Is motor-driven insertion of orthodontic miniscrews more advantageous than manual insertion? A micro-CT evaluation of bone miniscrew contact surface area and cortical microcracks in rabbits.

AIM: This in vitro study aimed to evaluate and compare the bone-miniscrew contact surface area (BMC) and the cortical bone microcracks (CM) resulting from manual (hand-driven) and automated (motor-driven) orthodontic miniscrew (OM) insertion methods. METHODS: Thirty-three OM were inserted in the femurs of nine New Zealand rabbits using manual (n = 16) and automated (n = 17) insertions. After euthanizing the rabbits, bone blocks, each including one OM, were sawed. Micro-CT scanning was performed, and data analysis included reconstruction, binarization and quantification of morphometric parameters of BMC and the number and length of CM. Means and standard deviations for complete BMC, complete BMC proportion, cortical BMC, cortical BMC proportion, and length and number of CM were calculated. Mixed model analysis was used to adjust for more than one sample/CM per animal. A paired t-test was used to compare the number of CM between the two groups. RESULTS: Compared to the automated insertion, manually inserted miniscrews had significantly lower complete BMC (7.54 ± 1.80 mm2 vs. 11.99 ± 3.64 mm2), cortical BMC (5.91 ± 1.48 mm2 vs. 8.48 ± 1.90 mm2) and cortical BMC proportion (79.44 ± 5.84% vs. 87.94 ± 3.66%). However, it was not statistically significant in complete BMC proportion (p = .052). The automated insertion also resulted in a significantly lower mean number of CM than the manual method (p = .012). However, the length of the cracks was shorter in the manual group but with no significant difference (p = 0.256). CONCLUSION: Motor-driven OM insertion results in superior BMC and reduction in the number of CM, which may lead to better miniscrew stability.

Effect of surface treatments on push-out bond strength of calcium silicate-based cements to fiber posts.

BACKGROUND: To evaluate the effect of surface treatments on the push-out bond strength of Biodentine (BD) and white mineral trioxide aggregate (WMTA) to fiber posts. METHODS: Two brands of fiber posts were used: Reblida post; RP and RelyX post; RX. Each type of post (n = 80/group) was divided into four groups (n = 20/group) and exposed to surface treatment as follows: Control (no treatment), sandblasting (SB), hydrofluoric acid (HF), and TiF4 4 wt/v%. Each group was further subdivided into two subgroups (n = 10/subgroup) based on the type of CSCs used as follows: Subgroup A: BD and Subgroup B: WMTA. Push-out bond strength of BD and WMTA to glass fiber posts was assessed. Data were statistically analyzed using three-way ANOVA and Tukey's test. A Weibull analysis was performed on the push-out bond strength data. RESULTS: BD showed higher bond strength than WMTA (P < 0.001). The push-out bond strength for posts treated with TiF4 4 wt/v% showed greater bond strength than the other surface treatments (P < 0.05). The BD/RP-TiF4 4 wt/v% showed the greater characteristic bond strength (σ0) (15.93) compared with the other groups. Surface treatments modified the surface topography of glass fiber posts. CONCLUSIONS: The BD/RP-TiF4 4 wt/v% showed greater bond strength compared with the other groups. The TiF4 4 wt/v% surface treatment enhanced the bond strength of BD and WMTA to glass fiber posts than the other treatments. Surface treatment of fiber post with TiF4 4 wt/v% could be used to improve the bond strength with calcium silicate-based cements.

Pulp volume changes after piezocision-assisted tooth movement: a randomized clinical trial.

BACKGROUND: Orthodontic treatment may result in undesirable side effects, such as root resorption and a decrease in the size of the pulp tissue which could be associated with the duration of the orthodontic treatment. Piezocision-assisted tooth movement was introduced as a minimally invasive surgical procedure to shorten orthodontic treatment time. This prospective randomized clinical trial was aimed to compare the pulp volume changes of maxillary anterior teeth after en-masse retraction with or without piezocision-assisted orthodontics. METHODS: Patients who required orthodontic treatment with bilateral maxillary first premolar extractions and en-masse retraction were recruited. Patients were randomly divided into extraction with piezocision, or only extraction, serving as controls. Pulp volume and root length changes of the maxillary six anterior teeth were measured and compared between the two groups using a 3-Dimensional analytical software. Paired and independent sample t-tests were used to compare within and between groups. Bivariate correlation was done between the mean change in pulp volume and its corresponding root length. The significance level was set at α = 0.05. RESULTS: A total of 23 patients were included, 12 in the piezocision, and 11 in the control group. At the end of the en-masse retraction phase, (mean = 122.74 ± 3.06 days) pulp volume was significantly decreased in all six anterior teeth in both groups (P < 0.01). The decrease in pulp volume was not statistically different between both groups, (P > 0.05). There was a statistically significant but moderate correlation only between the pulp volume change of the right canine and its root length, r = 0.44, P = 0.034. CONCLUSIONS: The effect of piezocision-assisted orthodontic tooth movement on the pulp volume was comparable to the conventional orthodontic treatment. The degree of change in pulp volume does not appear to be related to the amount of root resorption. Trial registration NCT03180151. Registered December 25, 2016, retrospectively registered, https://clinicaltrials.gov/ct2/show/record/NCT03180151 .

RF Energy Harvesting IoT System for Museum Ambience Control with Deep Learning.

Museum contents are vulnerable to bad ambience conditions and human vandalization. Preserving the contents of museums is a duty towards humanity. In this paper, we develop an Internet of Things (IoT)-based system for museum monitoring and control. The developed system does not only autonomously set the museum ambience to levels that preserve the health of the artifacts and provide alarms upon intended or unintended vandalization attempts, but also allows for remote ambience control through authorized Internet-enabled devices. A key differentiating aspect of the proposed system is the use of always-on and power-hungry sensors for comprehensive and precise museum monitoring, while being powered by harvesting the Radio Frequency (RF) energy freely available within the museum. This contrasts with technologies proposed in the literature, which use RF energy harvesting to power simple IoT sensing devices. We use rectenna arrays that collect RF energy and convert it to electric power to prolong the lifetime of the sensor nodes. Another important feature of the proposed system is the use of deep learning to find daily trends in the collected environment data. Accordingly, the museum ambience is further optimized, and the system becomes more resilient to faults in the sensed data.

Impact of Dental Visits on Oral Health Awareness in Saudi Arabia.

AIM: The aim of this study is to assess the impact of dental visits on oral health awareness among the Saudi population. MATERIALS AND METHODS: A cross-sectional survey was conducted in Saudi Arabia. An online self-administered questionnaire was distributed from January 2011 to June 2013. The questionnaire consisted of 21 multiple choice questions which was categorized into four: demographic data, dental care status, oral hygiene behavior, and oral health knowledge (OHK). Responses to the questions in the OHK category were grouped and scored according to their percentage of correct answers: 1 = very poor (0 to <25% correct), 2 = poor (25% to <50% correct), 3 = acceptable (50 to <75% correct), and 4 = good (75-100% correct). The sample was divided based on dental visit behavior into poor, average, and good dental visitors. Descriptive statistics, group comparisons, correlations, and linear regressions were conducted using SPSS (V16.0). A significance was set at p < 0.05. RESULTS: A total of 845 participants were included: 73.4% were females, 85.1% were older than 19 years, 76.9% had a college-level education, and 75.3% were from western Saudi Arabia. A total of 14.1% were poor dental visitors, 67.5% were average dental visitors, and 18.5% were good dental visitors. The good dental visitor group showed significantly better results than the other two groups in terms of dental services received, brushing habits, interdental cleansing habits, use of miswak, and OHK (p < 0.05). The best predictors with significant but weak effects on dental visit habits were brushing habits, interdental cleansing habits, use of miswak, and OHK (F(8,836) = 7.212, R2 = 0.065, p < 0.0001). CONCLUSION: Dental visits were significantly correlated with OHK. However, the impact of dental visits on oral health awareness was found to be weak. CLINICAL SIGNIFICANCE: Well-designed preventive and educational dental visit programs need to be widely implemented as part of the governmental oral health plans.

Zein based magnesium oxide nanoparticles: Assessment of antimicrobial activity for dental implications.

MgO nanoparticles have been recently discovered as an antibacterial, however, they limited by property degradation due to agglomeration. The addition of a coating agent, such as a zein polymer, is effective in preventing agglomeration without affecting nanosized properties. The aim of this study was to assess the antimicrobial property of MgO nanoparticles when coated with a zein polymer against several oral bacteria and fungi. This was done by utilizing various assessment techniques. The ultimate aim is to use these nanoparticles in dental preparations. The antimicrobial activity of zein-coated MgO nanoparticles at different concentrations of 0.5, 1 and 2% were tested against four different microorganisms: Staphylococcus aureus, Streptococcus mutans and Enterococcus faecalis (gram positive bacteria), and Candida albicans (as oral fungus). Two different techniques were utilized: the Kirby-Bauer test, and a modified direct contact test. The results indicated that the antibacterial effect of 1% or 2% zein-coated MgO nanowires were statistically significant (p<0.05) against the four organisms studied: S. mutans, S. aureus, E. faecalis and C. albicans. Zein-coated MgO nanoparticles are a new human friendly and potent antimicrobial agent that can be incorporated in the formulation of a variety of new dental materials and products that should provide improvements in dental care and oral health.

Controlled release of injectable liposomal in situ gel loaded with recombinant human bone morphogenetic protein-2 for the repair of alveolar bone clefts in rabbits.

BACKGROUND AND OBJECTIVE: The aim of the present study was to develop and examine a new non-invasive injectable graft for the repair of alveolar bone clefts using recombinant human bone morphogenetic protein-2 (rhBMP-2) encapsulated within injectable liposomal in situ gel (LIG). METHOD: Different liposomal formulations loaded with rhBMP-2 were prepared, and the effects of the preparation methods and lipid content on the efficiency of rhBMP-2 encapsulation within the liposomes were studied. For the preparation of in situ gel, deacetylated gellan gum (DGG) was used, and the in vitro gelation characteristics of the gel were evaluated. In vivo pharmacokinetics and histology were also assessed. Critical size alveolar defects were surgically created in the maxillae of 30 New Zealand rabbits and treated with different injectable formulae, including rhBMP-2 liposomes and in situ gel (rhBMP-2-LIG). RESULTS: The results indicated that the prepared rhBMP-2-LIG prolonged the release and residence time of BMP-2 within rabbits for more than 7 days. Histomorphometric assessment showed 67% trabecular bone filling of the defects treated using this novel formula. CONCLUSION: BMP-2-LIG is a promising delivery device for the repair of alveolar bone defects associated with cleft deformities.

Corrigendum to "Correction of a Class III Malocclusion with a Functional Shift and Severe Crowding".

[This corrects the article DOI: 10.1155/2020/8867130.].

Characterization of a novel enamel sealer for bioactive remineralization of white spot lesions.

OBJECTIVES: 45S5 Bioglass is a bioactive glass capable of releasing ions that can interact with dental hard tissues. The current study aimed at examining the effectiveness of 45S5 Bioglass in remineralizing enamel white spot lesion (WSL) as well as its effect on the bond strength of orthodontic brackets bonded to demineralized enamel. MATERIALS AND METHODS: WSLs were induced in the buccal surfaces of 135 human extracted teeth by storage in acid solution pH 4.5 for four days. The specimens were then equally divided into three groups; Demineralized group, Bioglass group (BG), and control group (intact enamel). The groups were chemically analyzed using (FTIR/ATR) Fourier-transform infrared spectroscopy/attenuated total reflectance, (XRD) X-ray diffraction, and (SEM/EDS) scanning electron microscope equipped with electron-dispersive-spectroscopy. Moreover, 10 specimens from each group were tested using Transverse Micro Radiography (TMR) technique, and 15 specimens from each group were bonded with metal orthodontic brackets and tested for shear bond strength test (SBS). The data were analyzed statistically using One way ANOVA p < 0.05. RESULTS: TMR study showed that bioglass group samples recorded lesion depth of 70.19 ± 29.21 µm and Δ Z (mineral loss) 732.15 ± 210.16 vol% µm which was significantly lower than the demineralized specimens having lesion depth of 115.75 ± 19.98 µm and Δ Z (mineral loss) 3472.69 ± 738.38 vol%µm, moreover, bioglass specimens recorded 14.15 ± 2.35 Mpa which was significantly higher than demineralized specimens 6.82+1.83 Mpa but less than the control specimens 20.5 + 6.1 MPa (p < 0.05). FTIR/ATR, XRD, and SEM/EDS tests showed that bioglass paste formed a layer of brushite crystals onto the treated enamel surface. CONCLUSION: 45S5 bioglass paste may serve as an effective remineralizing agent for demineralized enamel.

In vitro Investigation of the Antimicrobial Activity of Mouth Washes Incorporating Zein-Coated Magnesium Oxide Nanoparticles.

PURPOSE: This in vitro study was undertaken to investigate the antimicrobial effect of distinctive oral mouth washes after the addition of zein-coated (Magnesium oxide) MgO nanoparticles on exemplary of some oral microorganisms. MATERIALS AND METHODS: Three hundred and twelve samples were used in this study. A set of five concentrations of MgO nanoparticles with zein and without zein-coating were incorporated into three oral mouth washes: Listerine zero, Listerine total control and Oral B in the mass percentages of 0.3%, 0.5%, 1%, 2%, 5% and 10%, in addition to controls with no MgO nanoparticles. The antimicrobial effect of three mouth washes with variable concentrations of MgO was tested against the following organisms: Staphylococcus aureus, Streptococcus mutans, Enterococcus faecalis and Candida albicans using the disc diffusion test (DDT) and direct contact test (DCT). Data were analyzed using one-way ANOVA statistical test. RESULTS: The tested mouthwashes with zein-coated MgO nanoparticles showed significant differences of antimicrobial activity on S. mutans, S. aureus, E. faecalis, and C. albicans in the disc diffusion test. While in the DCT, all tested mouthwashes with MgO nanoparticles with and without zein coating showed antimicrobial activity on all tested microorganisms. CONCLUSION: Zein-coated MgO nanoparticles may be considered as a potential antimicrobial agent when added to oral mouthwashes. Future analysis, including in vivo studies, is required in order to incorporate zein/MgO nanoparticles into oral mouthwashes that may improve its antibacterial property.

Association of orthodontic treatment needs and oral health-related quality of life in young adults.

INTRODUCTION: Our objective was to assess the effect of different orthodontic treatment needs on the oral health-related quality of life of young adults. METHODS: The study sample comprised 366 young adult orthodontic patients (153 men, 213 women; age range, 21-25 years). Each participant was assessed for orthodontic treatment need and oral health-related quality of life by using the dental health component of orthodontic treatment need index and the shortened version of oral health impact profile questionnaire. RESULTS: Orthodontic patients who had little or no, borderline, and actual need for orthodontic treatment represented 14.8%, 56%, and 29.2% of the total sample, respectively. Orthodontic treatment need significantly affected mouth aching, self-consciousness, tension, embarrassment, irritability, and life satisfaction in both sexes. Also, orthodontic treatment need significantly affected taste and relaxation in both men and women. However, pronunciation and the ability to do jobs or function effectively were not significantly associated with orthodontic treatment needs in either sex. CONCLUSIONS: These findings emphasize the impact of malocclusion on oral health-related quality of life of young adults.

Nonextraction Management of Severely Malaligned and Constricted Upper Arch.

This case report presents the treatment of a 12-year-old female with a severely crowded upper arch, severely palatally displaced upper premolars and lateral incisors, large midline diastema, lower midline deviation to the right, class III dental and skeletal relationships due to mild maxillary deficiency, retroclined lower incisors, straight profile, and retrusive lips. A nonextraction treatment approach is described, in which the upper and lower arches were expanded to their original three dimensions using a trihelix expander, a lip bumper appliance, and a fixed orthodontic appliance. Retention was also planned in accordance with the original malocclusion, which inclued a full-time-wear upper wraparound retainer, upper and lower anterior fixed lingual retainers, upper frenectomy, and fibrotomy for rotated teeth. Conclusion. Severe malalignment of teeth does not necessarily require extraction treatment. Gaining space is an art that requires a proper assessment of the anteroposterior and transverse dimensions of alveolar arches, lip prominence, and postorthodontic stability.

Oral Health-Related Quality of Life of Saudi Young Adults with Vertical Discrepancies in Occlusion.

BACKGROUND: Malocclusion is one of the most common oral health problems that affects quality of life. It is important to understand how different types of malocclusion can affect the oral health-related quality of life (OHRQoL). Vertical discrepancy in occlusion is highly prevalent, yet there are no studies evaluating its impact on OHRQoL in the Saudi population. Therefore, in this study, we aim to investigate the impact of vertical discrepancy in occlusion on patients' OHRQoL. PATIENT AND METHODS: A cross-sectional evaluation of 109 patients with open and deep bites who attended the orthodontics screening clinic at King Abdulaziz University Dental Hospital was carried out. The OHRQoL of each participant was assessed using the shortened, Arabic-version of the oral health impact profile-14 questionnaire. Chi-squared and Fisher's exact tests were used for analysis. RESULTS: The findings indicated a statistically significant association between anterior vertical discrepancy in occlusion and embarrassment (p = 0.001), followed by being self-conscious about their appearance, discomfort while eating (p = 0.009), generalized mouth aching (p = 0.012), and speech problems (p = 0.049). This Impact was significantly higher in participants with open bites. Regarding gender variables, female patients were found to be significantly more embarrassed (p = 0.005), while male patients were more self-conscious (p = 0.018). CONCLUSION: Vertical discrepancy in occlusion has a negative impact on OHRQoL and its domains in both genders. The negative impact is highlighted in the psychological disability, psychological discomfort, physical pain, and functional limitation domains.

Effect of piezocision corticotomy on en-masse retraction.

OBJECTIVES: To compare the amount of en-masse retraction with or without piezocision corticotomy, to assess the type of tooth movement, to evaluate root integrity after retraction, and to record reported pain levels. MATERIALS AND METHODS: This randomized, controlled clinical trial included 26 orthodontic patients requiring premolar extraction. The patients were divided into two groups: (1) an extraction with piezocision corticotomy group (PCG) and (2) an extraction-only group, which served as the control group (CG). Cone-beam computed tomography images were acquired before and 4 months after the initiation of en-masse retraction utilizing miniscrews. The following variables were assessed: the amount of en-masse retraction, incisor inclination, incisor and canine root resorption, and patient-reported pain. RESULTS: Twelve and 11 participants completed the entire study in the PCG and CG, respectively. The amount of en-masse retraction was significantly greater in the PCG compared to the CG (mean = 4.8 ± 0.57 mm vs 2.4 ± 0.33 mm, respectively [P < .001]). There was also significantly less tipping and root resorption of incisors in the PCG (P < .05). The reported pain was significantly higher on the first day in the PCG compared to the CG (P < .001); however, it became similar between the groups after 24 hours. CONCLUSIONS: Piezocision corticotomy enhanced the amount of en-masse retraction two times more with less root resorption. However, future studies are required to assess the long-term effects of this technique.

Relationship between blood-spot insulin-like growth factor 1 levels and hand-wrist assessment of skeletal maturity.

INTRODUCTION: Accurate prediction of the timing of the pubertal growth spurt and the amount of remaining growth are factors that affect treatment decisions in orthodontics, orthognathic surgery, and dental implantology. For many years, medical and dental professionals have considered hand-wrist radiographs the method of choice for the assessment of skeletal maturity. Insulin-like growth factor 1 (IGF-1) mirrors growth hormone levels and is used by endocrinologists to diagnose growth hormone disturbances. METHODS: The objective of this study was to establish a relationship between IGF-1 levels collected from blood-spot samples and hand-wrist radiographs at various skeletal stages. Eighty-four subjects (45 female, 39 male) between the ages of 5 and 25 were included in the study. Each subject had personal information, a hand-wrist radiograph, and a blood-spot sample collected on the same day. RESULTS: The IGF-1 levels were highest at the hand-wrist skeletal stages that were previously associated with the greatest amount of mandibular growth. These levels were significantly higher than at prepubertal and postpubertal stages. In the postpubertal group, the IGF-1 levels were lower as the subjects' ages increased and they moved away from the onset of puberty. CONCLUSIONS: Longitudinal data are necessary to confirm the usefulness of this technique in predicting the timing, the intensity, and the end of the growth spurt.

Nonsurgical Orthodontic Intervention of a Severe Class II Case Accompanied by Posterior Crossbite Using a Miniscrew-Assisted Straight Wire Technique.

Class II malocclusion in nongrowing patients is a great challenge in treatment especially if the degree of malocclusion is severe. In such cases, the use of miniscrews for orthodontic camouflage can produce results comparable to that of orthognathic surgery. This case report presents an adult patient with severe Class II malocclusion combined with bilateral posterior crossbite, deep bite, a crowded lower arch, and a history of extraction of the lower right first molar. The treatment involved upper arch expansion by a quad helix appliance followed by the extraction of the right and left upper 1st premolars. A miniscrew-assisted straight wire technique was used to close the extraction space and reduce the overjet. Lower molar protraction was done to close the previous extraction space in the lower arch. At the end of treatment, overjet was reduced, lower arch crowding was relieved, lip competency was established, and the wide buccal corridor was reduced with a pleasing smile and normal facial proportions.

Protective Effects of Low-Intensity Pulsed Ultrasound on Mandibular Condylar Cartilage Exposed to Mechanical Overloading.

The aim of this study was to assess the effect of low-intensity pulsed ultrasound (LIPUS) application on rat temporomandibular joints (TMJs) with early-stage of osteoarthritis-like conditions induced by mechanical overloading. Fifteen-week-old male Wistar rats were divided into two experimental groups and a control group (n = 10 each). Both TMJs of all rats in one experimental group were subjected to mechanical overloading for 5 d, and those in the other experimental group were exposed to LIPUS for 20 min/d after overloading. Condyles were assessed using micro-computed tomography, histology and histomorphometry. LIPUS treatment attenuated cartilage degeneration, decreased the number of osteoclastic cells and restored the expression of aggrecan after an initial decrease induced by mechanical overloading. These results indicate that LIPUS may have a protective effect on the early progression of TMJ osteoarthritis.

Comparison of vascular response to zotarolimus-eluting stent versus sirolimus-eluting stent: intravascular ultrasound results from ENDEAVOR III.

BACKGROUND: The purpose of this study was to investigate the vascular response of zotarolimus-eluting stent (ZES) and sirolimus-eluting stent (SES) using serial intravascular ultrasound (IVUS). METHODS: Data were obtained from the Endeavor Drug-Eluting Coronary Stent System Versus the Center Siromlimus-Eluting Coronary Stent System in De Novo Native Coronary Artery Lesions (ENDEAVOR) III trial, a randomized study comparing ZES and SES for the treatment of de novo native coronary artery lesions. Serial (baseline and 8-month follow-up) IVUS was available in 258 patients (190 ZES, 68 SES). RESULTS: At 8 months, ZES had greater percentage of neointimal volume index (ZES 1.1 +/- 0.8 mm3/mm vs SES 0.2 +/- 0.1 mm3/mm, P < .01), resulting in smaller lumen volume index (6.0 +/- 2.0 mm3/mm vs 7.0 +/- 2.1 mm3/mm, P < .05). Zotarolimus-eluting stents showed larger IVUS-detectable neointimal coverage over stent surface (50.2% vs 10.5%, P < .01) and greater mean neointimal thickness (0.19 +/- 0.07 mm vs 0.10 +/- 0.06 mm, P < .01). Zotarolimus-eluting stents had a significantly lower incidence of late-acquired incomplete stent apposition. CONCLUSIONS: Zotarolimus-eluting stent is associated with a significantly greater amount of neointimal hyperplasia compared with SES. This amount of hyperplasia in ZES is distributed throughout the stent at 8-month follow-up.

Effect of anterior crowding or spacing on oral health-related quality of life: a cross-sectional study.

INTRODUCTION: Oral health-related quality of life (OHRQoL) involves many aspects such as chewing ability, sleeping, social interactions, self-esteem, and satisfaction with life and oral health. The increasing research interest in OHRQoL began only after the shortcomings of previous approaches of treating symptoms only and neglecting the patient's self-perception were revealed. PATIENTS AND METHODS: The current study design is a cross-sectional study of patients who attended King Abdulaziz University Dental Hospital (Jeddah, Saudi Arabia) and King Saud University Dental Hospital (Riyadh, Saudi Arabia). After obtaining their verbal consent, young adult and adult patients (mean age 25.19±7.29 years old) with anterior spacing or crowding were recruited to participate in the study. They filled the Arabic short version of the oral-health impact profile-14 questionnaire after a clinical evaluation of the severity of their spacing or crowding. Parameters of spacing/crowding severity assessment were as follows: <4, mild; 4-8, moderate; and >8, severe. Data were analyzed using the chi-square test in SPSS statistical package. The level of significance was set to <0.05. RESULTS: The sample size of this study was 308 subjects. Findings indicated a statistically significant (p=0.001) association between anterior spacing malocclusion (ASM) with Q5 "self-consciousness", since 64.2% of patients with ASM reported being self-conscious. Results indicated a statistically significant association between educational level with anterior crowding malocclusion (ACM; p=0.02) and ASM (p=0.01) with Q3 "painful aching". Moreover, findings indicated a statistically significant association (p=0.04) between income and ACM with Q5 "self-consciousness". On the other hand, results showed no significant association between gender with either ACM or ASM. CONCLUSION: This study sheds light on how anterior malocclusion (crowding or spacing) impacts OHRQoL negatively, especially heightening self-consciousness about their appearance. These effects should be addressed by the orthodontist during the course of treatment.

Effectiveness of presurgical nasoalveolar molding therapy on unilateral cleft lip nasal deformity.

OBJECTIVES: To evaluate the effectiveness of pre-surgical nasoalveolar molding (PNAM) in patients with unilateral cleft lip nasal deformities. Methods: This was a retrospective study involving 29 patients with unilateral cleft lip and palate defects, of whom 13 were treated with palatal devices with nasal stents (PNAM group) and 16 were treated with palatal devices without nasal stents or surgical tapes (control group). Submental oblique photographs and orthodontic models were longitudinally obtained at the initial visit (T1) and immediately before (T2) and  after cheiloplasty (T3). Asymmetry of the external nose, degree of columellar shifting, nasal tip/ala nose ratio, nasal base angle, interalveolar gap, and the sagittal difference in the alveolar gap were measured. The study was conducted in the Orthodontic Clinic at Tokushima University Hospital, Tokushima, Japan between 1997 and 2012. Results: At T1, there were no significant intergroup differences in the first 4 asymmetry parameters. At T2, the PNAM group showed a significant improvement in all values compared to the control group. At T3, the PNAM group showed significant improvement in nasal asymmetry and columellar shifting. Model analysis showed significantly greater changes in the inter-alveolar gap and the sagittal difference of the alveolar cleft gap from T1 to T2 in the PNAM group. Conclusion: The use of PNAM is indispensable for pre-surgical orthodontic treatment at the early postnatal age.