Three-dimensional analyses of palatal morphology and its relation to upper airway area in obstructive sleep apnea

Objective:To evaluate the relationship between palatal morphology and pharyngeal airway morphology in patients who have obstructive sleep apnea (OSA) and compare with a nonsnoring and nonapneic control group.Materials and Methods:Three-dimensional maxillary dental cast measurements from 25 OSA patients (6 women, 19 men) with a mean age of 41.5 (4.8) years, and 25 control group participants (14 women, 11 men) without any symptom of OSA with a mean age of 38.3 (3.7) were correlated with an analysis of pharyngeal area evaluated with lateral cephalograms. Intermolar and intercanine widths and palatal volumes were calculated on the dental casts, and the upper airway area measurements were performed on lateral cephalograms.Results:OSA patients had smaller oropharyngeal volume and upper airway when compared with controls (P < .001). Palatal area measurements were significantly smaller in OSA (P < .001). OSA patients had significantly narrower maxilla with smaller intermolar and intercanine widths (P < .001). A positive correlation was found between the palatal morphology and pharyngeal dimensions.Conclusions:A significant correlation exists between palatal morphology and pharyngeal airway.     

Dental arch size and shape after maxillary expansion in bilateral complete cleft palate: A comparison of three expander designs

Objective:The objective of this study was to compare the effects on upper dental arch size and shape after maxillary expansion with Hyrax, Quad-helix, and a differential opening expander in bilateral cleft lip and palate (BCLP) patients.Materials and Methods:Seventy-five BCLP patients were divided into three groups: Hyrax (H), Quad-helix (QH), and Expander with differential opening (EDO). Digital models were obtained before (T1) and after 6 months (T2) of maxillary expansion. Twelve landmarks were placed by one investigator on T1 and T2 dental models of each group, and x,y coordinates for each landmark were collected. For dental arch size analysis, centroid size of each dental arch at T1 and T2 was calculated from raw coordinates and was used as the measure of size. Procrustes Analysis was performed for dental arch shape analysis. Analysis of variance was used to compare the groups for size and shape differences (P < .05).Results:There were no significant dental arch size differences among the expanders at T1 or T2. Differences in arch shape were found between all groups at T2. Intragroup arch shape showed a significant variation for the QH and EDO groups. while it remained stable in the H group.Conclusions:Both the QH and the EDO create dental arch shape changes with greater intercanine than intermolar increase. The H does not change the dental arch shape.     

Orthopedic outcomes of hybrid and conventional Hyrax expanders:: Secondary data analysis from a randomized clinical trial

ObjectivesTo compare the effects of a hybrid miniscrew-supported expander versus a conventional Hyrax (CH) expander in growing patients.Materials and MethodsForty patients were randomized into two groups: a hybrid Hyrax (HH) expander group using a Hyrax expander with two miniscrews and a CH expander group. The final sample had 18 subjects (8 female, 10 male; initial age of 10.8 years) in the HH group and 14 subjects (6 female, 8 male; initial age of 11.4 years) in the CH group. Cone-beam computed tomography examinations and digital dental models were obtained before expansion and 11 months postexpansion. The primary outcomes included the orthopedic transverse effects of expansion. Intergroup comparison was performed using analysis of covariance (P < .05).ResultsSignificantly greater increases in the nasal cavity width, maxillary width, and buccal alveolar crest width were found for the HH group. No intergroup differences were observed for dental arch width or shape changes.ConclusionsThe HH group showed greater increases in the nasal cavity width, maxillary width, and buccal alveolar crest width. No differences were observed for intermolar, interpremolar, or intercanine widths; arch length; or arch perimeter. Arch size and shape showed similar changes in both groups.     

Three-dimensional nasal septum and maxillary changes following rapid maxillary expansion in patients with cleft lip and palate:: A case-series analysis

ObjectivesTo determine the three-dimensional changes of the nasal septum (NS), alveolar width, alveolar cleft volume, and maxillary basal bone following rapid maxillary expansion (RME) in consecutive patients with unilateral cleft lip and palate (UCLP).Materials and MethodsA retrospective investigation was conducted based on the analysis of cone-beam computed tomography (CBCT) data of 40 consecutive patients with UCLP (mean age 11.1 ± 2.2 years). Scans were acquired prior to RME (T0) and after removal of the expander (T1) before graft surgery. A three-dimensional analysis of the effects of RME on the nasal septum, alveolar width, alveolar cleft volume, and maxillary basal bone was performed.ResultsNo changes in the NS deviation were observed following RME (P > .05). Significant increases of the alveolar transverse dimension were found in the anterior (14.2%; P < .001) and posterior (7.7%; P < .001) regions as well as in the volume of the alveolar cleft (19.6%; P < .001). No changes in the basal bone dimensions and morphology were observed (P > .05).ConclusionsFollowing RME, no changes were observed in the NS and maxillary basal bones of patients with UCLP despite the significant gain in the anterior and posterior alveolar width and the increase of the alveolar cleft defect. Clinicians should be aware that maxillary changes following RME in patients with UCLP are restricted to the dentoalveolar region.     

Age-Related Long-Term Posttreatment Occlusal and Arch Changes

Objective:To evaluate differences in long-term postretention changes between adolescents and adults.Materials and Methods:The sample included 96 subjects, 51 adolescents and 45 adults (14.2 ± 0.8 and 21.5 ± 6.8 years of age, respectively, at the end of treatment) retained for 3 years and followed approximately 16 years post treatment, who were randomly selected from two private practices. Prior to treatment, 38 and 58 had Class I and Class II malocclusions, respectively.Results:With the exception of adult midlines, all of the occlusal variables (overjet [0.50–0.77 mm], overbite [0.85–0.95 mm], the maxillary incisor irregularity [0.69–0.80 mm], the mandibular incisor irregularity [0.85–1.50 mm] and the PAR score [0.86–1.92 points]) showed significant increases over time. Adolescents consistently showed greater increases of the occlusal variables than adults, with mandibular incisor irregularity and the PAR index attaining statistically significant (P < .05) levels. Arch length and mandibular intercanine width showed statistically significant decreases over time in both groups; maxillary intercanine and intermolar widths did not change significantly. Overjet increased significantly more in Class II patients than in Class I patients, whereas Class I patients showed significantly greater decreases in mandibular intermolar width than Class II patients.Conclusions:Over the 16-year posttreatment period, adolescents showed significantly greater increases in mandibular incisor irregularity, and the PAR index than adults. Treated Class I patients demonstrated less increase in overjet and greater decreases in mandibular intermolar width than Class II patients.     

Dental archforms in dentoalveolar Class I,II and III

Objective:To test the hypothesis that no differences exist in dental arch dimensions between dentoalveolar Classes I, II, and III, and between male and female subjects, as measured on virtual three-dimensional (3D) models.Materials and Methods:Samples included randomly selected plaster dental casts of 137 white patients (43 Class I, 50 Class II, and 44 Class III) from the Department of Orthodontics, School of Dental Medicine, University of Zagreb, Croatia. Dental models were scanned and digitized using ATOS II SO (“Small Objects”) scanning technology (GOM mbH, Braunschweig, Germany). Eight linear and two proportional measurements were calculated for both upper and lower dental arches.Results:In men, a significant difference in the upper dental arch was present in the incisor region, and in the lower dental arch, differences were found in intercanine and intermolar widths (P < .05). Significant differences were noted between male groups in the upper molar depth dimension (P  =  .022) and in the lower molar and canine depth dimensions (P < .05). Class III males had the greatest lower molar and canine width/depth ratios and the smallest lower canine depth/molar depth ratio. Class III women had wider and shorter mandibular arches when compared with Class I and Class II females.Conclusion:The hypothesis was rejected. The dimensions of the dental arches are related to gender and to dentoalveolar class. Class I and II subjects have similar dimensions of maxillary dental arch, but Class II subjects have a transverse deficit in the mandible. In Class III subjects, the maxillary dental arch is insufficient in transverse and sagittal dimensions, and the mandibular arch dominates in the transverse but not in the sagittal dimension.     

Initial growth pattern of children with cleft before alveolar bone graft stage according to cleft type: Unilateral cleft lip and alveolus,unilateral cleft lip and palate,and cleft palate

Objective:To test the null hypothesis that there is no significant difference in the initial growth pattern among three cleft types before alveolar bone graft (ABG) according to cleft type (unilateral cleft lip and alveolus [UCLA], unilateral cleft lip and palate [UCLP], and cleft palate [CP]).Materials and Methods:Samples consisted of the UCLA group, the UCLP group, and the CP group. Individuals were treated with the identical surgical technique by the same surgeon and had no history of orthodontic/orthopedic treatment. Lateral cephalograms taken 1 month before ABG were analyzed using 29 variables. One-way analysis of variance (ANOVA) testing and bivariate and logistic regression analyses were performed.Results:An increasing tendency for Class III relationships in the order of UCLA, UCLP, and CP was noted (ANB, AB-to-facial plane angle, AB-to-mandibular plane angle; P < .001, respectively). UCLP and CP groups demonstrated more posterior positioning of the maxilla (SNA, A-to-N-perp; P < .001, respectively) and a hyperdivergent pattern (gonial angle, SN-GoMe angle, FMA; P < .001, respectively) compared with the UCLA group. Because no differences in palatal plane angle and SN-to-occlusal plane angle were noted among the three groups, the hyperdivergent pattern in the UCLP and CP groups might be due to an innate growth pattern and eventual adaptation of the mandible to maxillary growth. UCLP and CP groups showed more Class III relationships (ANB: P < .05, P < .001, respectively) and a more hyperdivergent pattern (FMA: P < .05, P < .01, respectively) than the UCLA group.Conclusion:When the degree of cleft involvement increases from the primary palate to the secondary palate, the predominance of the Class III relationship and the hyperdivergent pattern increases also.     

Assessment of pharyngeal airway volume in adolescent patients affected by bilateral cleft lip and palate using cone beam computed tomography

Objective:To test the null hypothesis that there were no significant differences for pharyngeal airway volumes between the adolescent patients affected by bilateral cleft lip and palate (BCLP) and well-matched controls using cone beam computed tomography.Materials and Methods:The study sample consisted of 16 patients (11 female and 5 male; mean [SD] age 14.1 [2.1] years) affected by BCLP and 16 patients (10 female and 6 male; mean [SD] age 13.4 [2.0] years) as age- and sex-matched control group. Craniofacial measurements and pharyngeal airway dimension, area, and volume measurements of patients in both groups were calculated and statistically examined using Student''s t-test and multiple linear regression analyses.Results:Statistically significant differences were found between the BCLP and control groups for SNB (P < .05), SN-GoGn (P < .05), Co-A (P < .05), PAS (P < .01), minAx (P < .01), and oropharyngeal airway volume (P < .05). The most predictive variables for oropharyngeal airway volume were found as PAS (r  =  .655 and P  =  .000) and minAx (r  =  .787 and P  =  .000).Conclusions:The null hypothesis was rejected. Oropharyngeal (P < .05) and total (P > .05) airway volumes were found to be less in the BCLP group, and thus the treatment choice in these patients should have positive effects on the pharyngeal airway.     

Skeletal and dental effects of tooth-borne versus hybrid devices for mandibular symphyseal distraction osteogenesis

Objective: To evaluate and compare, retrospectively, the skeletal and dental effects of mandibular symphyseal distraction osteogenesis (MSDO) achieved through the use of tooth-borne versus hybrid distractors.Materials and Methods:Pretreatment (T1), predistraction (T2), postdistraction (T3), and posttreatment (T4) orthodontic records were collected and analyzed for 47 patients (20 tooth-borne, 27 hybrid). At each time point, records included intraoral photographs, study models, postero-anterior cephalometric radiographs, and lateral cephalometric radiographs. Submental vertex radiographs were taken at T2, T3, and T4. Changes in a total of 18 measurements were analyzed to compare patients undergoing tooth-borne versus hybrid distraction.Results:The cumulative effects of orthodontics and MSDO produced similar gains in measured arch widths, with a decreased irregularity index in both groups (P > .05). However, there were differences in the timing during which the expansion was achieved. The hybrid distractor group gained space during the distraction phase of treatment. The tooth-borne group showed greater gains during pre- and postdistraction orthodontics. Comparisons of intercanine and interbone marker widths demonstrated a more parallel separation of bone during distraction with the hybrid distractor (P < .001). Distraction with the tooth-borne distractor was disproportionate, with greater separation of the canines in alveolar bone than of the bone markers in basal bone. During postdistraction orthodontics, the tooth-borne distractor group showed statistically greater increases in measurements.Conclusion:Both skeletal and dental expansion was achieved with both appliances. Greater skeletal expansion was achieved with a hybrid distractor. Greater dental expansion was achieved with a tooth-borne distractor.     

Short- and long-term evaluation of mandibular dental arch dimensional changes in patients treated with a lip bumper during mixed dentition followed by fixed appliances

Objective:To evaluate short- and long-term mandibular dental arch changes in patients treated with a lip bumper during the mixed dentition followed by fixed appliances, compared with a matched control sample.Materials and Methods:Dental casts and lateral cephalograms obtained from 31 consecutively treated patients before (T₀) and after (T₁) lip bumper, after fixed appliances (T₂), and a minimum of 3 years after fixed appliances (T₃) were analyzed. The control group was matched as closely as possible. Arch width, arch perimeter, arch length, and incisor proclination were evaluated. Repeated measures ANOVA was used to analyze changes in measurements over all four time points between treatment and control groups.Results:Arch widths and crowding were always significantly different except at T₂−T₁. At T₁−T₀, only crowding decreased 3.2 mm while intercanine, interpremolar, and intermolar widths increased by 3.8, 3.3, and 3.9 mm, respectively. Changes at T₃−T₂ showed a significant decrease of 2.1 mm for crowding and an increase of 3.5, 2.9, 2.7, and 0.8 mm for intercanine, interpremolar, and intermolar widths and arch perimeter, respectively. Finally, at T₃−T₀, the reduction in crowding of 5.03 mm was significant and clinically important in the treated group. The differences between intercanine, interpremolar, and intermolar widths were also significant (2.1, 3.8, and 3.6 mm, respectively). All those differences favored the treated group.Conclusions:Mandibular dental arch dimensions were significantly changed after lip bumper treatment. At follow-up, all arch widths were slightly decreased, generating an increase of 0.4 mm in crowding, considered clinically irrelevant. Overall changes remained stable after an average 6.3-year follow-up.     

Long-term assessment of conventional and mini-screw–assisted rapid palatal expansion on the nasal cavity

ObjectivesTo evaluate the long-term effects of mini-screw–assisted rapid palatal expansion (MARPE), rapid palatal expansion (RPE), and controls on the nasal cavity with cone-beam computed tomography (CBCT).Materials and MethodsA total of 180 CBCT scans that were part of a previous randomized trial were evaluated retrospectively for 60 patients at pretreatment (T1), postexpansion (T2), and posttreatment (T3). Patients were randomly assigned into 3 groups: MARPE, RPE, and controls (time period T1 to T3; MARPE: 2 years 8 months; RPE: 2 years 9 months; control: 2 years 7 months). Nasal height, nasal length, nasion–ANS height, ANS–PNS length, pyriform height, and nasal septal deviation angle were measured. The changes in alar width, alar base width, anterior nasal cavity width, posterior nasal cavity width, maxillary intermolar width, and maxillary intercanine width were also evaluated.ResultsThe alar base width, posterior nasal cavity width, anterior nasal cavity width, maxillary intercanine width, and maxillary intermolar width significantly increased (P < .05), and the nasal septal deviation angle significantly decreased (P < .05) in both the MARPE and RPE groups as compared with controls in the short term. In the long term, the nasal septal deviation angle was significantly decreased (P < .05) in the MARPE and RPE groups as compared with controls, and the posterior nasal cavity width was significantly increased (P < .05) in the MARPE group compared with the RPE group and controls.ConclusionsMARPE and RPE led to a significant increase in the nasal cavity and alar base width compared with controls in the short term. In the long term, a significant increase was observed only in the posterior nasal cavity width with MARPE. Both MARPE and RPE led to a minimal decrease in nasal septal deviation angle in comparison with controls.     

Three-dimensional palatal anatomic characteristics' correlation with dermatoglyphic heterogeneity in Angle malocclusions

Objectives:To assess correlation of dermatoglyphic (DG) pattern with quantitative palatal anatomic parameters measured using three-dimensional (3D) scanning of dental casts and to explore the possibility of utilizing these to predict future occurrence of malocclusion.Materials and Methods:Pretreatment casts of 477 Saudi Arabian patients were divided into Class I, II, and III malocclusion groups. Fingerprints were recorded for all hand digits using a digital biometric device. Maxillary arch analysis was accomplished including intercanine, intermolar distance, palatal height, and palatal area. The results were statistically analyzed.Results:The mean surface area of the palate was highest in Class II malocclusion. The DG pattern was not significantly associated with the type of malocclusion, except in the instance of the double loop characteristic (P = .05). There was a strong correlation, however, between DG characteristics like simple arch, loop, and double loop and palatal dimensions (intercanine, intermolar distance, and palatal height). Heterogeneity of DG pattern could be reliably used to predict palatal dimensions. Logistic regression revealed that only tented arch, symmetrical, spiral DG patterns and palatal area were significant but weak predictors of Angle malocclusion (P < .05).Conclusions:A novel correlation of DG pattern with 3D palatal anatomic characteristics was assessed in different Angle malocclusion classes. Few of the DG characteristics and palatal dimensions showed significant correlations. However, only some of these were significant predictors of Angle malocclusion.     

Dental and alveolar arch widths in normal occlusion and Class III malocclusion

The aim of this study was to compare the transverse dimensions of the dental arches and alveolar widths of Class III malocclusion group with a group of untreated normal occlusion subjects. This study was performed using measurements on dental casts of 150 normal occlusion (mean age, 21.6 +/- 2.6 years) and 100 Class III malocclusion (mean age, 15.4 +/- 2.2 years) subjects. Independent samples t-test was applied for comparing the groups. The findings of this study indicated that the mandibular intercanine and intermolar alveolar widths were significantly larger in the Class Ill group when compared with the normal occlusion sample (P < .001). Maxillary interpremolar, intermolar widths and all maxillary alveolar width measurements were significantly narrower in the Class III group (P < .001). In addition, the lower canine and premolar alveolar width measurements were also statistically significantly larger in the normal occlusion group when compared with the Class III malocclusion group (P < .001). Subjects with Class III malocclusion tend to have the maxillary teeth inclined to the lingual and mandibular teeth inclined to the buccal direction because of the restriction of maxillary growth and development according to dental arch width measurements. Therefore, rapid maxillary expansion should be considered before or during the treatment of a Class III patient with or without face-mask therapy.     

Long-Term Effects of Rapid Maxillary Expansion Followed by Fixed Appliances

Objective:To evaluate the long-term changes in maxillary arch widths, overjet, and overbite in patients who were treated with rapid maxillary expansion (RME) followed by edgewise appliances.Materials and Methods:The material for the study consisted of study casts taken from 41 patients (19 males, 22 females) on four different occasions (before treatment, T1; after RME, T2; after treatment, T3; and during follow-up period, T4). The upper intercanine, interpremolar, and intermolar widths and overjet and overbite were measured on each set of study casts. Mean age of the subjects was 13.2 ± 1.3 years (range, 11.2–16.9 years) at T1, 13.3 ± 1.3 years (range, 11.3–17 years) at T2, 15.5 ± 1.4 years (range, 13.1–18.8 years) at T3, and 20.4 ± 1.6 years (range, 17.9–24.8 years) at T4.Results:The net increase in intercanine width, interpremolar width, intermolar width, overjet, and overbite was 1.4 ± 2.4 mm, 4.6 ± 2.6 mm, 4.3 ± 2.5 mm, 0.1 ± 0.6 mm, and 0.2 ± 0.6 mm, respectively, and the relapse rates were 37% for intercanine width, 19% for interpremolar width, and 17% for intermolar width at the end of the follow-up period.Conclusions:A significant amount of relapse occurred in maxillary arch widths at the postretention assessment, the greatest being in intercanine width. RME significantly decreased overbite and increased overjet, and a statistically significant decrease was observed in both overbite and overjet at the postretention assessment.     

Molar Inclination and Surrounding Alveolar Bone Change Relative To the Design of Bone-borne Maxillary Expanders: A Cbct study

ObjectiveTo evaluate the molar inclination and skeletal and alveolar bone changes when comparing tooth bone-borne (MSE) and tissue bone-borne type maxillary expanders (C-expander) using cone-beam computed tomography (CBCT) in late adolescence.Materials and MethodsA sample of 48 late-adolescent patients were divided into two groups according to the type of expander: MSE group (n = 24, age = 19.2 ± 5.9 years) and C-expander group (n = 24, age = 18.1 ± 4.5 years). CBCT scans were taken before treatment and 3 months after expansion. Transverse skeletal and dental expansion, alveolar inclination, tooth axis, buccal alveolar bone height, thickness, dehiscence, and fenestration were evaluated on the maxillary first molar. Paired t-test, independent t-test, Pearson''s chi-square test, and Spearman correlation analysis were performed.ResultsThe MSE group produced greater dental expansion (P < .05), whereas skeletal expansion was similar in both groups (P = .859). The C expander group had more alveolar bone inclination change (P < .01), and the MSE group had more buccal tipping of the anchorage teeth (P < .01 or .001). Buccal alveolar bone height loss and thickness changes were greater in the MSE group (P < .01 or <.001). Formation of dehiscences was more frequent in the MSE group (P < .001), whereas for fenestrations, there were no significant differences between the two groups. Buccal bone height loss in the MSE group had a negative correlation with initial buccal bone thickness.ConclusionsThe incorporation of teeth into bone-borne expanders resulted in an increase in the severity of side effects. For patients in late adolescence, tissue bone-borne expanders offer comparable skeletal effects to tooth bone-borne expanders, with fewer dentoalveolar side effects.     

Comparison of tooth development stage of the maxillary anterior teeth before and after secondary alveolar bone graft: Unilateral cleft lip and alveolus vs unilateral cleft lip and palate

Objective:To compare the effect of secondary alveolar bone graft (SABG) on the tooth development stage of the maxillary central incisor (MXCI) and maxillary canine (MXC) in terms of the severity of unilateral cleft.Materials and Methods:The subjects consisted of 50 boys with unilateral cleft lip and alveolus (UCLA) or unilateral cleft lip, alveolus, and palate (UCLP). The age- and sex-matched subjects were divided into group 1 (UCLA, n = 25; 9.3 ± 0.8 years old) and group 2 (UCLP, n = 25; 9.4 ± 0.6 years old). In panoramic radiographs taken 1 month before (T0) and 1 year after SABG (T1), tooth development stage was evaluated according to the Nolla developmental (ND) stage. A panoramic radiograph taken 3 years after SABG was used as a reference for the final root length of individual tooth.Results:In groups 1 and 2, the ND stage of the MXCI did not exhibit differences between the cleft and non-cleft sides at T0 and T1, respectively. However, although the ND stage of the MXC of group 2 was delayed on the cleft side compared with the non-cleft side at T0 (P < .05), the MXC on the cleft side developed faster than that on the non-cleft side after SABG (P < .01). In terms of tooth development speed, group 2 showed a higher rate of faster developed MXCs on the cleft side compared with the non-cleft side after SABG than group 1 (36.0% vs 8.0%, P < .05).Conclusion:SABG performed at approximately 9 years of age might increase tooth development speed of MXC in patients with UCLP compared with patients with UCLA.     

Long-term stability of maxillary protraction therapy in Class III patients with complete unilateral cleft lip and palate

Objectives:This study evaluated the long-term stability of maxillary protraction (MP) in patients with complete unilateral cleft lip and palate (UCLP) and identified factors influencing relapse and long-term outcomes.Materials and Methods:Twenty-three adolescents with UCLP who underwent MP therapy were recalled when craniofacial growth was close to completion. Subjects exhibiting reverse/positive overjets were assigned to unstable/stable groups. Lateral cephalometric measurements were made before treatment (T0), after active treatment (T1), and at the end of the growth spurt (T2).Results:About 63% of the subjects exhibited positive overjets during follow-up. The unstable group demonstrated higher B–x and Co–Gn distances than the stable group (both P < .05) at T0. More short-term (T0–T1) sagittal advancement of point A (A–y) was evident in the unstable group than in the stable group (P < .05), but no long-term difference was apparent between the two groups (P = .481). During the posttreatment period (T1–T2), the SNA angle and maxillary incisor protrusion (U1–SN angle) were considerably lower in the unstable group than in the stable group (both P < .05). Overall, the unstable group exhibited a lower increase in the vertical extent of point A (A–x) than the stable group from T0 to T2 (P < .05).Conclusions:In the long term, MP affords favorable maxillary advancement in patients with UCLP. A mandibular excess at T0 and vertical maxillary hypoplasia may contribute to the long-term relapse of a reverse overjet.     

Evaluation of dehiscence and fenestration in adolescent patients affected by unilateral cleft lip and palate: A retrospective cone beam computed tomography study

Objective:To evaluate the presence of dehiscence and fenestration defects around anterior teeth in the cleft region and to compare these findings with the noncleft side in the same patients using cone beam computed tomography (CBCT).Materials and Methods:CBCT scans of 44 patients (26 males, 18 females; mean age, 14.04 ± 3.81 years) with unilateral cleft lip and palate (UCLP) were assessed to define dehiscences and fenestrations of the anterior teeth in both cleft and noncleft sides of the UCLP patients and a control group of noncleft patients (51 patients; 21 males, 30 females; mean age, 14.52 ± 1.16 years). Data were analyzed using Pearson’s χ² and Student’s t-test.Results:The prevalence of dehiscences at the maxillary central incisors, lateral incisors, and canines teeth were 43.2%, 70.6%, and 34.1% on the cleft side and 22.7%, 53.1%, and 27.3% on the noncleft side of UCLP patients, and 13.7%, 7.8%, and 13.7% in controls, respectively (statistically no difference between the sides of cleft patients). The cleft patients had a statistically significantly higher prevalence of dehiscences than did the controls on both the cleft and noncleft sides (P < .05), except for the maxillary central incisors. Fenestrations for these teeth were significantly more common on the cleft side in UCLP patients compared with controls (P < .05), whereas the difference for maxillary lateral incisors was not statistically significant.Conclusions:Patients with UCLP showed a higher prevalence of dehiscence and fenestration defects around the maxillary anterior teeth.     

Reliability of digital orthodontic setups

Objective:To evaluate the reliability of digital orthodontic setup technology by comparing it with manual setups and models cast at the end of orthodontic treatment.Materials and Methods:Initial models, manual setups, and final models of 20 patients were used. The initial and final models, as well as the manual setups, were scanned using a 3Shape R-700 scanner, while the digital setups were fabricated based on the initial models using 3Shape OrthoAnalyzer software. Evaluation of the models based on the manual setup, digital setup, and final models of each patient was performed using the following linear measurements: intercanine widths, intermolar widths, and length of the upper and lower dental arches.Results:The results disclosed that none of the measures assessed through the manual setup, digital setup, and final models showed statistically significant differences (P > .05).Conclusions:Based on these findings, it can be inferred that digital setups are as effective and accurate as manual setups and constitute a tool for diagnosing and treatment planning that can be reliably reproduced in orthodontic treatments.