region by using three-dimensional finite element analysis. METHODS: Six models of maxillary protraction were developed: conventional facemask (Type A), facemask with dentoskeletal hybrid anchorage (Type B), facemask with a palatal plate (Type C), intraoral traction using a Class III palatal plate (Type D), facemask with a palatal plate combined with rapid maxillary expansion (RME; Type E), and Class III palatal plate intraoral traction with RME (Type F). In Types A, B, C, and D, maxillary protraction alone was performed, whereas in Types E and F, transverse expansion was performed simultaneously with maxillary protraction. RESULTS: Type C displayed the greatest amount of anterior dentoskeletal displacement in the sagittal plane. Types A and B resulted in similar amounts of anterior displacement of all the maxillofacial landmarks. Type D showed little movement, but Type E with expansion and the palatal plate displayed a larger range of movement of the maxillofacial landmarks in all directions. CONCLUSIONS: The palatal plate served as an effective skeletal anchor for use with the facemask in maxillary protraction. In contrast, the intraoral use of Class III palatal plates showed minimal skeletal and dental effects in maxillary protraction. In addition, palatal expansion with the protraction force showed minimal effect on the forward movement of the maxillary complex.