Quality of occlusal outcome in adult Class II patients treated with completely customized lingual appliances and Class II elastics compared to adult Class I patients.

OBJECTIVES: The aim of this investigation was to evaluate whether Class II malocclusion in adult patients can be successfully corrected using a completely customized lingual appliance (CCLA) in combination with Class II elastics. METHODS: In order to detect differences in the final treatment outcome, two groups were matched for age and gender. Treatment results of 40 adult orthodontic patients with a Class I malocclusion (Group 1) were compared to 40 adults with a Class II malocclusion (Group 2). All patients had completed treatment with a CCLA (WIN, DW Lingual Systems, Bad Essen, Germany) without known centric occlusion-centric relation discrepancies, issues of compliance, or overcorrection in the individual treatment plan which was defined by a target set-up. In order to compare the treatment results of the two groups, 7 measurements using the American Board of Orthodontics Model Grading System (ABO MGS) and linear measurements for anterior-posterior (AP) and vertical dimensions were assessed at the start of lingual treatment (T1), after debonding (T2B) and compared to the individual target set-up (T2A). RESULTS: A statistically significant AP correction was achieved in Group 2 which represented 95% of the planned amount. The planned overbite correction was fully achieved in the Class I and Class II group. In both groups, there was a statistically significant improvement in the ABO scores, with no significant difference between the two groups at T2. 100% of the patients in Group 2 and 92.5% in Group 1 would meet the ABO standards after CCLA treatment. LIMITATIONS: The main limitation of this study is that only patients who were wearing the elastics as prescribed were retrospectively included. Therefore, the results of this study may have limited generalizability. CONCLUSIONS: Completely customized lingual appliances in combination with Class II elastics can correct a Class II malocclusion successfully in adult patients. The final treatment outcome can be of a similar high quality in Class I and Class II patients.

Factors influencing treatment outcomes assessed by the American Board of Orthodontics Objective Grading System (ABO-OGS).

BACKGROUND: Treatment outcomes can be influenced by various factors. This study aimed to determine the association between predisposing patient- and treatment-related factors (demographic, cephalometric parameters, skeletal relationships, Discrepancy Index (DI), extractions, treatment type and duration) and treatment outcomes measures according to the American Board of Orthodontics Objective Grading System index (ABO-OGS). METHODS: Completed cases (N = 100) were included in this cross-sectional study. One calibrated examiner assessed DI, pretreatment lateral cephalometric parameters and ABO-OGS. Patient data, including sex, age, types of malocclusion, extractions, treatment type, and duration, were also collected. Intraexaminer reliability for each measurement was evaluated using the intraclass correlation coefficients. Multiple linear regression analysis, using the backward elimination method with a significance level (α) of 0.05, was used to determine which factors significantly influenced the ABO-OGS score. RESULTS: From the study, the overall mean ABO-OGS score was 11.36 points. Factors influencing the ABO-OGS score were pretreatment Wits values (p value = .000), L1-NB (°) (p value = .023) and treatment duration (p value = .019). Subjects with lower negative values of Wits and L1-NB (°) tended to have higher ABO-OGS scores. Additionally, the ABO-OGS score tended to be higher for subjects with longer treatment times. CONCLUSIONS: The majority of treated subjects had satisfactory orthodontic treatment outcomes assessed by the ABO-OGS. The pretreatment severity of skeletal discrepancies determined by the Wits parameter, the degree of retroclined lower incisors and longer treatment duration negatively impacted the treatment outcomes.

An objective, markerless videosystem for staging facial palsy.

PURPOSE: To propose a new objective, video recording method for the classification of unilateral peripheral facial palsy (UPFP) that relies on mathematical algorithms allowing the software to recognize numerical points on the two sides of the face surface that would be indicative of facial nerve impairment without positioning of markers on the face. METHODS: Patients with UPFP of different House-Brackmann (HB) degrees ranging from II to V were evaluated after video recording during two selected facial movements (forehead frowning and smiling) using a software trained to recognize the face points as numbers. Numerical parameters in millimeters were obtained as indicative values of the shifting of the face points, of the shift differences of the two face sides and the shifting ratio between the healthy (denominator) and the affected side (numerator), i.e., the asymmetry index for the two movements. RESULTS: For each HB grade, specific asymmetry index ranges were identified with a positive correlation for shift differences and negative correlation for asymmetry indexes. CONCLUSIONS: The use of the present objective system enabled the identification of numerical ranges of asymmetry between the healthy and the affected side that were consistent with the outcome from the subjective methods currently in use.

Objective analysis of microtia reconstruction in Indian patients and modifications in management protocol.

INTRODUCTION: An ideal ear, with representation of all anatomic landmarks, is the aim of any reconstructive surgeon embarking on reconstructing the ear in a microtia patient. The literature is abundant with the description of techniques, but these have been reported mainly in Caucasian and Oriental population. There have been very few publications on results in the population belonging to the Indian subcontinent. In spite of strictly adhering to the recommended techniques of reconstruction, the results obtained in these patients have often been marred by problems that are not reported with the Oriental or Caucasian populations. This may necessitate a relook into the management strategy of these cases. Hindering the assessment of the results, their reporting and auditing the improvement obtained by such change in the management strategy, is the lack of a standardized method for assessment of the outcome. Hence, an attempt was made in a series of patients who underwent microtia reconstruction to assess the outcome using a new tool based on the attained definition of anatomical components of the reconstructed pinna. Further effort was made to document the modifications in the technical execution of the reconstruction during the period of the study. MATERIALS AND METHODS: A retrospective review of 44 patients and a prospective analysis of 11 patients, who underwent ear reconstruction for microtia from December 2003 to September 2014 at a tertiary care teaching hospital, was undertaken. Taking a cue from Nagata's description of an 'ideal reconstructed ear' which should show all the anatomical components, we developed an objective grading system to assess our results. The technique had undergone several changes during these years combining the principles of three universally accepted methods, that is, those described by Nagata, Brent, and Firmin. These changes, as well as the reasons behind them, were documented. RESULTS: On objectively measuring and analysing the replication of normal morphologic characteristics of the reconstructed ears, we documented progressive improvement of our results. Good or excellent results could be achieved in 70% of cases in the second group compared to a poor outcome in more than 2/3(rd) of the cases carried out during the initial period. Based on these results and the changes adopted in our practice we propose suggestions for management of microtia cases in the Indian population. CONCLUSIONS: An objective, weighted grading system has further enabled us to critically evaluate the outcomes and to further improve upon the existing results. Our amalgamation of the salient features of the established techniques as well as changes made based on our experience has enabled us to get good results more consistently in our attempts at microtia reconstruction. We believe that the adoption of such amalgamated methods will be more suitable in Indian patients.

Anterior Vitreous Objective Assessment in Uveitis: An Anterior Segment Swept Source Optical Coherence Tomography Study.

PURPOSE: To assess inflammatory changes in the anterior vitreous (AV) using a swept source anterior segment optical coherence tomography (SS-ASOCT) and to correlate them with uveitis features and clinical grading of intraocular inflammation. METHODS: 140 eyes from 96 patients were included in this observational, cross-sectional study: 40 ACTIVE uveitis, 40 INACTIVE uveitis and 60 CONTROLS. All eyes underwent intraocular inflammation clinical grading (anterior chamber (AC) cells counting and vitreous haze evaluation) and AV imaging with SS-ASOCT. Cells seen in the AV on OCT were manually counted using imageJ. Vitreous reflectivity variation was indirectly measured by calculating the vitreous/iris pigment epithelium (VIT/IPE) relative intensity. These OCT-based parameters were compared across the groups and correlated with inflammation clinical grading. RESULTS: The mean [SD] number of AV OCT cells was significantly higher (both p < 0.001) in ACTIVE uveitis (12[9.8]) compared to INACTIVE uveitis (4.5[3.5]) and CONTROLS (4[3.1]). In ACTIVE uveitis the number of AV OCT cells was significantly and positively correlated with the AC cells (p = 0.04), the VIT/IPE relative intensity (p = 0.0002), the uveitis anatomical classification (INTERMEDIATE UVEITIS, p = 0.02) and the vitreous haze clinical grading (p < 0.0001). The mean[SD] VIT/IPE relative intensity of the AV increased from CONTROLS (0.12[0.01]) to INACTIVE uveitis (0.15[0.01]) to ACTIVE uveitis (0.17[0.02]), but with no statistically significant differences. CONCLUSIONS: We were able to visualize and objectively evaluate changes occurring in the AV in eyes with uveitis by means of a commercially available SS-ASOCT. OCT-cells in the AV could represent an adjunctive tool in the objective evaluation of intraocular inflammation.

Beef-on-dairy: Meat quality of veal and prediction of intramuscular fat using the Q-FOM™ Beef camera at the 5th-6th thoracic vertebra.

This study aims to describe the meat quality of young Holstein (HOL) beef-on-dairy heifers and bulls sired by Angus (ANG, n = 109), Charolais (CHA, n = 101) and Danish Blue (DBL, n = 127), and to investigate the performance of the handheld vision-based Q-FOM™ Beef camera in predicting the intramuscular fat concentration (IMF%) in M. longissimus thoracis from carcasses quartered at the 5th-6th thoracic vertebra. The results showed significant differences between crossbreeds and sexes on carcass characteristics and meat quality. DBL × HOL had the highest EUROP conformation scores, whereas ANG × HOL had darker meat with higher IMF% (3.52%) compared to CHA × HOL (2.99%) and DBL × HOL (2.51%). Bulls had higher EUROP conformation scores than heifers, and heifers had higher IMF% (3.70%) than bulls (2.31%). These findings indicate the potential for producing high-quality meat from beef-on-dairy heifers and ANG bulls. The IMF% prediction model for Q-FOM performed well with R2 = 0.91 and root mean squared error of cross validation, RMSECV = 1.33%. The performance of the prediction model on the beef-on-dairy veal subsample ranging from 0.9 to 7.4% IMF had lower accuracy (R2 = 0.48) and the prediction error (RMSEveal) was 1.00%. When grouping beef-on-dairy veal carcasses into three IMF% classes (2.5% IMF bins), 62.6% of the carcasses were accurately predicted. Furthermore, Q-FOM IMF% predictions and chemically determined IMF% were similar for each combination of sex and crossbreed, revealing a potential of Q-FOM IMF% predictions to be used in breeding, when aiming for higher meat quality.

Optimising subjective grading of corneal staining in Sjögren's syndrome dry eye disease.

AIM: To assess whether smaller increment and regionalised subjective grading improves the repeatability of corneal fluorescein staining assessment, and to determine the neurological approach adopted for subjective grading by practitioners. METHODS: Experienced eye-care practitioners (n = 28, aged 45 ± 12 years), graded 20 full corneal staining images of patients with mild to severe Sjögren's syndrome with the Oxford grading scheme (both in 0.5 and 1.0 increments, globally and in 5 regions), expanded National Eye Institute (NEI) and SICCA Ocular Staining Score (OSS) grading scales in randomised order. This was repeated after 7-10 days. The digital images were also analysed objectively to determine staining dots, area, intensity and location (using ImageJ) for comparison. RESULTS: The Oxford grading scheme was similar with whole and half unit grading (2.77vs2.81,p = 0.145), but the variability was reduced (0.14vs0.12,p < 0.001). Regional grade was lower (p < 0.001) and more variable (p < 0.001) than global image grading (1.86 ± 0.44 for whole increment grading and 1.90 ± 0.39 for half unit increments). The correlation with global grading was high for both whole (r = 0.928,p < 0.001) and half increment (r = 0.934,p < 0.001) grading. Average grading across participants was associated with particle number and vertical position, with 74.4-80.4% of the linear variance accounted for by the digital image analysis. CONCLUSIONS: Using half unit increments with the Oxford grading scheme improve its sensitivity and repeatability in recording corneal staining. Regional grading doesn't give a comparable score and increased variability. The key neurally extracted features in assigning a subjective staining grade by clinicians were identified as the number of discrete staining locations (particles) and how close to the vertical centre was their spread, across all three scales.

Treatment effectiveness of young adults using clear aligners versus buccal fixed appliances in class I malocclusion with first premolar extraction using the ABO-Objective Grading System: A randomized controlled clinical trial.

OBJECTIVE: To compare the effectiveness of the clear aligners with the traditional fixed appliances in the treatment of premolars extraction complex cases using the American Board of Orthodontics Objective Grading System (ABO-OGS). MATERIAL AND METHODS: A single-centre, 2-parallel groups RCT with two arms. Forty severe crowding patients (14 males, 26 females; mean age: 21.40±2.42) who required four first premolars extraction were included and randomly allocated into two treatment groups: clear aligners therapy group (CAT), and fixed appliances therapy group (FAT). Cases complexities were measured on pre-treatment records using the Discrepancy index (DI). Post-treatment records were evaluated using the American Board of Orthodontics Objective Grading System (ABO-OGS). Two sample t-tests and Fisher's Exact tests were used to test for significant differences between the two groups. The statistical significance was set at P < 0.006 using Bonferroni's correction. RESULTS: For the DI, the mean scores were 32.25 (± 4.33) in the CAT group and 33 (± 7.92) in the FAT group. In the CAT group, the total OGS score ranged between 6-33 points with an average of 17.50(± 7.41), whereas the total score in the FAT group went between 4-30 points with an average of 12.89 (± 6.31) with no significant differences between the two groups (P=0.05). When comparison of the successful cases between the two groups was made, 11 cases received passing scores, and 9 cases received failing scores in the CAT group. Whereas in the FAT group, 17 cases received passing scores, and 3 received a failing score. No statistically significant differences were found in the passing rates between of the CAT and FAT groups (P = 0.421). CONCLUSIONS: According to the ABO-OGS total scores, there was no significant difference between the clear aligners and fixed appliances in the treatment of class I severe crowding cases with first premolars extraction in young adults. There were no differences between the two techniques in the OGS components scores except for the occlusal contacts, which were significantly better with the fixed appliances. When comparing the number of successful and failed cases between the two groups, no significant differences were noted, with the fixed appliances having a 30% higher success rate than the clear aligners, which must be considered clinically when choosing between these two techniques in the complex orthodontic cases treatment.

A comparison of subjective and objective conjunctival hyperaemia grading with AOS® Anterior software.

CLINICAL RELEVANCE: This study evaluates a commercially available conjunctival hyperaemia grading system, providing validation of an important tool for ocular surface research and clinical trials. BACKGROUND: Bulbar conjunctival hyperaemia is a sign of ocular surface inflammation, and proper measurement is essential to clinical care and trials. The aim of this study was to assess the validity and repeatability of an objective grading system in comparison with subjective grading. METHODS: This study was a retrospective, randomised analysis of 300 bulbar conjunctival images that were collected at an academic institution. The images used were de-identified and collected from the Keratograph K5 and Haag-Streit slitlamp. Six investigators graded the images with either a 0.1 or 0.5 unit scaling using a 0-4 Efron grading scale. Three of the investigators also imported the images into the AOS ® Anterior software and graded them objectively. All measurement techniques were assessed for repeatability and comparability to each other. RESULTS: Mean hyperaemia with the objective system (1.1 ± 0.7) was significantly less than the subjective grading (2.0 ± 0.8) (P < 0.001). Both inter- and intra-subject repeatability of the objective system (0.15) was better than the subjective methods (1.70). CONCLUSION: The results showed excellent repeatability of the AOS ® Anterior objective conjunctival hyperaemia grading software, although they were not found to be interchangeable with subjective scores. This system has value in monitoring levels of hyperaemia in contact lens wearers and patients in clinical care and research trials.

The Relationship between Posttreatment Smile Esthetics and the ABO Objective Grading System: Class I Extraction versus Non-Extraction Cases.

OBJECTIVE: This study aimed to evaluate the relationship between the components of the objective grading system developed by the American Board of Orthodontics (ABO) and smile esthetics in Class I extraction vs non-extraction cases. METHODS: A total of 40 extraoral smile images of orthodontically treated (20 extraction and 20 non-extraction) cases in the age group of 13-30 years and Class I skeletal malocclusion with an average mandibular plane angle were selected. Smile images were rated only by the orthodontist, and this panel included 12 members. Scoring of post-treatment dental casts and panoramic radiographs of each patient was performed by 1 investigator per the guidelines of the ABO grading system. The Pearson correlation coefficient and logistic regression analysis were used to ascertain whether the scores of the ABO grading system could foretell whether a smile would be "attractive" or "unattractive." RESULTS: The correlation between all the criteria of the ABO grading system and attractiveness of the smile was extremely weak. The r values ranged from -0.53 to 0.37 for extraction cases and -0.63 to 0.003 for non-extraction cases (p>0.05). Neither individual parameters nor total scores of the ABO grading system could predict whether the smile was attractive or unattractive in either group. CONCLUSION: No correlation was found between post-treatment ABO grading and smile esthetics in patients with extraction or non-extraction. Hence, this study recommends that ancillary soft tissue variables have to be incorporated into the grading system to evaluate a smile.

Objective grading of eye muscle area, intramuscular fat and marbling in Australian beef and lamb.

The objective of this study was to test the performance of a prototype vision system in phenotypically diverse beef and lamb carcasses against visual grading of eye muscle area (EMA), marbling and chemical intramuscular fat (IMF%). Validation in beef demonstrated that the camera prototype in combination with analytical techniques enabled prediction of EMA (r2 = 0.83, RMSEP = 6.4 cm2), MSA marbling (r2 = 0.76, RMSEP = 66.1), AUS-MEAT marbling (r2 = 0.70, RMSEP = 0.74) and chemical IMF% (r2 = 0.78, RMSEP = 1.85%). Accuracy was also maintained on validation with all four traits displaying minimal bias of -3.6, 6.3, 0.07 and - 0.01, for EMA, MSA marbling, AUS-MEAT marbling and IMF% respectively. Preliminary analysis in lamb indicates potential of the system for the prediction of EMA (r2 = 0.41, RMSEP = 1.87) and IMF% (r2 = 0.28, RMSEP = 1.10), however further work to standardise image acquisition and environmental conditions is required.

Clinical outcomes of lingual fully customized vs labial straight wire systems : Assessment based on American Board of Orthodontics criteria.

PURPOSE: To evaluate orthodontic treatment outcome in patients treated with a lingual appliance (Incognito™ Appliance System, 3M Unitek, Monrovia, CA, USA) versus patients treated with a labial appliance (Victory series™, 3M Unitek, Monrovia, CA, USA). METHODS: A total of 72 patients were retrospectively analyzed. The complexity of each case was evaluated using the American Board of Orthodontics (ABO) Discrepancy Index (DI), and orthodontic clinical outcomes were evaluated using the ABO Objective Grading System (cast-radiograph evaluation: C­R Eval). RESULTS: The mean total ABO C­R Eval score was 16 ± 9.1 in the labial appliance group and 12.7 ± 5.4 in lingual appliance group (p = 0.152). The mean total ABO-DI scores were 16.3 ± 7.3 and 15.4 ± 6.6 in the labial and lingual appliance groups, respectively (p = 0.445). A significant correlation was observed between the total DI and total C­R Eval scores. CONCLUSIONS: In this particular study and in the hands of two experienced orthodontists, no differences in the finishing quality of orthodontic treatments using the lingual technique or the buccal appliance technique were found. However, further prospective studies with larger sample sizes are necessary in order to generalize these results.

Curative effect evaluation by using Andrews' six elements for completed orthodontic treatment cases.

OBJECTIVES: To assess the treatment outcome of patients who completed their orthodontic treatment by using Andrews' six elements and the American Board of Orthodontic (ABO) objective grading system (OGS); to determine whether Andrews' six elements can be used as a new assessment system for patients who completed their orthodontic treatment. METHODS: A total of 160 patients who completed their orthodontic treatment were included in the study. The participants were randomly selected from patients who completed their orthodontic procedures in Kunming Medical University Affiliated Stomatological Hospital during the period of 2015 to 2019. The retrospective completed cases were examined in accordance with the Andrews' six elements and ABO measuring scales. Scores were assigned to each tooth in each category. All the measurement items in both evaluation criteria, the composite category score, and the total score were calculated. The passing and potential passing rates of the completed cases were compared with two measuring scales via the Chi-square test. RESULTS: The passing rate for the evaluation of cases by using the Andrews' six elements measuring scale was 83.8%, and that for the evaluation of cases by using the ABO measuring scale was 86.3%. The differences in achieving the standard between the cases of Andrews' six elements and ABO-OGS via the Chi-square test were statistically insignificant (P>0.05). The mean Andrews' six elements score for the completed cases: the category of the anteroposterior change in position of the incisors contributed the most, whereas the core discrepancy presented the least percentage in total scores. In ABO-OGS, alignment and marginal ridges contributed the most, whereas interproximal contacts exhibited the least percentage in total scores. CONCLUSIONS: The performance of Andrews' six elements was comparable with that of ABO-OGS in assessing the treatment outcome of patients who completed their orthodontic treatment. Andrews' six elements can be used as a new system for assessing the treatment outcome of patients who completed their orthodontic treatment. It demonstrated particular advantage in controlling facial profile, and had just completed material of patients who completed their orthodontic treatment it can measure. The Andrews' six elements measuring scale is convenient to disseminate and use.

Objective treatment outcome assessment of a completely customized lingual appliance: A retrospective study.

OBJECTIVE: To assess the outcome quality of subjects treated with a completely customized lingual appliance (CCLA) in a postgraduate university program, using the ABO Objective Grading System (OGS), by testing the null-hypothesis of a significant proportion of post-treatment cases exceeding an adjusted 'exam failure' threshold value of OGS=24. MATERIALS AND METHODS: This retrospective single-arm study included 66 consecutively debonded CCLA cases (m/f 19/47; mean age: 25.1±9 years) treated at Hannover Medical School (MHH, Hannover, Germany). The discrepancy index (DI) was assessed on initial plaster casts. The OGS of the cast-radiograph evaluation was scored for both set-up and post-treatment casts, including the seven components of alignment/rotation, marginal ridges, buccolingual inclination, overjet, occlusal contacts, occlusal relationships and interproximal contacts, to parameterize differences between those. RESULTS: DI score distribution (≥20, <20) was 25 (37.9%)/41 (62.1%) subjects. Mean initial DI was 17.3±8.5. Mean set-up OGS was 10.4±4.4 (min-max: 3-21), mean final OGS was 17.7±5.9 (min-max: 7-33), and the difference 7.3 (post-treatment - set-up) was statistically significant (p<0.0001; 95% CI [5.8, 8.7]). The null-hypothesis was rejected: A statistically significant proportion of the final casts (n=58; 87.8%) scored below OGS=24 by exact binomial test (P<0.0001; 95% CI [77.5%, 94.6%]). The rate of a final OGS score<24 was not significantly different (P=0.98) between both DI (≥20, <20) groups. CONCLUSIONS: The outcome quality of the CCLA treatment in this postgraduate university setting was high and therefore sufficient for a vast majority of treated cases to pass the ABO-OGS clinical examination.

Evaluating a new objective grading software for conjunctival hyperaemia.

BACKGROUND/ AIMS: Standardised numeric grading scales are used in ophthalmic practice to improve consistency between clinicians in recording the severity of ocular conditions and to facilitate the monitoring of such changes. We investigated the intra- and inter-observer grading reliability and the agreement between subjective Cornea and Contact Lens Research Unit (CCLRU) and Efron grading scales as well as a new Advanced Ophthalmic Systems (AOS) software which uses an objective approach to grading conjunctival hyperaemia. METHODS: One experienced observer graded n = 30 bulbar and n = 26 palpebral conjunctival hyperaemia images to 0.1 increments. Masked grading of randomised images was undertaken for all three methods, on two separate occasions. The agreement within and between the grading methods was assessed between sessions, and compared to the results of a novice observer. RESULTS: There were no statistically significant differences (P > 0.05) between test and retest values. However, repeatability in the grading estimates of both bulbar and palpebral conjunctival hyperaemia was improved using the AOS grading method (R2 = 0.998; Coefficient of Repeatability CoR 0.10-0.13), compared to Efron (R2 = 0.926; CoR 0.62) and CCLRU (R2 = 0.885-0.911; CoR 0.50-0.78). Intraclass coefficient correlations (ICC) improved inter-observer agreement using objective (> 0.995) versus subjective methods (0.853-0.959). CONCLUSION: These subjective and objective grading methods are not interchangeable. Due to the excellent repeatability and improved agreement between experienced and novice observers, the objective grading method provides a more consistent approach when grading ocular abnormalities and may achieve greater reliability in record keeping and clinical monitoring in the future.

The Herbst appliance combined with a completely customized lingual appliance: A retrospective cohort study of clinical outcomes using the American Board of Orthodontics Objective Grading System.

OBJECTIVES: In this retrospective study we aimed to evaluate the quality of treatment outcomes using the American Board of Orthodontics (ABO) scoring system with a completely customized lingual appliance used in combination with a Herbst appliance for Class II correction. MATERIALS AND METHODS: Patient selection criteria for this study were Class II division 1, II/2 or subdivision treated with a WIN® lingual appliance combined with an L-pin Herbst device. Thirty-two consecutively debonded cases were included in this retrospective case series. Pre- and post- treatment dental casts, dental set-ups, panoramic X-rays, cephalometric analysis, photographs and clinical files were available for data collection. The primary outcome was the ABO score based on the Discrepancy Index (ABO DI) including: overjet, overbite, anterior open bite, lateral open bite, crowding, occlusion (Angle class), lingual posterior crossbite, buccal posterior crossbite, ANB, IMPA and SN-GoGN angles and the Cast-Radiograph Evaluation (ABO CR-Eval) comprising of alignment/rotations, marginal ridges, buccolingual inclination, overjet, occlusal contacts, occlusal relationship (Angle class), interproximal contacts and root angulation. In addition, overjet, overbite and Class II correction were also evaluated on pre- and post-treatment models. The secondary outcome was bracket failure and complications related to the Herbst device. RESULTS: The study cohort included 18 female and 12 male patients with a mean age of 15.8 (range 12, 6- 18, 5). Twenty patients were Class II division 1 and ten were Class II division 2. The mean pre-treatment value of ABO DI was 20.8 (range 10-39); more than two-thirds of the sample were rated as being either of moderate difficulty (ABO DI: 16-24) or severe (ABO DI: over 25). The average post-treatment ABO Cast-Radiograph Evaluation score was 15.0 (SD=4.4), which is considered a passing score. Twenty-six patients had a score equal or lower than 20 (undisputed passing score). The Class II discrepancy was effectively corrected from a score of 16.83 penalty points (SD: 3.65) pre-treatment to a score of 1.57 (SD: 1.70) post-treatment. No association was found between initial and final Class II occlusal relationships (P=0.42), indicating that regardless of the initial discrepancy, no difference in the success of Class II correction was observed. The mean bracket failure rate was 3.8 per patient. Herbst related complications were few: 1.6 per patient, with the majority of complications being of little consequence and with 43% of the patients having no breakages. CONCLUSION: The completely customized lingual appliance assessed in this study combined with an L-pin Herbst led to effective Class II correction regardless of the initial severity of the sagittal discrepancy. The average ABO CR-Eval score for this sample was well below the undisputed passing score indicating a high quality of treatment outcomes.

Validation of the objective assessment of facial movement with a new software-based system.

BACKGROUND: Most used subjective Unilateral Peripheral Facial Palsy (UPFP) grading systems are characterized by high variability and low reproducibility and doesn't allow a separate evaluation of single facial regions. OBJECTIVE: To assess the reliability of a new objective method for classification of UPFP, comparing it with House-Brackmann (HB) and Sunnybrook facial grading (SFGS) systems. METHOD: Forty-seven patients affected by UPFP of different HB grade were included. Each patient underwent a blinded examination by three different operators, via the two subjective methods (HBGS and SFGS) and a newly proposed objective one, that was obtained from a digital video-analysis, named SMART FACIAL system. Results were converted by validated conversion scales into HBGS grades and statistically compared. RESULTS: In 87,23% (n° 41 pts) consistency was found between the grades obtained with all the three evaluation methods; in 10,41% (n°5 pts), between HBGS and SFGS grade and in 2,08% (n°1 pt) between HBGS grades and SMART-FACIAL system. Statistical analysis showed significant correlation among the three systems (p < .000). CONCLUSIONS: The SMART FACIAL system presents high reliability also in comparison with the most frequently used subjective methods. SIGNIFICANCE: This method represents a fast, simple and thorough way to analyze UPFP, especially during physical rehabilitation.

Treatment outcome differences between pass and fail scores and correlation between cephalometric changes and cast-radiograph evaluation of the American Board of Orthodontics.

OBJECTIVE: Using the cast-radiograph evaluation (CRE) score of the American Board of Orthodontics (ABO), the purpose of this study was 1) to find the post-treatment discrepancies that contributed to low-quality outcomes and 2) to identify if there might be any correlation between cephalometric changes and post-treatment discrepancies. MATERIALS AND METHODS: About 200 records submitted for the Thai Board of Orthodontics examination were analyzed. Overall, 23 parameters of the CRE scores and 12 cephalometric changes were collected. Based on the total CRE score, the cases were classified into three categories: pass (score <20), undetermined (score 20-30), and fail (score >30). Kruskall-Wallis was used to analyze the differences of mean CRE scores among these three categories. In addition, the cases were further classified into fixed appliance, two-phase and orthognathic surgery groups. Correlation tests were carried out to determine if there might be any association between cephalometric changes and CRE parameters. RESULTS: Significant differences of mean CRE scores were found for all CRE components except interproximal contacts. Significant correlation coefficients with the total CRE scores were found for all parameters except interproximal contacts. Significant moderate association was found between lower incisor changes and CRE scores in the two-phase and orthognathic surgery group. CONCLUSIONS: In order to improve treatment outcome quality, the top four parameters that orthodontists should pay attention to are occlusal contacts, occlusal relationship, marginal ridges, and alignment and rotations. Cephalometric changes were not suitable as weighting factors for total CRE scores.

Curative effect evaluation by using Andrews' six elements for completed orthodontic treatment cases / 华西口腔医学杂志

OBJECTIVES@#To assess the treatment outcome of patients who completed their orthodontic treatment by using Andrews' six elements and the American Board of Orthodontic (ABO) objective grading system (OGS); to determine whether Andrews' six elements can be used as a new assessment system for patients who completed their orthodontic treatment.@*METHODS@#A total of 160 patients who completed their orthodontic treatment were included in the study. The participants were randomly selected from patients who completed their orthodontic procedures in Kunming Medical University Affiliated Stomatological Hospital during the period of 2015 to 2019. The retrospective completed cases were examined in accordance with the Andrews' six elements and ABO measuring scales. Scores were assigned to each tooth in each category. All the measurement items in both evaluation criteria, the composite category score, and the total score were calculated. The passing and potential passing rates of the completed cases were compared with two measuring scales via the Chi-square test.@*RESULTS@#The passing rate for the evaluation of cases by using the Andrews' six elements measuring scale was 83.8%, and that for the evaluation of cases by using the ABO measuring scale was 86.3%. The differences in achieving the standard between the cases of Andrews' six elements and ABO-OGS via the Chi-square test were statistically insignificant (@*CONCLUSIONS@#The performance of Andrews' six elements was comparable with that of ABO-OGS in assessing the treatment outcome of patients who completed their orthodontic treatment. Andrews' six elements can be used as a new system for assessing the treatment outcome of patients who completed their orthodontic treatment. It demonstrated particular advantage in controlling facial profile, and had just completed material of patients who completed their orthodontic treatment it can measure. The Andrews' six elements measuring scale is convenient to disseminate and use.

Predicted and actual end-of-treatment occlusion produced with aligner therapy.

OBJECTIVE: To compare three-dimensional (3D) ClinCheck™ models with the subjects' actual 3D posttreatment models using the American Board of Orthodontics Objective Grading System (OGS). MATERIALS AND METHODS: This prospective, within-subject study included 27 consecutive cases treated with aligner therapy. The posttreatment plaster models taken immediately after treatment were scanned and converted to stereolithography (STL) files; the ClinCheck models were also converted to STL format. MeshLab software was used to measure the seven components of the OGS, including alignment, marginal ridges, buccolingual inclinations, occlusal contacts, occlusal relationships, overjet and interproximal contacts. An overall OGS deduction score was also calculated. RESULTS: Compared with the posttreatment models, the ClinCheck models showed significantly (P  =  .016) fewer overall OGS point deductions (24 vs 15). These overall differences were due to significantly (P < .05) more deductions among the posttreatment models than the ClinCheck models for alignment (4.0 vs 1.0 deductions), buccolingual inclinations (4.0 vs 3.0 deductions), occlusal contacts (3.0 vs 2.0 deductions), and occlusal relations (4.0 vs 2.0 deductions). CONCLUSION: The ClinCheck models do not accurately reflect the patients' final occlusion, as measured by the OGS, at the end of active treatment.