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Ronsivalle V, Leonardi R, Lagravere M, Flores-Mir C, Grippaudo C, Alessandri Bonetti G, Lo Giudice A. Medium-term effects of rapid maxillary expansion on nasal cavity and pharyngeal airway volumes considering age as a factor: A retrospective study. J Dent 2024; 144:104934. [PMID: 38461886 DOI: 10.1016/j.jdent.2024.104934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 03/06/2024] [Accepted: 03/07/2024] [Indexed: 03/12/2024] Open
Abstract
OBJECTIVES The medium-term effects of rapid maxillary expansion (RME) on nasal cavity (NC) and upper airway (UA) dimensions based on chronological age are still unclear. This retrospective study evaluated the medium-term changes occurring in the NC and pharyngeal airways (PA) after RME in two distinct age-based cohorts of patients. METHODS This retrospective study included 48 subjects who underwent RME grouped in two cohorts: a 6-9-year-old group (EEG group: early expansion group - 25 subjects) and an 11-14-year-old group (LEG group: late expansion group - 23 subjects). NC and PA volumes were analyzed from CBCT imaging segmentation before RME (T0) and twelve months after RME (T1). The amount of maxillary expansion (PW) and minimal cross-sectional area (CSmin) were also considered. RESULTS All PAs' volumetric sub-regions, CSmin and PW showed a significant volumetric increment (p < 0.05). Inter-group comparisons showed significant differences (p < 0.05) for nasopharynx and CSmin parameters (p < 0.05), while no significant changes were recorded for the other UA's sub-regions and PW (p > 0.05). According to a deviation analysis, part of the UA increase (more marked for the nasopharynx area) may have occurred due to reduced adenotonsillar tissues, which were larger in the EEG group. CONCLUSIONS Twelve months after treatment, clinicians should not expect changes in the UAs dimensions to be solely related to treatment effects of RME; instead, normal craniofacial growth changes and spontaneous regression of the adenotonsillar tissue could represent the most significant factors influencing UAs changes. CLINICAL SIGNIFICANCE From the clinical perspective, the results of the present study encourage caution when considering the therapeutic effects of RME on airways dimensions.
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Affiliation(s)
- Vincenzo Ronsivalle
- Department of General Surgery and Medical-Surgical Specialties, Section of Oral Surgery, University of Catania, Policlinico Universitario "Gaspare Rodolico - San Marco", Via Santa Sofia 78, 95123, Catania, Italy.
| | - Rosalia Leonardi
- Department of General Surgery and Medical-Surgical Specialties, Section of Orthodontics, University of Catania, Policlinico Universitario "Gaspare Rodolico - San Marco", Via Santa Sofia 78, 95123, Catania, Italy
| | - Manuel Lagravere
- Orthodontic Graduate Program, University of Alberta, Edmonton, Alberta, Canada
| | - Carlos Flores-Mir
- Orthodontic Graduate Program, University of Alberta, Edmonton, Alberta, Canada
| | - Cristina Grippaudo
- Orthodontic Graduate Program, University of Roma Cattolica - Sacro Cuore
| | | | - Antonino Lo Giudice
- Department of General Surgery and Medical-Surgical Specialties, Section of Orthodontics, University of Catania, Policlinico Universitario "Gaspare Rodolico - San Marco", Via Santa Sofia 78, 95123, Catania, Italy
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Huang X, Huang W, Pei T, Zhao Y, Wang Y, Gu Y, Bai X. Evaluation of three-dimensional reconstructed palatal morphology in skeletal class III subjects with different vertical patterns using cone beam computed tomography. Head Face Med 2024; 20:8. [PMID: 38281028 PMCID: PMC10821571 DOI: 10.1186/s13005-024-00408-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 01/11/2024] [Indexed: 01/29/2024] Open
Abstract
BACKGROUND This study aims to evaluate the difference of three-dimensional (3D) reconstructed palatal morphology between subjects with skeletal Class III and skeletal Class I in different vertical patterns using cone beam computed tomography (CBCT). METHODS In this study, 89 subjects with skeletal Class III (49 females, 40 males; 25.45 ± 3.81 years) and 85 subjects with skeletal Class I (45 females, 40 males; 23.95 ± 4.45 years) were collected retrospectively and divided into hyperdivergent, normodivergent and hypodivergent groups. Dolphin software was used to reorient the CBCT images of these subjects. After segmenting 3D object of maxilla from the 3D skull by ProPlan software, Geomagic Studio was used to reconstruct 3D palatal morphology and establish an average 3D palatal morphology for each group. The differences of 3D palatal morphology between different groups were compared by deviation patterns on 3D colored map analysis. RESULTS 3D colored map analysis showed the posterior part of male's palate was higher and wider than that of female's palate in skeletal Class III subjects. In skeletal Class III subjects, males with hyperdivergent pattern had a higher and narrower palate compared with hypodivergent subjects, while females with hyperdivergent had a higher but not obviously narrower palate compared with hypodivergent subjects. In the similar vertical patterns, skeletal Class III subjects had a flatter but not narrower palate compared with skeletal Class I subjects, along with a smaller palate volume. CONCLUSIONS This method allows more intuitive between-group comparisons of the differences of 3D palatal morphology. In skeletal Class III subjects, as the vertical dimension increased, the palate tends to be higher and narrower. Therefore, the influence of vertical patterns on the palatal morphology should be fully considered in the orthodontic and orthognathic treatment of skeletal Class III subjects.
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Affiliation(s)
- Xiaoyi Huang
- Department of Orthodontics, Stomatological Center, Guangdong Provincial High-level Clinical Key Specialty & Guangdong Province Engineering Research Center of Oral Disease Diagnosis and Treatment, Peking University Shenzhen Hospital, Shenzhen, 518036, Guangdong, PR China
- Department of Materials Science and Engineering, Southern University of Science and Technology, Shenzhen, 518055, Guangdong, PR China
| | - Wenbin Huang
- Department of Orthodontics, Stomatological Center, Guangdong Provincial High-level Clinical Key Specialty & Guangdong Province Engineering Research Center of Oral Disease Diagnosis and Treatment, Peking University Shenzhen Hospital, Shenzhen, 518036, Guangdong, PR China
- Department of Materials Science and Engineering, Southern University of Science and Technology, Shenzhen, 518055, Guangdong, PR China
| | - Tao Pei
- Department of Orthodontics, Stomatological Center, Guangdong Provincial High-level Clinical Key Specialty & Guangdong Province Engineering Research Center of Oral Disease Diagnosis and Treatment, Peking University Shenzhen Hospital, Shenzhen, 518036, Guangdong, PR China
| | - Yijiao Zhao
- Center of Digital Dentistry, Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry, Peking University School and Hospital of Stomatology & National, No.22, Zhongguancun South Avenue, Haidian District, Beijing, 100081, PR China
| | - Yong Wang
- Center of Digital Dentistry, Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry, Peking University School and Hospital of Stomatology & National, No.22, Zhongguancun South Avenue, Haidian District, Beijing, 100081, PR China
| | - Yan Gu
- National Center for Stomatology & National Clinical Research Center for Oral Disease & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing Key Laboratory of Digital Stomatology, Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Department of Orthodontics, Peking University School and Hospital of Stomatology, No. 22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, PR China.
| | - Xueqin Bai
- Department of Orthodontics, Stomatological Center, Guangdong Provincial High-level Clinical Key Specialty & Guangdong Province Engineering Research Center of Oral Disease Diagnosis and Treatment, Peking University Shenzhen Hospital, Shenzhen, 518036, Guangdong, PR China.
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Pan S, Gao X, Sun J, Yang Z, Hu B, Song J. Effects of novel microimplant-assisted rapid palatal expanders manufactured by 3-dimensional printing technology: A finite element study. Am J Orthod Dentofacial Orthop 2023; 164:700-711. [PMID: 37330728 DOI: 10.1016/j.ajodo.2023.04.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 04/01/2023] [Accepted: 04/01/2023] [Indexed: 06/19/2023]
Abstract
INTRODUCTION The expansion effects of several new microimplant-assisted rapid palatal expanders (MARPEs) manufactured by 3-dimensional printing technology were evaluated by finite element analysis (FEA). The aim was to identify a novel MARPE suitable for treating maxillary transverse deficiency. METHODS The finite element model was established using MIMICS software (version 19.0; Materialise, Leuven, Belgium). First, the appropriate microimplant insertion characteristics were identified via FEA, and several MARPEs with the above insertion patterns were manufactured by 3-dimensional printing technology. Then, the stress distribution and displacement prediction of the 4 MARPEs and hyrax expander (model E) were evaluated via FEA: bone-borne (model A), bone-tooth-borne (model B), bone-mucous-borne (model C), bone-tooth-mucous-borne (model D). RESULTS Monocortical microimplants perpendicular to the cortical bone on the coronal plane resulted in better expansion effects. Compared with a conventional hyrax expander, the orthopedic expansion of each of the 4 MARPEs was far larger, the parallelism was greater, and the posterior teeth tipping rate was lower. Among them, the expansion effects of models C and D were the best; the von Mises peak values on the surfaces of the microimplants were smaller than those of models A and B. CONCLUSIONS This study may demonstrate that the 4 MARPEs obtained more advantageous orthopedic expansion effects than a hyrax expander. Models C and D obtained better biomechanical effects and had better primary stability. Overall, model D is the recommended expander for treating maxillary transverse deficiency because its structure acts like an implant guide and is beneficial for the accurate insertion of the microimplant.
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Affiliation(s)
- Shengyuan Pan
- College of Stomatology, Chongqing Medical University, Chongqing, China; Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China; Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Xiang Gao
- College of Stomatology, Chongqing Medical University, Chongqing, China; Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China; Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Jicheng Sun
- College of Stomatology, Chongqing Medical University, Chongqing, China; Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China; Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Zun Yang
- College of Stomatology, Chongqing Medical University, Chongqing, China; Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China; Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Bo Hu
- College of Stomatology, Chongqing Medical University, Chongqing, China; Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China; Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China.
| | - Jinlin Song
- College of Stomatology, Chongqing Medical University, Chongqing, China; Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China; Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China.
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Mei YS, Syed Mohamed AMF, Marizan Nor M, Rosli TI. Gender and age effects on dental and palatal arch dimensions among full siblings. J Oral Sci 2023; 65:237-242. [PMID: 37612067 DOI: 10.2334/josnusd.23-0043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/25/2023]
Abstract
PURPOSE This study was conducted to investigate the dental and palatal arch dimensions of male and female siblings in relation to gender and age, using three-dimensional (3D) digital casts. METHODS This study involved 54 subjects (27 pairs) of male-female siblings aged 15 to 45 years. Dental casts were digitized and analyzed for tooth size (TS), arch width (AW), arch length (AL), arch length discrepancy (ALD), and palatal arch dimensions (PAD). The data obtained were subjected to t-tests, and the palatal curvature (PC) was modeled using a fourth-order polynomial. RESULTS Significant differences (P < 0.05) between the sexes were found in the mesiodistal TS, particularly in all canines, as well as 16, 36, 46, and 41. Maxillary AW and AL were also significantly (P < 0.05) influenced by sexes. Most arch parameters were more prominent in male siblings, and the effect of age on PC differed between the sexes. In addition, the PC of adolescent females was mostly superimposed on adult females relative to males. CONCLUSION Among siblings, males were found to have significantly larger dental arch dimensions than females. Furthermore, PC showed some differences between the sexes in both the frontal and sagittal planes.
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Affiliation(s)
- Yong S Mei
- Department of Family Oral Health, Faculty of Dentistry, The National University of Malaysia
- Private Practice
| | - Alizae M F Syed Mohamed
- Discipline of Orthodontics, Department of Family Oral Health, Faculty of Dentistry, The National University of Malaysia
| | - Murshida Marizan Nor
- Discipline of Orthodontics, Department of Family Oral Health, Faculty of Dentistry, The National University of Malaysia
| | - Tanti I Rosli
- Discipline of Dental Public Health, Department of Family Oral Health, Faculty of Dentistry, The National University of Malaysia
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Cen Y, Huang X, Liu J, Qin Y, Wu X, Ye S, Du S, Liao W. Application of three-dimensional reconstruction technology in dentistry: a narrative review. BMC Oral Health 2023; 23:630. [PMID: 37667286 PMCID: PMC10476426 DOI: 10.1186/s12903-023-03142-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 06/16/2023] [Indexed: 09/06/2023] Open
Abstract
BACKGROUND Three-dimensional(3D) reconstruction technology is a method of transforming real goals into mathematical models consistent with computer logic expressions and has been widely used in dentistry, but the lack of review and summary leads to confusion and misinterpretation of information. The purpose of this review is to provide the first comprehensive link and scientific analysis of 3D reconstruction technology and dentistry to bridge the information bias between these two disciplines. METHODS The IEEE Xplore and PubMed databases were used for rigorous searches based on specific inclusion and exclusion criteria, supplemented by Google Academic as a complementary tool to retrieve all literature up to February 2023. We conducted a narrative review focusing on the empirical findings of the application of 3D reconstruction technology to dentistry. RESULTS We classify the technologies applied to dentistry according to their principles and summarize the different characteristics of each category, as well as the different application scenarios determined by these characteristics of each technique. In addition, we indicate their development prospects and worthy research directions in the field of dentistry, from individual techniques to the overall discipline of 3D reconstruction technology, respectively. CONCLUSIONS Researchers and clinicians should make different decisions on the choice of 3D reconstruction technology based on different objectives. The main trend in the future development of 3D reconstruction technology is the joint application of technology.
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Affiliation(s)
- Yueyan Cen
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, No.14, 3Rd Section of Ren Min Nan Rd. Chengdu, Sichuan, 610041, China
| | - Xinyue Huang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, No.14, 3Rd Section of Ren Min Nan Rd. Chengdu, Sichuan, 610041, China
| | - Jialing Liu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, No.14, 3Rd Section of Ren Min Nan Rd. Chengdu, Sichuan, 610041, China
| | - Yichun Qin
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, No.14, 3Rd Section of Ren Min Nan Rd. Chengdu, Sichuan, 610041, China
| | - Xinrui Wu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, No.14, 3Rd Section of Ren Min Nan Rd. Chengdu, Sichuan, 610041, China
| | - Shiyang Ye
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, No.14, 3Rd Section of Ren Min Nan Rd. Chengdu, Sichuan, 610041, China
| | - Shufang Du
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, No.14, 3Rd Section of Ren Min Nan Rd. Chengdu, Sichuan, 610041, China.
| | - Wen Liao
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, No.14, 3Rd Section of Ren Min Nan Rd. Chengdu, Sichuan, 610041, China.
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Moreira Machado MAA, Passucci Ambrosio EC, Bringel M, Moffa EB, Siqueira WL, Oliveira TM. Comparative 3D study of dental arches in children with microcephaly associated with congenital Zika syndrome, orofacial cleft, and without craniofacial anomalies. SPECIAL CARE IN DENTISTRY 2023; 43:572-578. [PMID: 36529535 DOI: 10.1111/scd.12800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 09/15/2022] [Accepted: 10/10/2022] [Indexed: 12/23/2022]
Abstract
INTRODUCTION The dentist participates in the treatment protocol for craniofacial anomalies in individuals from the first months of life. OBJECTIVE to compare in a retrospective cohort study the morphometry of the edentulous palate of children microcephaly associated with congenital Zika syndrome (CZS), unilateral complete cleft lip and alveolus (UCL), and without craniofacial anomalies. METHODS Forty-five digitized dental molds composed the sample divided into three groups: CZS; UCL; and without craniofacial anomalies (control group). The following measurements were evaluated: intercanine and intertuberosity distances; dental arch length, area, volume, and mismatch superimposition. Parametric and non-parametric tests were applied (α = 5%). RESULTS CZS group showed the smallest means of intercanine distance and area than those of the other groups (p = .001 and p = .010, respectively). The dental arch length was greater in the CZS group than in the control group (p = .020). The evaluation of the mismatch superimposition showed that the CZS group had the lowest means of maximum distance and root mean square than that of the UCL group (p = .025 and p = .005, respectively). CONCLUSION CZS participants tended to palatal narrowing, while UCL individuals had parameters similar to those of the control group, despite the alveolus defect.
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Affiliation(s)
| | - Eloá Cristina Passucci Ambrosio
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Mayara Bringel
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Eduardo Buozi Moffa
- School of Dentistry, University Center - UNIFAE, São João da Boa Vista/São Paulo, Brazil
- School of Dentistry, Federal University of Alfenas, Alfenas, Brazil
| | - Walter Luiz Siqueira
- College of Dentistry, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Thais Marchini Oliveira
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
- Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, São Paulo, Brazil
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Carvalho PDTA, Junior MC, Wandalsen GF, Solé D. Rapid maxillary expansion and nasal patency in mouth breathing children with maxillary atresia due to or not due to allergic rhinitis. Allergol Immunopathol (Madr) 2023; 51:55-62. [PMID: 37422780 DOI: 10.15586/aei.v51i4.853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 04/13/2023] [Indexed: 07/11/2023]
Abstract
AIM To evaluate the effects of rapid maxillary expansion (RME) on nasal patency in mouth breathing (MB) children with maxillary atresia due to or not due to allergic rhinitis (AR) associated with asthma. METHODS Fifty-three MB children/adolescents (aged 7-14 years) with mixed or permanent dentition and maxillary atresia participated, with or without unilateral or bilateral crossbite. They formed the groups: RAD (AR + asthma; clinical treatment, RME); RAC (AR + asthma; clinical treatment, no RME); and D (mouth breathers; RME only). RAD and RAC patients received topical nasal corticosteroid and/or systemic H1 antihistamine (continuous use) and environmental exposure control. All were evaluated before RME (T1) and 6 months after (T2) with the CARATkids score, acoustic rhinometry, and nasal cavity computed tomography (CT). Patients RAD and D underwent RME (Hyrax® orthopedic appliance). RESULTS A significant reduction in the CARATkids score occurred in the RAD (-4.06; p < 0.05), similarly when patient and parent/guardian scores were evaluated (-3.28 and -3.16, respectively). Acoustic rhinometry (V5) showed increased nasal volume in all groups, significantly higher in RAD patients than in RAC and D (0.99 × 0.71 × 0.69 cm3, respectively). CT of the nasal cavity documented increased volume in all three groups, with no significant differences between them. CONCLUSION In MB patients with AR, asthma, and maxillary atresia, RME increased nasal cavity volume and improved respiratory symptoms. However, it should not be used as the only treatment for managing patients with respiratory allergies.
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Affiliation(s)
- Paulo de Tarso Almeida Carvalho
- Division of Allergy, Clinical Immunology and Rherumatology - Federal University of São Paulo - Escola Paulista de Medicina (UNIFESP-EPM), São Paulo, Brazil
| | | | - Gustavo Falbo Wandalsen
- Division of Allergy, Clinical Immunology and Rherumatology - Federal University of São Paulo - Escola Paulista de Medicina (UNIFESP-EPM), São Paulo, Brazil
| | - Dirceu Solé
- Division of Allergy, Clinical Immunology and Rherumatology - Federal University of São Paulo - Escola Paulista de Medicina (UNIFESP-EPM), São Paulo, Brazil; ;
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Analysis of maxillary arch morphology and its relationship with upper airway in mouth breathing subjects with different sagittal growth patterns. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101386. [PMID: 36646284 DOI: 10.1016/j.jormas.2023.101386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/05/2022] [Accepted: 01/12/2023] [Indexed: 01/15/2023]
Abstract
OBJECTIVE This three-dimensional cone beam computed tomography(CBCT) study assessed pharyngeal airway and maxillary arch in mouth breathing subjects with different skeletal classifications and analyzed the factors associated with the upper airway morphological variations in mouth breathing (MB) and nasal breathing (NB) subjects. METHODS One hundred and five subjects (52 MB and 53 NB children), divided into three skeletal groups: Class I (1° ≤ ANB° ≤ 5°), Class II (ANB° >5°), and Class III (ANB°<1°). An independent t-test and one-way ANOVA test were utilized in the group analysis of normal distributed data. The linear multiple regression test was applied to create a model for the airway volumes based on the maxillary arch parameters in different skeletal groups. RESULTS In three skeletal groups, NB individuals had greater oropharyngeal airway volume (OPV) and total pharyngeal airway volume (TPV) than MB. Maxillary arch parameters of intermolar width (IMW), intercanine width (ICW), and maxillary width of canines (MWC) were larger in NB participants than in MB subjects. In the MB group, we discovered that Class II individuals had lower NPV (nasopharyngeal airway volume) than Class I and Class III. MWC was lower in Class II subjects compared to Class I and Class III in both the NB and MB groups. CONCLUSION NB individuals had greater pharyngeal airway and maxillary arch parameters than MB subjects. Our model equation revealed that the inter-molar width (IMW) and palatal area (PA) parameters were the strongest predictors of total pharyngeal airway volume (TPV) in the skeletal Class II and Class I groups.
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Saadeh ME, Ghafari JG. Uniformity of palatal volume and surface area in various malocclusions. Orthod Craniofac Res 2023; 26:72-80. [PMID: 35470544 DOI: 10.1111/ocr.12580] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 04/14/2022] [Accepted: 04/20/2022] [Indexed: 01/11/2023]
Abstract
AIMS To assess palatal volume, surface area and linear dimensions across sagittal and vertical components of malocclusion. METHODS Pre-treatment cephalographs and dental casts of 178 non-growing patients (88 males, 90 females, age 25.81 ± 8.23 years) were used for classification in sagittal malocclusion groups: Class I (n = 48), Class II division 1 (n = 42), Class II division 2 (n = 40) and Class III (n = 48); and in vertical divergence groups based on the MP/SN angle: hypodivergent (n = 35), normodivergent (n = 95) and hyperdivergent (n = 48). Dental casts were scanned and palatal measurements recorded: palatal width, depth and interdental distances; palatal surface area (PSA, mm2 ) and volume (PV, mm3 ). A 3-way ANOVA was used to compare palatal dimensions across groups. Pearson product-moment correlations were employed to assess associations among variables. RESULTS PSA and PV (in both sex groups) were not statistically significantly different across sagittal malocclusions and vertical patterns. Significant differences were depicted more among the vertical divergence groups than sagittal groups. Correlations between PSA and PV and palatal dimensions were low to moderate. Predictability of PSA and PV ranged between 15 and 18%. CONCLUSION The finding of similar palatal volume and surface area, on average, across malocclusions possibly underscores the limitations of environmental influences within the inherited orofacial phenotype. The vertical facial pattern seems to be more interactive with palatal dimensions than sagittal relations. Studies of palatal changes following orthodontic and orthognathic treatments are warranted.
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Affiliation(s)
- Maria E Saadeh
- Department of Forensic Odontology, Faculty of Dental Medicine, Lebanese University, Beirut, Lebanon.,Department of Orthodontics, Faculty of Dental Medicine, Lebanese University, Beirut, Lebanon.,Division of Orthodontics and Dentofacial Orthopedics, American University of Beirut Medical Center, Beirut, Lebanon
| | - Joseph G Ghafari
- Division of Orthodontics and Dentofacial Orthopedics, American University of Beirut Medical Center, Beirut, Lebanon.,Department of Orthodontics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Luzzi V, DE Filippo M, Guarnieri R, Fioravanti M, Guaragna M, Marasca B, Pirro V, Altieri F, Vozza I, Ndokaj A, Brindisi G, Barbato E, Polimeni A, Zicari AM. Evaluation of nasal airway resistance in a cohort of children with primary snoring and maxillary deficiency. Minerva Dent Oral Sci 2023; 72:54-59. [PMID: 36345835 DOI: 10.23736/s2724-6329.22.04727-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND The aim of this study was to test whether rapid palatal expansion is effective to improve nasal airway patency in a sample of pediatric patients with primary snoring. METHODS A group of 21 subjects, 11 girls (52%) and 10 boys (48%), with a mean age of 7.1 years (SD=1.3; range 4-9 years) were treated with a rapid maxillary expansion (RME) device. Nasal airway resistance was assessed via rhinomanometric exam before (pre-) and 6 months after (post-) the rapid palatal expansion treatment. RESULTS Data analysis showed a statistically significant increase in the mean scores of the results of the rhinomanometric exam between the pre- and post-measurements with a significant reduction in total inspiratory and expiratory air resistance values after rapid palatal expansion. CONCLUSIONS Our results show that RME treatment is associated with an improvement in nasal airway resistance due to a substantial reduction in nasal resistance associated with the orthopedic action of the orthodontic device.
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Affiliation(s)
- Valeria Luzzi
- Department of Oral and Maxillofacial Sciences, Sapienza University, Rome, Italy
| | - Maria DE Filippo
- Department of Maternal, Child Health and Urological Sciences, Sapienza University, Rome, Italy
| | - Rosanna Guarnieri
- Department of Oral and Maxillofacial Sciences, Sapienza University, Rome, Italy
| | - Miriam Fioravanti
- Department of Oral and Maxillofacial Sciences, Sapienza University, Rome, Italy -
| | - Mariana Guaragna
- Department of Oral and Maxillofacial Sciences, Sapienza University, Rome, Italy
| | - Beatrice Marasca
- Department of Oral and Maxillofacial Sciences, Sapienza University, Rome, Italy
| | - Valentina Pirro
- Department of Oral and Maxillofacial Sciences, Sapienza University, Rome, Italy
| | - Federica Altieri
- Department of Oral and Maxillofacial Sciences, Sapienza University, Rome, Italy
| | - Iole Vozza
- Department of Oral and Maxillofacial Sciences, Sapienza University, Rome, Italy
| | - Artnora Ndokaj
- Department of Maternal, Child Health and Urological Sciences, Sapienza University, Rome, Italy
| | - Giulia Brindisi
- Department of Maternal, Child Health and Urological Sciences, Sapienza University, Rome, Italy
| | - Ersilia Barbato
- Department of Oral and Maxillofacial Sciences, Sapienza University, Rome, Italy
| | - Antonella Polimeni
- Department of Oral and Maxillofacial Sciences, Sapienza University, Rome, Italy
| | - Anna Maria Zicari
- Department of Maternal, Child Health and Urological Sciences, Sapienza University, Rome, Italy
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11
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Habumugisha J, Ma SY, Mohamed AS, Cheng B, Zhao MY, Bu WQ, Guo YC, Zou R, Wang F. Three-dimensional evaluation of pharyngeal airway and maxillary arch in mouth and nasal breathing children with skeletal Class I and II. BMC Oral Health 2022; 22:320. [PMID: 35915494 PMCID: PMC9341067 DOI: 10.1186/s12903-022-02355-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Accepted: 07/25/2022] [Indexed: 11/26/2022] Open
Abstract
Objective This study aimed to investigate whether the subjects with mouth breathing (MB) or nasal breathing (NB) with different sagittal skeletal patterns showed different maxillary arch and pharyngeal airway characteristics. Methods Cone-beam computed tomography scans from 70 children aged 10 to 12 years with sagittal skeletal Classes I and II were used to measure the pharyngeal airway, maxillary width, palatal area, and height. The independent t-test and the Mann–Whitney U test were used for the intragroup analysis of pharyngeal airway and maxillary arch parameters. Results In the Skeletal Class I group, nasopharyngeal airway volume (P < 0.01), oropharyngeal airway volume (OPV), and total pharyngeal airway volume (TPV) (all P < 0.001) were significantly greater in subjects with NB than in those with MB. Furthermore, intermolar width, maxillary width at the molars, intercanine width, maxillary width at the canines, and palatal area were significantly larger in subjects with NB than in those with MB (all P < 0.001). In the Skeletal Class II group, OPV, TPV (both P < 0.05) were significantly greater in subjects with NB than in those with MB. No significant differences in pharyngeal airway parameters in the MB group between subjects with Skeletal Class I and those with Skeletal Class II. Conclusion Regardless of sagittal Skeletal Class I or II, the pharyngeal airway and maxillary arch in children with MB differ from those with NB. However, the pharyngeal airway was not significantly different between Skeletal Class I and II in children with MB.
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12
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Yassaei S, Safi Y, Valian F, Mohammadi A. Evaluation of maxillary arch width and palatal volume and depth in patients with maxillary impacted canine by CBCT. Heliyon 2022; 8:e10854. [PMID: 36247115 PMCID: PMC9561739 DOI: 10.1016/j.heliyon.2022.e10854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 07/27/2022] [Accepted: 09/26/2022] [Indexed: 11/06/2022] Open
Abstract
Introduction Canines are the second most common tooth in terms of impaction. Impacted teeth can be associated with some different indices of dental arch and dentoalveolar structures. The aim of this study was to evaluate maxillary arch width as well as volume and depth of palate in patients with maxillary impacted canine by cone beam computed tomography (CBCT). Methods In this cross-sectional study, 45 CBCT images of patients with unilateral maxillary impacted canines were examined. All patients had palatally impacted canines. Three parameters of maxillary arch width, palatal volume and palatal depth were assessed using axial and sagittal incisions on the CBCT images. Then all the measurements on the impacted side were compared with the non-impacted side. Data were entered into SPSS software and paired sample t-test and Student's t-test were used to comparison. The significance level of 0.05 was considered. Results The maxillary arch width on the impacted side was significantly less than the normal side (P < 0.001). The mean depth of the palate was 14.86 ± 3.53 mm. There was a significant correlation between canine impaction and Palatal volume (R = 0.728 and P-value< 0.001), but no significant correlation between canine impaction and Maxillary arch width was shown (R = 0.15 and p-value = 0.326). Conclusion The impacted canine was significantly associated with a reduction in the width of the maxillary arch on the affected side, and it made no difference if the impacted side was left or right. Also, impacted canine teeth were significantly associated with volume reduction on the affected side.
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Affiliation(s)
- Soghra Yassaei
- Full Professor, Department of Orthodontics, Faculty of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, Iran,Corresponding author.
| | - Yaser Safi
- Associate Professor, Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Faeze Valian
- Dentist, Faculty of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Asma Mohammadi
- Postgraduate Student, Department of Orthodontics, Faculty of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd Iran
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13
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Lo Vecchio F, Tabolacci E, Nobile V, Pomponi MG, Pietrobono R, Neri G, Amenta S, Candida E, Grippaudo C, Lo Cascio E, Vita A, Tiberio F, Arcovito A, Lattanzi W, Genuardi M, Chiurazzi P. Mother and Daughter Carrying of the Same Pathogenic Variant in FGFR2 with Discordant Phenotype. Genes (Basel) 2022; 13:genes13071161. [PMID: 35885943 PMCID: PMC9319849 DOI: 10.3390/genes13071161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 06/23/2022] [Accepted: 06/24/2022] [Indexed: 11/16/2022] Open
Abstract
Craniosynostosis are a heterogeneous group of genetic conditions characterized by the premature fusion of the skull bones. The most common forms of craniosynostosis are Crouzon, Apert and Pfeiffer syndromes. They differ from each other in various additional clinical manifestations, e.g., syndactyly is typical of Apert and rare in Pfeiffer syndrome. Their inheritance is autosomal dominant with incomplete penetrance and one of the main genes responsible for these syndromes is FGFR2, mapped on chromosome 10, encoding fibroblast growth factor receptor 2. We report an FGFR2 gene variant in a mother and daughter who present with different clinical features of Crouzon syndrome. The daughter is more severely affected than her mother, as also verified by a careful study of the face and oral cavity. The c.1032G>A transition in exon 8, already reported as a synonymous p.Ala344 = variant in Crouzon patients, also activates a new donor splice site leading to the loss of 51 nucleotides and the in-frame removal of 17 amino acids. We observed lower FGFR2 transcriptional and translational levels in the daughter compared to the mother and healthy controls. A preliminary functional assay and a molecular modeling added further details to explain the discordant phenotype of the two patients.
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Affiliation(s)
- Filomena Lo Vecchio
- UOC Genetica Medica, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Roma, Italy; (F.L.V.); (M.G.P.); (S.A.); (M.G.)
| | - Elisabetta Tabolacci
- Dipartimento Universitario Scienze Della Vita e Sanità Pubblica, Sezione di Medicina Genomica, Università Cattolica del Sacro Cuore, 00168 Roma, Italy; (E.T.); (V.N.); (R.P.); (G.N.)
- Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Roma, Italy;
| | - Veronica Nobile
- Dipartimento Universitario Scienze Della Vita e Sanità Pubblica, Sezione di Medicina Genomica, Università Cattolica del Sacro Cuore, 00168 Roma, Italy; (E.T.); (V.N.); (R.P.); (G.N.)
- Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Roma, Italy;
| | - Maria Grazia Pomponi
- UOC Genetica Medica, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Roma, Italy; (F.L.V.); (M.G.P.); (S.A.); (M.G.)
| | - Roberta Pietrobono
- Dipartimento Universitario Scienze Della Vita e Sanità Pubblica, Sezione di Medicina Genomica, Università Cattolica del Sacro Cuore, 00168 Roma, Italy; (E.T.); (V.N.); (R.P.); (G.N.)
- Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Roma, Italy;
| | - Giovanni Neri
- Dipartimento Universitario Scienze Della Vita e Sanità Pubblica, Sezione di Medicina Genomica, Università Cattolica del Sacro Cuore, 00168 Roma, Italy; (E.T.); (V.N.); (R.P.); (G.N.)
| | - Simona Amenta
- UOC Genetica Medica, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Roma, Italy; (F.L.V.); (M.G.P.); (S.A.); (M.G.)
| | | | - Cristina Grippaudo
- Dipartimento Testa Collo, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Università Cattolica del Sacro Cuore, 00168 Roma, Italy;
| | - Ettore Lo Cascio
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, 00168 Roma, Italy; (A.A.); (E.L.C.)
| | - Alessia Vita
- Dipartimento Universitario Scienze della Vita e Sanità Pubblica, Sezione di Biologia Applicata, Università Cattolica del Sacro Cuore, Largo F. Vito 1, 00168 Roma, Italy; (A.V.); (F.T.)
| | - Federica Tiberio
- Dipartimento Universitario Scienze della Vita e Sanità Pubblica, Sezione di Biologia Applicata, Università Cattolica del Sacro Cuore, Largo F. Vito 1, 00168 Roma, Italy; (A.V.); (F.T.)
| | - Alessandro Arcovito
- Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Roma, Italy;
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, 00168 Roma, Italy; (A.A.); (E.L.C.)
| | - Wanda Lattanzi
- Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Roma, Italy;
- Dipartimento Universitario Scienze della Vita e Sanità Pubblica, Sezione di Biologia Applicata, Università Cattolica del Sacro Cuore, Largo F. Vito 1, 00168 Roma, Italy; (A.V.); (F.T.)
| | - Maurizio Genuardi
- UOC Genetica Medica, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Roma, Italy; (F.L.V.); (M.G.P.); (S.A.); (M.G.)
- Dipartimento Universitario Scienze Della Vita e Sanità Pubblica, Sezione di Medicina Genomica, Università Cattolica del Sacro Cuore, 00168 Roma, Italy; (E.T.); (V.N.); (R.P.); (G.N.)
| | - Pietro Chiurazzi
- UOC Genetica Medica, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Roma, Italy; (F.L.V.); (M.G.P.); (S.A.); (M.G.)
- Dipartimento Universitario Scienze Della Vita e Sanità Pubblica, Sezione di Medicina Genomica, Università Cattolica del Sacro Cuore, 00168 Roma, Italy; (E.T.); (V.N.); (R.P.); (G.N.)
- Correspondence: ; Tel.: +39-06-3015-4606
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14
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Yu JL, Tangutur A, Thuler E, Evans M, Dedhia RC. The role of craniofacial maldevelopment in the modern OSA epidemic: a scoping review. J Clin Sleep Med 2022; 18:1187-1202. [PMID: 34984972 DOI: 10.5664/jcsm.9866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES There is increasing recognition that environmental factors affect human craniofacial development and our risk for disease. A scoping review of the literature was performed looking at environmental influences on craniofacial development to better understand this relationship and investigate what further study is needed to determine how this relationship may impact obstructive sleep apnea. METHODS A comprehensive literature search was performed using the Ovid Medline database from inception to May, 2020 with relevance to craniofacial development in 5 clinically-oriented variables: diet, secular change, breastfeeding/non-nutritive sucking habits (NNSH), nasal obstruction/mouth breathing, and masticatory muscle function. The Oxford Centre for Evidence-Based Medicine Levels of Evidence (LoE) was used to assess studies based on study design. RESULTS 18,196 articles were initially identified, of which 260 studies were fully reviewed and 97 articles excluded. The remaining 163 articles were categorized as follows: Secular change (n = 16), Diet (n = 33), Breastfeeding/NNSH (n = 28), Nasal obstruction/Mouth breathing (n = 57), and Masticatory muscle function (n = 35). 93% of included studies reported a significant association between craniofacial morphology and environmental factors. The majority of studies were characterized as low LoE studies with 90% of studies being LoE 4 or 5. CONCLUSIONS The studies in this review suggest that environmental factors are associated with changes in craniofacial development. However, most studies were heterogeneous and low-level studies, making strong conclusions about these relationships difficult. Future rigorous studies are needed to further our understanding of environmental influences on craniofacial development and OSA risk.
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Affiliation(s)
- Jason L Yu
- Division of Sleep Surgery, Department of Otorhinolaryngology-Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, PA.,Division of Sleep Medicine, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, PA
| | - Akshay Tangutur
- Division of Sleep Surgery, Department of Otorhinolaryngology-Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, PA
| | - Eric Thuler
- Division of Sleep Surgery, Department of Otorhinolaryngology-Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, PA
| | - Marianna Evans
- Division of Sleep Medicine, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, PA
| | - Raj C Dedhia
- Division of Sleep Surgery, Department of Otorhinolaryngology-Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, PA.,Division of Sleep Medicine, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, PA
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15
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Calvo-Henriquez C, Branco AM, Lechien JR, Sandoval-Pacheco V, Maldonado-Alvarado B, Maza-Solano J, Trozzi M, Rivero-Fernández I, Martínez-Capoccioni G, Martin-Martin C. Assessing the effect of adenoidectomy on nasal resistance and airflow. A systematic review and meta-analysis. Int J Pediatr Otorhinolaryngol 2021; 151:110969. [PMID: 34781112 DOI: 10.1016/j.ijporl.2021.110969] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 10/03/2021] [Accepted: 11/08/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Clinical guidelines suggest adenoidectomy when enlarged adenoids are associated with nasal obstruction and other symptoms. Given that nasal obstruction is the leading symptom of adenoid hypertrophy, it should be thoroughly explored. However, there is no consensus regarding what could be the best approach. This systematic review is designed with the objective of exploring the extent to which adenoidectomy can decrease nasal resistance through rhinomanometry. REVIEW METHODS 3 authors members of the YO-IFOS rhinology study group independently analyzed the data sources (Pubmed, the Cochrane Library, EMBASE, SciELO) for papers assessing the change in nasal resistance and/or nasal airflow in rhinomanometry after adenoidectomy in pediatric patients. RESULTS A total of 9 studies with a total population of 423 participants (323 patients excluding healthy controls) met the inclusion criteria. All of them found decreased nasal resistance after adenoidectomy. 5 studies could be combined in a metanalysis, which revealed a statistically significant difference of 0.52 Pa in basal conditions, and 0.64 Pa in rhinomanometry under nasal decongestion. 4 authors explored changes in nasal airflow. All of them found a statistically significant increase in nasal airflow after adenoidectomy. However, their results could not be merged in a meta-analysis. CONCLUSION This systematic review and meta-analysis demonstrated the existence of a systematic decrease in nasal resistance and increase in nasal airflow with and without nasal decongestant after adenoidectomy. The available evidence suggests that rhinomanometry with nasal decongestant could help in intermediate cases of adenoid hypertrophy, in order to identify the presence of nasal obstruction and, when present, the possibility of other causes for it rather than enlarged adenoids, mainly turbinate hypertrophy.
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Affiliation(s)
- Christian Calvo-Henriquez
- Rhinology Study Group of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France; Service of Otolaryngology, Hospital Complex of Santiago de Compostela, Santiago de Compostela, Spain.
| | - Ana María Branco
- College of Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Jerome R Lechien
- Rhinology Study Group of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France; Foch Hospital, University of Paris Saclay, Paris, France
| | - Vilma Sandoval-Pacheco
- Rhinology Study Group of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France; Service of Otolaryngology, Hospital Complex of Santiago de Compostela, Santiago de Compostela, Spain
| | - Byron Maldonado-Alvarado
- Rhinology Study Group of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France; Service of Otolaryngology, Hospital Complex of Santiago de Compostela, Santiago de Compostela, Spain
| | - Juan Maza-Solano
- Rhinology Study Group of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France; Service of Otolaryngology, Virgen de la Macarena University Hospital, Seville, Spain
| | - Marilena Trozzi
- Rhinology Study Group of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France; Service of Otolaryngology, Bambino Gesù Children's Hospital, Rome, Italy
| | - Irene Rivero-Fernández
- Rhinology Study Group of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France; Service of Otolaryngology, 12 de Octubre University Hospital, Madrid, Spain
| | - Gabriel Martínez-Capoccioni
- Rhinology Study Group of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France; Service of Otolaryngology, Hospital Complex of Santiago de Compostela, Santiago de Compostela, Spain
| | - Carlos Martin-Martin
- Service of Otolaryngology, Hospital Complex of Santiago de Compostela, Santiago de Compostela, Spain
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16
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Pithon MM, Marañón-Vásquez GA, da Silva LP, Coqueiro RDS, Lacerda Dos Santos R, Tanaka OM, Maia LC. Effect of treatment of transverse maxillary deficiency using rapid palatal expansion on oral health-related quality of life in children: A randomized controlled trial. Am J Orthod Dentofacial Orthop 2021; 161:172-181. [PMID: 34711482 DOI: 10.1016/j.ajodo.2021.08.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 08/01/2021] [Accepted: 08/01/2021] [Indexed: 11/24/2022]
Abstract
INTRODUCTION This trial aimed to longitudinally evaluate the effect of the treatment of transverse maxillary deficiency using rapid palatal expansion (RPE) on self-perceived oral health-related quality of life (OHRQOL) in children. METHODS Eighty participants aged 8-10 years with transverse maxillary deficiency and bilateral posterior crossbite were randomly assigned to 2 groups (n = 40 each): a group treated with RPE using hyrax-type appliances and a nontreated control group. OHRQOL was assessed by using the Child Perceptions Questionnaire for 8-10-year-olds at 4 times: before RPE, during RPE (T1), at the end of RPE (T2), and 1 month after the appliance removal (T3). Generalized mixed models were used for data analysis (α = 0.05). RESULTS Both groups exhibited similar demographic characteristics and OHRQOL scores at baseline. All participants completed the study. RPE had a time-dependent effect on OHRQOL. At T1 and T2, this therapy is expected to increase the overall OHRQOL scores by 1.17 times (ie, ∼17% increase; T1 95% confidence interval [CI], 1.08-1.26; T2 95% CI, 1.09-1.27; P = 0.001). In contrast, the overall OHRQOL scores at T3 are expected to be 0.28 times the baseline scores (ie, ∼72% reduction; T3 95% CI, 0.26-0.31; P = 0.001). All individual domains of the OHRQOL evidenced a positive impact of treatment at T3 (P = 0.001). Only the oral symptoms and social well-being domains showed a significantly negative impact of the treatment at T1 and T2. CONCLUSIONS Correction of the transverse maxillary deficiency by RPE in children aged 8-10 years improves OHRQOL. There is a temporary worsening of OHRQOL during the treatment of this condition using RPE. REGISTRATION This trial was not registered. PROTOCOL The protocol was not published before trial commencement. FUNDING This study was financed by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brazil, Financing Code 001.
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Affiliation(s)
- Matheus Melo Pithon
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil; Department of Health I, School of Dentistry, Southwest Bahia State University, Jequié, Bahia, Brazil.
| | - Guido Artemio Marañón-Vásquez
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil.
| | - Luciana Pereira da Silva
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | | | | | | | - Lucianne Cople Maia
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
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17
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Nauwelaers N, Matthews H, Fan Y, Croquet B, Hoskens H, Mahdi S, El Sergani A, Gong S, Xu T, Bronstein M, Marazita M, Weinberg S, Claes P. Exploring palatal and dental shape variation with 3D shape analysis and geometric deep learning. Orthod Craniofac Res 2021; 24 Suppl 2:134-143. [PMID: 34310057 DOI: 10.1111/ocr.12521] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 07/16/2021] [Indexed: 12/18/2022]
Abstract
OBJECTIVES Palatal shape contains a lot of information that is of clinical interest. Moreover, palatal shape analysis can be used to guide or evaluate orthodontic treatments. A statistical shape model (SSM) is a tool that, by means of dimensionality reduction, aims at compactly modeling the variance of complex shapes for efficient analysis. In this report, we evaluate several competing approaches to constructing SSMs for the human palate. SETTING AND SAMPLE POPULATION This study used a sample comprising digitized 3D maxillary dental casts from 1,324 individuals. MATERIALS AND METHODS Principal component analysis (PCA) and autoencoders (AE) are popular approaches to construct SSMs. PCA is a dimension reduction technique that provides a compact description of shapes by uncorrelated variables. AEs are situated in the field of deep learning and provide a non-linear framework for dimension reduction. This work introduces the singular autoencoder (SAE), a hybrid approach that combines the most important properties of PCA and AEs. We assess the performance of the SAE using standard evaluation tools for SSMs, including accuracy, generalization, and specificity. RESULTS We found that the SAE obtains equivalent results to PCA and AEs for all evaluation metrics. SAE scores were found to be uncorrelated and provided an optimally compact representation of the shapes. CONCLUSION We conclude that the SAE is a promising tool for 3D palatal shape analysis, which effectively combines the power of PCA with the flexibility of deep learning. This opens future AI driven applications of shape analysis in orthodontics and other related clinical disciplines.
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Affiliation(s)
- Nele Nauwelaers
- Medical Imaging Research Center, UZ Leuven, Leuven, Belgium.,Department of Electrical Engineering, ESAT/PSI, KU Leuven, Leuven, Belgium
| | - Harold Matthews
- Medical Imaging Research Center, UZ Leuven, Leuven, Belgium.,Department of Human Genetics, KU Leuven, Leuven, Belgium.,Facial Sciences Research Group, Murdoch Children's Research Institute, Parkville, MO, Australia
| | - Yi Fan
- Facial Sciences Research Group, Murdoch Children's Research Institute, Parkville, MO, Australia.,Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China.,National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Balder Croquet
- Medical Imaging Research Center, UZ Leuven, Leuven, Belgium.,Department of Electrical Engineering, ESAT/PSI, KU Leuven, Leuven, Belgium
| | - Hanne Hoskens
- Medical Imaging Research Center, UZ Leuven, Leuven, Belgium.,Department of Electrical Engineering, ESAT/PSI, KU Leuven, Leuven, Belgium
| | - Soha Mahdi
- Medical Imaging Research Center, UZ Leuven, Leuven, Belgium.,Department of Electrical Engineering, ESAT/PSI, KU Leuven, Leuven, Belgium
| | - Ahmed El Sergani
- Center for Craniofacial and Dental Genetics, Department of Oral and Craniofacial Sciences, University of Pittsburgh, Pittsburgh, PA, USA
| | - Shunwang Gong
- Department of Computing, Imperial College London, London, UK
| | - Tianmin Xu
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China.,National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Michael Bronstein
- Department of Computing, Imperial College London, London, UK.,Institute of Computational Science, USI Lugano, Lugano, Switzerland.,Twitter
| | - Mary Marazita
- Center for Craniofacial and Dental Genetics, Department of Oral and Craniofacial Sciences, University of Pittsburgh, Pittsburgh, PA, USA.,Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Seth Weinberg
- Center for Craniofacial and Dental Genetics, Department of Oral and Craniofacial Sciences, University of Pittsburgh, Pittsburgh, PA, USA
| | - Peter Claes
- Medical Imaging Research Center, UZ Leuven, Leuven, Belgium.,Department of Electrical Engineering, ESAT/PSI, KU Leuven, Leuven, Belgium.,Department of Human Genetics, KU Leuven, Leuven, Belgium.,Facial Sciences Research Group, Murdoch Children's Research Institute, Parkville, MO, Australia
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18
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Croquet B, Matthews H, Mertens J, Fan Y, Nauwelaers N, Mahdi S, Hoskens H, El Sergani A, Xu T, Vandermeulen D, Bronstein M, Marazita M, Weinberg S, Claes P. Automated landmarking for palatal shape analysis using geometric deep learning. Orthod Craniofac Res 2021; 24 Suppl 2:144-152. [PMID: 34169645 DOI: 10.1111/ocr.12513] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 06/01/2021] [Accepted: 06/14/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To develop and evaluate a geometric deep-learning network to automatically place seven palatal landmarks on digitized maxillary dental casts. SETTINGS AND SAMPLE POPULATION The sample comprised individuals with permanent dentition of various ethnicities. The network was trained from manual landmark annotations on 732 dental casts and evaluated on 104 dental casts. MATERIALS AND METHODS A geometric deep-learning network was developed to hierarchically learn features from point-clouds representing the 3D surface of each cast. These features predict the locations of seven palatal landmarks. RESULTS Repeat-measurement reliability was <0.3 mm for all landmarks on all casts. Accuracy is promising. The proportion of test subjects with errors less than 2 mm was between 0.93 and 0.68, depending on the landmark. Unusually shaped and large palates generate the highest errors. There was no evidence for a difference in mean palatal shape estimated from manual compared to the automatic landmarking. The automatic landmarking reduces sample variation around the mean and reduces measurements of palatal size. CONCLUSIONS The automatic landmarking method shows excellent repeatability and promising accuracy, which can streamline patient assessment and research studies. However, landmark indications should be subject to visual quality control.
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Affiliation(s)
- Balder Croquet
- Medical Imaging Research Center, UZ Leuven, Leuven, Belgium.,Department of Electrical Engineering, ESAT/PSI, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Harold Matthews
- Medical Imaging Research Center, UZ Leuven, Leuven, Belgium.,Department of Human Genetics, Katholieke Universiteit Leuven, Leuven, Belgium.,Facial Science Research Group, Murdoch Children's Research Institute, Parkville, Australia
| | - Jules Mertens
- Medical Imaging Research Center, UZ Leuven, Leuven, Belgium
| | - Yi Fan
- Facial Science Research Group, Murdoch Children's Research Institute, Parkville, Australia.,Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China.,National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Nele Nauwelaers
- Medical Imaging Research Center, UZ Leuven, Leuven, Belgium.,Department of Electrical Engineering, ESAT/PSI, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Soha Mahdi
- Medical Imaging Research Center, UZ Leuven, Leuven, Belgium.,Department of Electrical Engineering, ESAT/PSI, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Hanne Hoskens
- Medical Imaging Research Center, UZ Leuven, Leuven, Belgium.,Department of Electrical Engineering, ESAT/PSI, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Ahmed El Sergani
- Center for Craniofacial and Dental Genetics, Department of Oral and Craniofacial Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Tianmin Xu
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China.,National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Dirk Vandermeulen
- Medical Imaging Research Center, UZ Leuven, Leuven, Belgium.,Department of Electrical Engineering, ESAT/PSI, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Michael Bronstein
- Department of Computing, Imperial College London, London, UK.,Institute of Computational Science, USI Lugano, Lugano, Switzerland
| | - Mary Marazita
- Department of Oral and Craniofacial Sciences, Center for Craniofacial and Dental Genetics, Department of Human Genetics University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Seth Weinberg
- Center for Craniofacial and Dental Genetics, Department of Oral and Craniofacial Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Peter Claes
- Medical Imaging Research Center, UZ Leuven, Leuven, Belgium.,Department of Electrical Engineering, ESAT/PSI, Katholieke Universiteit Leuven, Leuven, Belgium.,Department of Human Genetics, Katholieke Universiteit Leuven, Leuven, Belgium.,Facial Science Research Group, Murdoch Children's Research Institute, Parkville, Australia
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19
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Oka S, Kawanabe H, Yamanobe S, Fukui K, Baba Y, Deguchi T. Relationship between olfaction and maxillofacial morphology in children with malocclusion. Clin Exp Dent Res 2020; 7:33-39. [PMID: 32977366 PMCID: PMC7853900 DOI: 10.1002/cre2.329] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 07/29/2020] [Accepted: 08/21/2020] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVES Functional problems, including nasal flow problems, are associated with specific skeletal and dental features. Further, maxillary expansion has been associated with nasal airway resistance alterations. This study aimed to investigate whether there is a correlation between skeletal features and nasal airflow- and olfaction-related problems. MATERIALS AND METHODS This prospective study included 68 patients (30 boys, 38 girls; mean age 9 ± 2 years) examined at the Ohu University Hospital. We classified patients into three skeletal Classes (Class I, II, and III) based on the ANB angle. Olfactory disorder history was collected from the guardians. Maxillofacial measurements, nasal airflow assessments, and olfactory tests were performed using cephalometric analysis, rhinomanometry, and T&T olfactometer, respectively. RESULTS Malocclusion, resulting from skeletal mandibular protrusion and smaller maxilla, was associated with reduced olfaction in children. The detection and recognition thresholds of skeletal Class III were significantly higher than those of Classes I (p = .01) and II (p = .01). Significant correlations were observed between SNA and the detection threshold (r = -.50) as well as between nasion perpendicular-point A and the recognition threshold (r = -.53). The detection and recognition thresholds were significantly higher in Class III than in Classes I (r = .3) and II (r = -.1). CONCLUSIONS Maxillary growth and development may be associated with olfaction in children. Changing the maxillofacial morphology may improve olfactory function. In the future, we will investigate how malocclusion treatment affects olfactory function.
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Affiliation(s)
- Shiori Oka
- Department of Oral Growth and Development, Division of Dentofacial Orthopedics, Ohu University, Graduate School of Dentistry, Fukushima, Japan
| | - Hitoshi Kawanabe
- Division of Orthodontics and Dentofacial Orthopedics, Department of Oral Growth and Development, Ohu University, School of Dentistry, Fukushima, Japan
| | - Shinya Yamanobe
- Division of Orthodontics and Dentofacial Orthopedics, Department of Oral Growth and Development, Ohu University, School of Dentistry, Fukushima, Japan
| | - Kazunori Fukui
- Division of Orthodontics and Dentofacial Orthopedics, Department of Oral Growth and Development, Ohu University, School of Dentistry, Fukushima, Japan
| | - Yuh Baba
- Department of General Clinical Medicine, Ohu University, School of Dentistry, Fukushima, Japan
| | - Toru Deguchi
- Division of Orthodontics, The Ohio State University College of Dentistry, Columbus, Ohio, USA
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20
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Calvo-Henriquez C, Capasso R, Chiesa-Estomba C, Liu SY, Martins-Neves S, Castedo E, O'Connor-Reina C, Ruano-Ravina A, Kahn S. The role of pediatric maxillary expansion on nasal breathing. A systematic review and metanalysis. Int J Pediatr Otorhinolaryngol 2020; 135:110139. [PMID: 32502910 DOI: 10.1016/j.ijporl.2020.110139] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 05/21/2020] [Accepted: 05/22/2020] [Indexed: 01/08/2023]
Abstract
OBJECTIVE A reduced transversal dimension of the maxilla leads to narrower nasal cavities, which may reduce airflow to the lungs. Maxillary expansion widens nasal floor. However, there is huge controversy regarding whether this increase does actually lead to increased airflow. In this systematic review and meta-analysis we aim to resolve this question by evaluating studies that have undertaken rhinomanometric measurements. REVIEW METHODS Pubmed (Medline), the Cochrane Library, EMBASE and Trip Database were checked by two authors. Two authors extracted the data. Main outcome was expressed as the difference between resistance before and after treatment and the 95% confidence interval. RESULTS 30 studies were selected for full text reading. A total of 12 studies (301 patients) met the inclusion criteria. All selected articles found reduced resistance after palatal expansion. The data pooled in the meta-analysis reveals a statistically significant difference of 0.12 Pa s/cm3 mean reduction after palatal expansion (CI 95% 0.06, 0.18) for nine uncontrolled studies. Regarding nasal airflow, the pooled data show a statistically significant difference of 29.9 cm3/s increase after palatal expansion (CI 95% 9.17, 50.64). CONCLUSION According to the available evidence, palatal expansion in pediatric patients decreases nasal resistance and increases nasal flow.
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Affiliation(s)
- Christian Calvo-Henriquez
- Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS) Study Group, Paris, France; Service of Otolaryngology, Hospital Complex of Santiago de Compostela, Spain.
| | - Robson Capasso
- Department of Otolaryngology - Head and Neck Surgery, Sleep Surgery Division, Stanford University Medical Center, Stanford, CA, USA
| | - Carlos Chiesa-Estomba
- Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS) Study Group, Paris, France; Service of Otolaryngology, Donostia University Hospital, San Sebastian, Spain
| | - Stanley Yung Liu
- Department of Otolaryngology - Head and Neck Surgery, Sleep Surgery Division, Stanford University Medical Center, Stanford, CA, USA
| | | | - Elena Castedo
- Orthodontic Private Practice, Santiago de Compostela, Spain
| | | | - Alberto Ruano-Ravina
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Spain; CIBER de Epidemiología y Salud Pública, CIBERESP, Spain
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21
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Fox GC, Jones TA, Wilson JM, Claro WI, Williams RA, Trojan TM, Al Dayeh A. Sutural loading in bone‐ versus dental‐borne rapid palatal expansion: An ex vivo study. Orthod Craniofac Res 2020; 23:419-426. [DOI: 10.1111/ocr.12384] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 04/17/2020] [Accepted: 04/27/2020] [Indexed: 01/02/2023]
Affiliation(s)
- Gavin C. Fox
- Department of Orthodontics College of Dentistry University of Tennessee Health Science Center Memphis TN USA
| | - Thomas A. Jones
- Department of Orthodontics College of Dentistry University of Tennessee Health Science Center Memphis TN USA
| | - John M. Wilson
- College of Dentistry University of Tennessee Health Science Center Memphis TN USA
| | - Wanda I. Claro
- Department of Orthodontics College of Dentistry University of Tennessee Health Science Center Memphis TN USA
| | - Richard A. Williams
- Department of Orthodontics College of Dentistry University of Tennessee Health Science Center Memphis TN USA
| | - Terry M. Trojan
- Department of Orthodontics College of Dentistry University of Tennessee Health Science Center Memphis TN USA
| | - Ayman Al Dayeh
- Department of Orthodontics College of Dentistry University of Tennessee Health Science Center Memphis TN USA
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22
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Monga N, Kharbanda OP, Balachandran R, Neelapu BC. Palatal volume estimation in operated unilateral and bilateral cleft lip and palate subjects using digital study models. Orthod Craniofac Res 2020; 23:284-290. [DOI: 10.1111/ocr.12368] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 01/22/2020] [Accepted: 01/23/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Nitika Monga
- Indian Council of Medical Research (ICMR) New Delhi India
- Division of Orthodontics and Dentofacial Deformities Centre for Dental Education and Research All India Institute of Medical Sciences New Delhi India
| | - Om Prakash Kharbanda
- Division of Orthodontics and Dentofacial Deformities Centre for Dental Education and Research All India Institute of Medical Sciences New Delhi India
| | - Rajiv Balachandran
- Division of Orthodontics and Dentofacial Deformities Centre for Dental Education and Research All India Institute of Medical Sciences New Delhi India
| | - Bala Chakravarthy Neelapu
- Academy of Scientific & Innovative Research (AcSIR) CSIR‐Central Scientific Instruments Organisation Chandigarh India
- Koneru Lakshmaiah Education Foundation Vijayawada AP India
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23
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Huang X, Hu X, Zhao Y, Wang Y, Gu Y. Preliminary comparison of three-dimensional reconstructed palatal morphology in subjects with different sagittal and vertical patterns. BMC Oral Health 2020; 20:55. [PMID: 32066451 PMCID: PMC7027022 DOI: 10.1186/s12903-020-1041-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 02/10/2020] [Indexed: 12/25/2022] Open
Abstract
Background The aim of this study was to assess the difference of palatal morphology in different vertical patterns between skeletal Class I subjects and skeletal Class II subjects with retrusive mandible. Methods Seventy-six skeletal Class II subjects with retrusive mandible (38 females, 38 males) and 85 skeletal Class I subjects (45 females, 40 males) were collected retrospectively and divided into hyperdivergent, normodivergent and hypodivergent groups. CBCT images of these subjects were reoriented by Dolphin 3D Imaging software. Three-dimensional (3D) maxilla was segmented by ProPlan software before using Geomagic Studio software to reconstruct 3D palatal morphology. Deviation patterns on 3D colored map analysis was performed to compare the difference of 3D palatal morphology between different groups. Results 3D colored map analysis showed that male’s palate was higher and wider than that of female in the posterior part, regardless of different sagittal and vertical patterns. In skeletal Class II subjects with retrusive mandible, males with hyperdivergent and normodivergent showed higher and narrower in the posterior part of palate, while females with hyperdivergent and normodivergent had a higher but no obviously narrow palate compared with the hypodivergent subjects. Skeletal Class II subjects with retrusive mandible showed flatter and narrower in the posterior part of palate than that of skeletal Class I subjects. Conclusions Sagittal and vertical patterns have great influence on the palatal morphology and as the vertical dimension increased, the palate tended to be higher and narrower.
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Affiliation(s)
- Xiaoyi Huang
- Department of orthodontics, Peking University School and Hospital of Stomatology, No. 22 Zhongguancun Avenue South, Haidian District, Beijing, 100081, China
| | - Xinnong Hu
- Department of orthodontics, Peking University School and Hospital of Stomatology, No. 22 Zhongguancun Avenue South, Haidian District, Beijing, 100081, China
| | - Yijiao Zhao
- National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, No. 22 Zhongguancun Avenue South, Haidian District, Beijing, 100081, China
| | - Yong Wang
- National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, No. 22 Zhongguancun Avenue South, Haidian District, Beijing, 100081, China
| | - Yan Gu
- Department of orthodontics, Peking University School and Hospital of Stomatology, No. 22 Zhongguancun Avenue South, Haidian District, Beijing, 100081, China.
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24
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Tang H, Liu Q, Lin JH, Zeng H. [Three-dimensional morphological analysis of the palate of mouth-breathing children in mixed dentition]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2019; 37:389-393. [PMID: 31512831 DOI: 10.7518/hxkq.2019.04.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To study the effects of mouth-breathing on maxillary arch development by comparing the palatal morphology of mouth- and nose-breathing children in mixed dentition. METHODS Children in mixed dentition were enrolled and categorized into mouth-breathing (test group) and nose-breathing groups (control group) according to their breathing patterns. Children's plaster models were scanned with 3D laser scanner, and the 3D data were reconstructed and measured using Minics 15.0 and Geomagic 12.0 software. Measurement data (inter-molar width, palatal height, palatal volume, and palatal surface area) of the two groups were compared, and the correlation among the four measurement items was analyzed. RESULTS The participants were 73 children (37 in test group and 36 in control group) with a mean age of (8.63±0.78) years old. The test group had significantly smaller inter-molar width, palatal volume, and palatal surface area but significantly higher palatal height than the control group (P<0.05). Inter-molar width and palatal volume were positively correlated with the palatal surface area in the test group (P<0.05). Inter-molar width and palatal height were positively correlated with the palatal surface area in the control group (P<0.01). CONCLUSIONS Mouth-breathing children have significantly reduced inter-molar width, palatal volume, and surface, and substantially increased palatal height, leading to different developmental patterns of the palatal morphology.
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Affiliation(s)
- Huan Tang
- Dept. of Pediatric Dentistry, Stomatological Hospital of Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing 401147, China
| | - Qiao Liu
- Dept. of Pediatric Dentistry, Stomatological Hospital of Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing 401147, China
| | - Ju-Hong Lin
- Dept. of Pediatric Dentistry, Stomatological Hospital of Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing 401147, China
| | - Huan Zeng
- Dept. of Pediatric Dentistry, Stomatological Hospital of Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing 401147, China
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25
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Botticelli S, Küseler A, Mølsted K, Ovsenik M, Nørholt SE, Dalstra M, Cattaneo PM, Pedersen TK. Palatal morphology in unilateral cleft lip and palate patients: Association with infant cleft dimensions and timing of hard palate repair. Orthod Craniofac Res 2019; 22:270-280. [PMID: 31056824 DOI: 10.1111/ocr.12318] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 04/05/2019] [Accepted: 04/26/2019] [Indexed: 01/05/2023]
Abstract
OBJECTIVES To assess the impact of cleft severity and timing of hard palate repair on palatal dimensions in unilateral cleft lip and palate (UCLP) children. SETTING AND SAMPLE POPULATION Single-centre analysis within a multicenter RCT of primary surgery; 122 UCLP randomized to early hard palate closure (EHPC) at 12 months or delayed hard palate closure (DHPC) at 36 months; 28 frequency-matched controls. METHODS Linear measurements of palatal height, width and length were performed on 116 digital models of UCLP subjects (8.21 years, SD = 0.53) and 28 models of non-cleft individuals (8.44 years SD = 0.72). Cleft dimensions at infancy (mean 1.8 months) were considered. In a pilot study, shell-to-shell distances between the 3D cleft palate objects and a reference mesh were calculated and differences between the groups assessed. Morphological differences were visualized using colour mapping. RESULTS Compared to controls, UCLP subjects presented a higher palate at the level of the anterior scar (P = 0.002), but generally a lower palate in the middle region (P < 0.001). Comparing UCLP subgroups, the DHPC subjects showed a flatter palate posteriorly (P = 0.048) and the EHPC group exhibited more transversal constriction (P = 0.003 at M1 level). 3D analysis revealed a shallower palate in the DHPC group both in the middle (P = 0.002) and the posterior part (P = 0.008). Anterior cleft severity correlated negatively with palatal height (P = 0.01). CONCLUSIONS Unilateral cleft lip and palate palates differ from controls in width and height. DHPC may represent an advantage for the transversal dimension, but a disadvantage for palatal height. Infant cleft dimensions partially explain differences in palatal height.
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Affiliation(s)
- Susanna Botticelli
- Section of Orthodontics, Aarhus University, Aarhus, Denmark.,Cleft Lip and Palate Department, Institut for Komunikation og Handikap (IKH), Aarhus, Denmark
| | - Annelise Küseler
- Section of Orthodontics, Aarhus University, Aarhus, Denmark.,Cleft Lip and Palate Department, Institut for Komunikation og Handikap (IKH), Aarhus, Denmark.,Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Kirsten Mølsted
- Copenhagen Cleft Palate Center-University Hospital of Copenhagen, Copenhagen, Denmark
| | - Maja Ovsenik
- Department of Orthodontics and Dentofacial Orthopedics, University of Ljubljana, Ljubljana, Slovenia
| | - Sven Erik Nørholt
- Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark.,Section of Oral Surgery and Oral Pathology, Aarhus University, Aarhus, Denmark
| | - Michel Dalstra
- Section of Orthodontics, Aarhus University, Aarhus, Denmark
| | | | - Thomas Klit Pedersen
- Section of Orthodontics, Aarhus University, Aarhus, Denmark.,Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark
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Zhongpeng Y, Tianmin X, Ruoping J. Deviations in palatal region between indirect and direct digital models: an in vivo study. BMC Oral Health 2019; 19:66. [PMID: 31029133 PMCID: PMC6487036 DOI: 10.1186/s12903-019-0751-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 03/31/2019] [Indexed: 11/14/2022] Open
Abstract
Background Studies focusing on accuracy of intraoral digital models in the palatal region are scarce. The present study aimed to investigate the influence of different scanning sequences on palatal trueness and to assess deviation and distribution character of trueness in palate. Methods Overall, 35 participants accepted three types of procedures to acquire upper digital models. Indirect models digitalised from plaster models were considered as the reference. Two direct digital models were acquired using TRIOS 3 POD intraoral scanners, namely Groups Tr1 and Tr2, wherein intraoral scanning differed in terms of palatal scanning sequences. Based on a modified dental-level superimposition method, 3D measurements of trueness in palate and palatal vault region (PVR) for palatal stable regional superimposition in Groups Tr1 and Tr2, respectively, were performed. Absolute deviations were measured for trueness, while signed deviations were analysed for shape distortion. Colour-coded maps were used for quantitative analysis of deviation distribution pattern. Paired t test was used to analyse differences in palatal trueness between different scanning sequences. One-way repeated-measures analysis of variance and Bonferroni test were used to compare trueness measurements among different superimposition methods. Intraclass correlation coefficient (ICC) was used to verify reproducibility of the proposed method. Results Palatal trueness in Group Tr1 (118.59 ± 37.67 μm) was slightly less accurate than that (108.25 ± 33.83 μm) in Group Tr2 (p = 0.012 < 0.05). Trueness of PVR in Groups Tr1 (127.35 ± 54.11 μm) and Tr2 (118.17 ± 49.52 μm) did not differ significantly (p = 0.149). Moreover, no significant difference was noted in distortion of the palatal region and PVR in Groups Tr1 and Tr2 (p = 0.582 and 0.615, respectively). A similar pattern of palatal trueness was noted in a majority of participants (22/35). For 3D palatal trueness measurement, there were different applications for different superimposition methods. ICC for the proposed method was > 0.90. Conclusions Scanning sequences can affect palatal trueness. Palatal scanning should be initiated at the palatal side of the posterior teeth where the initial scan begins. For 3D PVR superimposition, distal boundary of the selected region should be adjusted mesially whilst referring to intraoral digital models. Trial registration The trial has been registered (registration No: R000039467, Trial ID: UMIN000034617, date of registration: 2018/10/24‘retrospectively registered’).
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Affiliation(s)
- Yang Zhongpeng
- National Engineering Laboratory for Digital and Material Technology of Stomatology, Peking University School and Hospital of Stomatology, No.22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, China.,Department of Orthodontics, Peking University School and Hospital of Stomatology, No.22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, China
| | - Xu Tianmin
- National Engineering Laboratory for Digital and Material Technology of Stomatology, Peking University School and Hospital of Stomatology, No.22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, China.,Department of Orthodontics, Peking University School and Hospital of Stomatology, No.22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, China
| | - Jiang Ruoping
- National Engineering Laboratory for Digital and Material Technology of Stomatology, Peking University School and Hospital of Stomatology, No.22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, China. .,Department of Orthodontics, Peking University School and Hospital of Stomatology, No.22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, China.
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27
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Bucci R, Montanaro D, Rongo R, Valletta R, Michelotti A, D'Antò V. Effects of maxillary expansion on the upper airways: Evidence from systematic reviews and meta-analyses. J Oral Rehabil 2019; 46:377-387. [PMID: 30664799 DOI: 10.1111/joor.12766] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 12/13/2018] [Accepted: 01/13/2019] [Indexed: 01/08/2023]
Abstract
BACKGROUND Constricted maxilla is frequently associated with reduced nasal airway dimensions. Wheatear skeletal maxillary expansion (ME) is effective on the dimension of the upper airways is still a debated issue. OBJECTIVES This overview aimed to report the evidence provided by systematic reviews (SRs) on the effect of ME on the upper airways and to assess the methodological quality of the included SRs. METHODS Six electronic databases have been explored up to November 2017. After title and abstract screening, SRs addressing the effects of fixed palatal expanders on the dimension and function of the nasal airways were included. The methodological quality of the included SRs was assessed using the updated version of A Measurement Tool to Assess Systematic Review (AMSTAR-2). RESULTS Eight SRs were included. The methodological quality of most of the included SRs ranged between low and critically low. One SR was rated of high quality. A significant increase in nasal linear dimensions was reported both in the short and long term, but supported by low-/critically low-quality SRs. The significant increase in nasal cavity volume was the only outcome supported by a high-quality SR Controversial results were found with regards to nasal function. CONCLUSION Whenever a constricted maxilla is present general dentists, paediatricians and ENTs should be familiar with the potential improvement provided by ME. However, due to the low/critically low quality of SRs supporting these results, ME cannot be indicated only for upper airways enhancement, but should be supported by an orthodontic indication.
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Affiliation(s)
- Rosaria Bucci
- Department of Neurosciences, Reproductive Sciences and Oral Sciences, School of Orthodontics and Temporomandibular Disorders, University of Naples "Federico II", Naples, Italy
| | - Danilo Montanaro
- Department of Neurosciences, Reproductive Sciences and Oral Sciences, School of Orthodontics and Temporomandibular Disorders, University of Naples "Federico II", Naples, Italy
| | - Roberto Rongo
- Department of Neurosciences, Reproductive Sciences and Oral Sciences, School of Orthodontics and Temporomandibular Disorders, University of Naples "Federico II", Naples, Italy
| | - Rosa Valletta
- Department of Neurosciences, Reproductive Sciences and Oral Sciences, School of Orthodontics and Temporomandibular Disorders, University of Naples "Federico II", Naples, Italy
| | - Ambra Michelotti
- Department of Neurosciences, Reproductive Sciences and Oral Sciences, School of Orthodontics and Temporomandibular Disorders, University of Naples "Federico II", Naples, Italy
| | - Vincenzo D'Antò
- Department of Neurosciences, Reproductive Sciences and Oral Sciences, School of Orthodontics and Temporomandibular Disorders, University of Naples "Federico II", Naples, Italy
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Ahn MS, Shin SM, Choi YS, Wu TJ, Ko CC, Yamaguchi T, Maki K, Kim YI. Analysis of the relationship between the morphology of the palate and facial skeletal patterns in Class III malocclusion using structural equation modelling. Orthod Craniofac Res 2019; 22:87-92. [PMID: 30633439 DOI: 10.1111/ocr.12283] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 12/28/2018] [Accepted: 01/04/2019] [Indexed: 11/29/2022]
Abstract
INTRODUCTION The present study investigated the relationship between facial skeletal patterns and morphology of the palate in adult patients with Class III malocclusion using structural equation modelling (SEM). SETTING AND SAMPLE POPULATION One hundred cone beam computed tomography images of Class III adults were evaluated for skeletal measurements. MATERIALS AND METHODS The skeletal measurements were classified into the vertical, anteroposterior and transverse group based on factor analysis. 3D scanning model of the maxilla was analysed by Generalized procrustes analysis (GPA) and principal component analysis (PCA). Structural equation modelling was used to analyse relationship among the skeletal and morphometric factors. RESULTS According to the factor analysis, latent variables were extracted by each skeletal variable. First principal component (PC1) and PC2 of palatal morphology were used to analyse relationship with skeletal variables. As results of the structural equation model, the transverse latent variable had the most influence on PC1, followed by vertical and anteroposterior variables. This result means that as the facial width increases, the palate becomes narrower, deeper and longer. CONCLUSIONS The relationship between the skeletal pattern with Class III malocclusion and palatal morphology was analysed through SEM. The transverse facial skeletal pattern showed the highest correlation with PC1 of palatal morphology.
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Affiliation(s)
- Mi So Ahn
- Department of Orthodontics, Dental research institute, Pusan National University Dental Hospital, Yangsan, Korea
| | - Sang Min Shin
- Department of Management Information Systems, College of Business, Dong-A University, Busan, Korea
| | - Yong-Seok Choi
- Department of Statistics, College of Natural Sciences, Pusan National University, Busan, Korea
| | - Te-Ju Wu
- Department of Orthodontics, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Ching-Chang Ko
- Department of Orthodontics, School of Dentistry, University of North Carolina at Chapel Hill, North Carolina
| | - Tetsutaro Yamaguchi
- Department of Orthodontics, School of Dentistry, Showa University, Tokyo, Japan
| | - Koutaro Maki
- Department of Orthodontics, School of Dentistry, Showa University, Tokyo, Japan
| | - Yong-Il Kim
- Department of Orthodontics, Dental research institute, Pusan National University Dental Hospital, Yangsan, Korea.,Institute of Translational dental science, School of Dentistry, Pusan National University, Busan, Korea
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Volumetric measurement of dentoalveolar defects by means of intraoral 3D scanner and gravimetric model. Odontology 2019; 107:353-359. [PMID: 30617638 PMCID: PMC6557874 DOI: 10.1007/s10266-018-00410-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 12/10/2018] [Indexed: 11/04/2022]
Abstract
The aim of this study was to evaluate the accuracy in volumetric measurements obtained on an experimental model using an intraoral scanner and a gravimetric method. Three identical partial dentate maxillary acrylic models with three fabricated alveolar defects, in anterior and posterior regions, were scanned using an intraoral scanner (20 scans/defects). The defects differed in terms of size and distance of neighbouring teeth. As references, replicas of each defect were created using a dimensional stable silicone impression material. After measuring the mass of each replica, the volume was calculated by dividing the mass of each replica by the density of the impression material. The defects had a volume, according to the gravimetric method, ranging from 40.5 to 143.7 mm3. The scans were imported to metrology software for analyses. Accuracy was determined in terms of trueness and precision. The mean trueness for all defect types was 0.168 mm3 (SD 0.691, range 2.82). There was no statistical significant difference between the mean trueness for all defects measured (p = 0.910). The mean precision for all defect types was 0.147 mm3 (SD 0.524, range 2.86). There were no statistical significant differences between the dental models in regard to mean precision (p = 0.401), however, there were statistical significant differences between defects in position 1 and 2 (p = 0.002) and 1 and 3 (p = 0.001). Based on the findings of this study, the intraoral scanner utilized in the current study presented an acceptable level of accuracy when measuring volume of defects.
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Stark TR, Pozo-Alonso M, Daniels R, Camacho M. Pediatric Considerations for Dental Sleep Medicine. Sleep Med Clin 2018; 13:531-548. [DOI: 10.1016/j.jsmc.2018.08.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Parcha E, Bitsanis E, Halazonetis DJ. Morphometric covariation between palatal shape and skeletal pattern in children and adolescents: a cross-sectional study. Eur J Orthod 2018; 39:377-385. [PMID: 27694577 DOI: 10.1093/ejo/cjw063] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Objective To assess shape covariation of the palate and craniofacial complex (CFC) in children and adolescents. Methods Pre-treatment lateral cephalometric radiographs and corresponding maxillary casts of 100 children (8-10 years) and 100 adolescents (15-20 years) were digitized. Exclusion criteria were previous orthodontic treatment, craniofacial syndromes, mouth breathing, finger sucking, crossbite, tooth agenesis, and tooth impaction. Palatal shape was described with 239 surface and curve semilandmarks and craniofacial shape with 10 fixed landmarks and 117 curve semilandmarks. Procrustes superimposition and principal component analysis were applied for evaluation of shape variability. Shape covariation between palate and CFC was assessed with partial least squares analysis. Results The first five principal components explained 77 per cent (palate) and 60 per cent (CFC) of total shape variability. The palate varied mainly in height (adolescent group) and width-length (both groups), whereas the CFC varied mainly in the vertical dimension. Significant covariation was found between the craniofacial and palatal components (RV coefficient: 0.27, children; RV: 0.23, adolescents). Variation of the CFC in the vertical and anteroposterior direction was mainly related to variation in the height-width and the width-length ratio of the palate, respectively. Limitations The use of lateral cephalometric radiographs eliminated the transverse dimension from the craniofacial shape analysis. The study was cross-sectional, so the observed intergroup differences should be interpreted with caution. Conclusions Covariation strength and pattern were similar in children and adolescents. The closer a subject was to the high-angle end of the variability spectrum, the higher and narrower was the palate, and conversely.
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Affiliation(s)
- Eleni Parcha
- Department of Orthodontics, School of Dentistry, National and Kapodistrian University of Athens, Greece
| | - Elias Bitsanis
- Department of Orthodontics, School of Dentistry, National and Kapodistrian University of Athens, Greece
| | - Demetrios J Halazonetis
- Department of Orthodontics, School of Dentistry, National and Kapodistrian University of Athens, Greece
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Paoloni V, Cretella Lombardo E, Placidi F, Ruvolo G, Cozza P, Laganà G. Obstructive sleep apnea in children with Marfan syndrome: Relationships between three-dimensional palatal morphology and apnea-hypopnea index. Int J Pediatr Otorhinolaryngol 2018; 112:6-9. [PMID: 30055741 DOI: 10.1016/j.ijporl.2018.06.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 06/07/2018] [Accepted: 06/09/2018] [Indexed: 10/14/2022]
Abstract
OBJECTIVE To evaluate the relationship between the severity degree of OSA (apnea/hypopnea index AHI>1) and palatal area and volume, measured by 3D analysis of digital casts in Marfan children. METHODS Twenty children with a clinical diagnosis of MS were recruited from a tertiary medical center. All the subjects underwent standard nocturnal polygraphy testing. Sixteen Marfan patients (7F,9 M; mean age 8.8yy ± 1.5yy) with AHI>1 were enrolled. Marfan Group (MG) was compared with a control group (CG) of 17 children without Marfan syndrome (9F,8 M; mean age 8.5yy ± 1.7yy) presenting with nose-breathing pattern. For each subject maxillary digital casts were taken and palatal area and volume were measured. Unpaired t-test was used to test significant differences between MG and CG for area and volume measurements. Pearson correlation coefficient (PCC) was used to measure the linear correlation between the degree of OSA (AHI index) and palatal volume and palatal area. RESULTS 80% of Marfan children presented an AHI>1 and a diagnosis of OSA. MG presented statistically significant lower values of palatal surface area (662.68 mm2; P < 0.0001) and palatal volume (2578.1 mm3; P < 0.0001) with respect to CG (923.0 mm2 and 3756.6 mm3, respectively). Correlation analysis showed that AHI index had no linear correlation with palatal area (r = - 0,07) and with palatal volume (r = - 0,11). CONCLUSION OSA is highly prevalent in children with Marfan's syndrome (80%). Marfan children present a reduction of palatal area and volume when compared to healthy subjects. OSA in Marfan children is not linear correlated to the palatal morphology and it shows a multifactorial aetiology.
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Affiliation(s)
- V Paoloni
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Rome, Italy.
| | - E Cretella Lombardo
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Rome, Italy
| | - F Placidi
- Department of System Medicine, University of Rome Tor Vergata, Rome, Italy
| | - G Ruvolo
- Department of Cardiac Surgery Unit, Centre for Rare Diseases for Marfan Syndrome and Related Disorders, University of Tor Vergata General Hospital, Rome, Italy
| | - P Cozza
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Rome, Italy
| | - G Laganà
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Rome, Italy
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Yu C, Ahn HW, Kim SH. Three-dimensional morphological evaluation of the hard palate in Korean adults with mild-to-moderate obstructive sleep apnea. Korean J Orthod 2018; 48:133-142. [PMID: 29732299 PMCID: PMC5932315 DOI: 10.4041/kjod.2018.48.3.133] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Revised: 09/20/2017] [Accepted: 10/01/2017] [Indexed: 11/20/2022] Open
Abstract
Objective The purpose of this study was to evaluate differences in three-dimensional (3D) morphology of the hard palate between Korean adults with and without mild-to-moderate obstructive sleep apnea (OSA) using cone-beam computed tomographic (CBCT) data. Methods The protocol for the two-dimensional (2D) and 3D mathematical modeling was established by analyzing CBCT images of 30 adults with OSA and 30 matched controls without OSA, using MIMICS software. The linear and angular measurements were also determined using this software. The measurements were repeated for 30 palates, by the same operator, to assess reliability. Results The palates of OSA patients were higher in the posterior part and narrower in the anterior-superior part than those of the control group (p < 0.05). The nasal cavities of patients with OSA were narrower (p < 0.05) than those of controls. The increasing angle of the first molar palatal root is a compensation of the upper dental arch to improve occlusion. However, for most palatal measurements, there were no significant differences between the OSA and control groups (p > 0.05). The results of 2D and 3D mathematical models were consistent for linear and angular measurements, indicating that 2D and 3D mathematical modeling of the palate is a reliable methodology. Conclusions OSA is a multifactorial disease; the palates of adults with mild-to-moderate OSA do not have specific morphological features distinct from those of healthy controls.
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Affiliation(s)
- Chen Yu
- Department of Orthodontics, Medical College of Xiamen University, Xiamen, China
| | - Hyo-Won Ahn
- Department of Orthodontics, Graduate School, Kyung Hee University, Seoul, Korea
| | - Seong-Hun Kim
- Department of Orthodontics, Graduate School, Kyung Hee University, Seoul, Korea
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Prevalence of upper respiratory tract infections in habitually snoring and mouth breathing children. Int J Pediatr Otorhinolaryngol 2018; 107:37-41. [PMID: 29501308 DOI: 10.1016/j.ijporl.2018.01.022] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 01/07/2018] [Accepted: 01/10/2018] [Indexed: 02/06/2023]
Abstract
OBJECTIVES The aim of the study was to investigate the prevalence of upper respiratory tract infections (URI) - as indicated by rhinosinusitis (RS), ear infections (EI), and antibiotic consumption - in a general pediatric population and evaluate the relationship between these conditions and habitual snoring and mouth breathing during sleep. METHODS A population-based cross-sectional study was performed in three medium-sized Polish cities from 2011 to 2015. RESULTS 4837/6963 questionnaires (69.5%) were completed, returned and analyzed. Mean age of studied group was 7.07 ± 0.72 and 7.14 ± 0.73 in girls and boys, respectively. Habitual mouth breathing during sleep (MB) was reported in 907 (18.7%) children and habitual snoring (HS) in 290 (6.0%). 230/290 (79.3%) of children with HS were also MB. Both HS and MB were more prevalent in boys than in girls (p = 0.027 and p < 0.0001, respectively) and neither was associated with BMI (p = 0.11 and p = 0.07, respectively). Habitual snoring and habitual mouth breathing were highly associated with more frequent bouts of rhinosinusitis, ear infections, and antibiotic use (p < 0.0001 for each parameter). CONCLUSIONS Higher rates of rhinosinusitis, ear infections, and antibiotic consumption were similarly associated with HS and MB. MB is over three times more prevalent in the pediatric population relative to HS, therefore it might be considered as a risk factor for URI and may be included in history of URI.
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Shahen S, Carrino G, Carrino R, Abdelsalam R, Flores-Mir C, Perillo L. Palatal volume and area assessment on digital casts generated from cone-beam computed tomography scans. Angle Orthod 2018; 88:397-402. [PMID: 29561657 DOI: 10.2319/091117-611.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES The objective of this study was to develop a reproducible method to measure the change of palatal volume and area through superimposition using maxillary expansion digital cast models. MATERIALS AND METHODS A total of 10 pre- and 10 postexpansion dental cast models were scanned by the same cone-beam computed tomography machine. Superimposition was performed using a fully automated surface-best fit of the palatal surfaces on the digital cast models. A gingival plane, identified only once on superimposed casts, and a distal plane with the lateral closing border and the palatal surface were used to localize this selection of air. Area and volume were calculated for pre- and postexpansion records. Pre- and postexpansion palatal volume and area were measured by the main investigator and three different observers for inter- and intra-observer reproducibility assessment. RESULTS The level of intra- and inter-observer agreement was very strong (intraclass correlation coefficients ≥ 0.953; P value < .0001) for all measurements. CONCLUSIONS Palatal volume and area measurements based on the proposed superimposition are reproducible and can be used reliably.
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Brunetto DP, Sant'Anna EF, Machado AW, Moon W. Non-surgical treatment of transverse deficiency in adults using Microimplant-assisted Rapid Palatal Expansion (MARPE). Dental Press J Orthod 2018; 22:110-125. [PMID: 28444019 PMCID: PMC5398849 DOI: 10.1590/2177-6709.22.1.110-125.sar] [Citation(s) in RCA: 95] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Accepted: 10/10/2016] [Indexed: 01/05/2023] Open
Abstract
INTRODUCTION Maxillary transverse deficiency is a highly prevalent malocclusion present in all age groups, from primary to permanent dentition. If not treated on time, it can aggravate and evolve to a more complex malocclusion, hindering facial growth and development. Aside from the occlusal consequences, the deficiency can bring about serious respiratory problems as well, due to the consequent nasal constriction usually associated. In growing patients, this condition can be easily handled with a conventional rapid palatal expansion. However, mature patients are frequently subjected to a more invasive procedure, the surgically-assisted rapid palatal expansion (SARPE). More recently, researches have demonstrated that it is possible to expand the maxilla in grown patients without performing osteotomies, but using microimplants anchorage instead. This novel technique is called microimplant-assisted rapid palatal expansion (MARPE). OBJECTIVE The aim of the present article was to demonstrate and discuss a MARPE technique developed by Dr. Won Moon and colleagues at University of California - Los Angeles (UCLA). METHODS All laboratory and clinical steps needed for its correct execution are thoroughly described. For better comprehension, a mature patient case is reported, detailing all the treatment progress and results obtained. CONCLUSION It was concluded that the demonstrated technique could be an interesting alternative to SARPE in the majority of non-growing patients with maxillary transverse deficiency. The present patient showed important occlusal and respiratory benefits following the procedure, without requiring any surgical intervention.
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Affiliation(s)
- Daniel Paludo Brunetto
- Department of Restorative Dentistry, Dental School, Universidade Federal do Paraná, Curitiba, PR, Brazil
| | - Eduardo Franzzotti Sant'Anna
- Department of Pediatric Dentistry and Orthodontics, Dental School, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Andre Wilson Machado
- Department of Orthodontics, Dental School, Universidade Federal da Bahia, Salvador, BA, Brazil
| | - Won Moon
- Dental School, University of California, Los Angeles, CA, USA
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Huanca Ghislanzoni L, Lione R, Cozza P, Franchi L. Measuring 3D shape in orthodontics through geometric morphometrics. Prog Orthod 2017; 18:38. [PMID: 29192356 PMCID: PMC5709253 DOI: 10.1186/s40510-017-0194-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Accepted: 09/29/2017] [Indexed: 12/03/2022] Open
Abstract
Background Geometric morphometrics (GMM) has been traditionally applied to the field of biology to study developmental differentiations between species. Orthodontics deals with the shape and size of the face and its components. While several tools have been used to measure size, proportions, and relations between anatomical components, shape has been mainly described by esthetic criteria. The purpose of this paper is to present methods to measure shape of 3D orthodontic data, beyond the conventional tools that have been traditionally used in cephalometrics and in facial and dental cast analysis. Findings The authors showcase an example of applying geometric morphometrics to measure palates from scanned dental casts. GMM can be used as a useful tool to describe the three-dimensional shape of surfaces of orthodontic interest. A general introduction to the theoretical principles of how to apply GMM is provided. Conclusions Variability can be measured through the Principal Component Analysis (PCA) and can lead to the identification of shape patterns and sources of variability of the shape, independently from changes in size.
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Affiliation(s)
- Luis Huanca Ghislanzoni
- Department of Orthodontics, University of Geneve, Geneve, Switzerland. .,, Avenue Belles-Roches 7, 1004, Lausanne, VD, Switzerland.
| | - Roberta Lione
- Department of Orthodontics, University of Rome Tor Vergata, Rome, Italy
| | - Paola Cozza
- Department of Orthodontics, University of Rome Tor Vergata, Rome, Italy
| | - Lorenzo Franchi
- Department of Surgery and Translational Medicine, University of Florence, Florence, Italy
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Indiarti IS, Setyanto DB, Kusumaningrum A, Budiardjo SB. Changes in the palatal dimensions of mouth breathing children caused by nasal obstruction. ACTA ACUST UNITED AC 2017. [DOI: 10.1088/1742-6596/884/1/012036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Sakai RHUS, Marson FAL, Sakuma ETI, Ribeiro JD, Sakano E. Correlation between acoustic rhinometry, computed rhinomanometry and cone-beam computed tomography in mouth breathers with transverse maxillary deficiency. Braz J Otorhinolaryngol 2016; 84:S1808-8694(16)30234-8. [PMID: 28017262 PMCID: PMC9442894 DOI: 10.1016/j.bjorl.2016.10.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2016] [Revised: 10/26/2016] [Accepted: 10/30/2016] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION To provide clinical information and diagnosis in mouth breathers with transverse maxillary deficiency with posterior crossbite, numerous exams can be performed; however, the correlation among these exams remains unclear. OBJECTIVE To evaluate the correlation between acoustic rhinometry, computed rhinomanometry, and cone-beam computed tomography in mouth breathers with transverse maxillary deficiency. METHODS A cross-sectional study was conducted in 30 mouth breathers with transverse maxillary deficiency (7-13 y.o.) patients with posterior crossbite. The examinations assessed: (i) acoustic rhinometry: nasal volumes (0-5cm and 2-5cm) and minimum cross-sectional areas 1 and 2 of nasal cavity; (ii) computed rhinomanometry: flow and average inspiratory and expiratory resistance; (iii) cone-beam computed tomography: coronal section on the head of inferior turbinate (Widths 1 and 2), middle turbinate (Widths 3 and 4) and maxilla levels (Width 5). Acoustic rhinometry and computed rhinomanometry were evaluated before and after administration of vasoconstrictor. Results were compared by Spearman's correlation and Mann-Whitney tests (α=0.05). RESULTS Positive correlations were observed between: (i) flow evaluated before administration of vasoconstrictor and Width 4 (Rho=0.380) and Width 5 (Rho=0.371); (ii) Width 2 and minimum cross-sectional areas 1 evaluated before administration of vasoconstrictor (Rho=0.380); (iii) flow evaluated before administration of vasoconstrictor and nasal volumes of 0-5cm (Rho=0.421), nasal volumes of 2-5cm (Rho=0.393) and minimum cross-sectional areas 1 (Rho=0.375); (iv) Width 4 and nasal volumes of 0-5cm evaluated before administration of vasoconstrictor (Rho=0.376), nasal volumes of 2-5cm evaluated before administration of vasoconstrictor (Rho=0.376), minimum cross-sectional areas 1 evaluated before administration of vasoconstrictor (Rho=0.410) and minimum cross-sectional areas 1 after administration of vasoconstrictor (Rho=0.426); (v) Width 5 and Width 1 (Rho=0.542), Width 2 (Rho=0.411), and Width 4 (Rho=0.429). Negative correlations were observed between: (i) Width 4 and average inspiratory resistance (Rho=-0.385); (ii) average inspiratory resistance evaluated before administration of vasoconstrictor and nasal volumes of 0-5cm (Rho=-0.382), and average expiratory resistance evaluated before administration of vasoconstrictor and minimum cross-sectional areas 1 (Rho=-0.362). CONCLUSION There were correlations between acoustic rhinometry, computed rhinomanometry, and cone-beam computed tomography in mouth breathers with transverse maxillary deficiency.
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Affiliation(s)
| | - Fernando Augusto Lima Marson
- Universidade Estadual de Campinas (Unicamp), Faculdade de Ciências Médicas, Departamento de Pediatria, Campinas, SP, Brazil; Universidade Estadual de Campinas (Unicamp), Faculdade de Ciências Médicas, Departamento de Genética Médica, Campinas, SP, Brazil
| | - Emerson Taro Inoue Sakuma
- Universidade Estadual de Campinas (Unicamp), Faculdade de Ciências Médicas, Departamento de Radiologia, Campinas, SP, Brazil
| | - José Dirceu Ribeiro
- Universidade Estadual de Campinas (Unicamp), Faculdade de Ciências Médicas, Departamento de Pediatria, Campinas, SP, Brazil.
| | - Eulália Sakano
- Universidade Estadual de Campinas (Unicamp), Faculdade de Ciências Médicas, Departamento de Oftalmologia e Otorrinolaringologia, Campinas, SP, Brazil
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Kecik D. Three-dimensional analyses of palatal morphology and its relation to upper airway area in obstructive sleep apnea. Angle Orthod 2016; 87:300-306. [PMID: 27622701 DOI: 10.2319/051116-377.1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
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.
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Brunelli V, Lione R, Franchi L, Cozza P, Becker HMG, Franco LP, Souki BQ. Maxillary dentoskeletal changes 1-year after adenotonsillectomy. Int J Pediatr Otorhinolaryngol 2016; 86:135-41. [PMID: 27260596 DOI: 10.1016/j.ijporl.2016.04.027] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Revised: 04/20/2016] [Accepted: 04/21/2016] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To measure the maxillary dentoskeletal and soft tissue changes of severely obstructed mouth breathing (MB) young children who had their mode of breathing normalized after adenotonsillectomy (T&A), in comparison with a matched group of severely obstructed untreated MB children (CG). METHODS Seventy patients who had an Ear, Nose, and Throat examination (ENT), including flexible nasal endoscopy, to confirm the severe obstruction of the upper airways and the indication of T&A composed the sample. Cephalograms and dental casts were available from the patient's orthodontic records. Treatment group (TG) and CG included 35 children each. Groups were matched by gender (24 males and 11 females in each group), age (TG, 6.7 ± 1.8 years; CG, 6.9 ± 2.3 years), tooth development (TG, 13 primary dentition, 22 mixed dentition; CG, 14 primary dentition, 21 mixed dentition), and skeletal maturation status. Records were taken at baseline (T0) and 1-year after T&A (T1) for TG; while CG records were taken with a 1-year interval. Dentoskeletal measurements were performed in the lateral cephalograms, and dental casts were used to assess the palatal volume and occlusal changes. RESULTS TG showed a significant increase (503.3 mm(3), P < 0.001) in the palatal volume (10% of change), while CG palatal volume was stable. No dimensional occlusal changes were detected between T0 and T1 in both groups. Significant downward (point A, 2.1 mm; ANS, 2.1 mm) and forward displacements (point A, 0.7 mm; ANS, 1 mm) of the anterior region of the maxilla were observed in the TG, but CG presented only significant downward displacement (point A, 1.8 mm; ANS, 1.4 mm). The maxillary posterior region (PNS, PTM, and Molar) displaced downward in both groups (P < 0.05), however no sagittal change was found. The palatal plane inclination was stable in both groups. CONCLUSIONS TG presented significant increase in the palatal volume and in the forward displacement of the maxilla. No other significant maxillary dentoskeletal changes were found.
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Affiliation(s)
- Valerio Brunelli
- Department of Clinical Sciences and Traslational Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Roberta Lione
- Department of Clinical Sciences and Traslational Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Lorenzo Franchi
- Department of Surgery and Translational Medicine, Orthodontics, University of Florence, Florence, Italy; Thomas M. Graber Visiting Scholar, Department of Orthodontics and Pediatric Dentistry, School of Dentistry, The University of Michigan, Ann Arbor, United States
| | - Paola Cozza
- Department of Clinical Sciences and Traslational Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Helena M G Becker
- Outpatient Clinic for Mouth-Breathers, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Letícia P Franco
- Outpatient Clinic for Mouth-Breathers, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Bernardo Q Souki
- Outpatient Clinic for Mouth-Breathers, Federal University of Minas Gerais, Belo Horizonte, Brazil; School of Dentistry, Orthodontics, Pontifical Catholic University of Minas Gerais, Belo Horizonte, Brazil.
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McNamara JA, Lione R, Franchi L, Angelieri F, Cevidanes LHS, Darendeliler MA, Cozza P. The role of rapid maxillary expansion in the promotion of oral and general health. Prog Orthod 2015; 16:33. [PMID: 26446931 PMCID: PMC4596248 DOI: 10.1186/s40510-015-0105-x] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2015] [Accepted: 09/20/2015] [Indexed: 11/10/2022] Open
Abstract
Rapid maxillary expansion (RME) is an effective orthopedic procedure that can be used to address problems concerned with the growth of the midface. This procedure also may produce positive side effects on the general health of the patient. The aim of the present consensus paper was to identify and evaluate studies on the changes in airway dimensions and muscular function produced by RME in growing patients. A total of 331 references were retrieved from a database search (PubMed). The widening of the nasal cavity base after midpalatal suture opening in growing patients allows the reduction in nasal airway resistance with an improvement of the respiratory pattern. The effects of RME on the upper airway, however, have been described as limited and local, and these effects become diminished farther down the airway, possibly as a result of soft-tissue adaptation. Moreover, limited information is available about the long-term stability of the airway changes produced by RME. Several studies have shown that maxillary constriction may play a role in the etiology of more severe breathing disorders such as obstructive sleep apnea (OSA) in growing subjects. Early orthodontic treatment with RME is able to reduce the symptoms of OSA and improve polysomnographic variables. Finally, early orthopedic treatment with RME also is beneficial to avoid the development of facial skeletal asymmetry resulting from functional crossbites that otherwise may lead to functional and structural disorders of the stomatognathic system later in life.
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Affiliation(s)
- James A McNamara
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, The University of Michigan, Ann Arbor, MI, USA
- Cell and Developmental Biology, School of Medicine, The University of Michigan, Ann Arbor, MI, USA
- Center for Human Growth and Development, The University of Michigan, Ann Arbor, MI, USA
| | - Roberta Lione
- Department of Clinical Sciences and Translational Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Lorenzo Franchi
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, The University of Michigan, Ann Arbor, MI, USA.
- Department of Surgery and Translational Medicine, University of Florence, Via del Ponte di Mezzo, 46-48, Florence, 50127, Italy.
| | - Fernanda Angelieri
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, The University of Michigan, Ann Arbor, MI, USA
- Department of Orthodontics, São Paulo Methodist University, São Bernardo do Campo, Brazil
| | - Lucia H S Cevidanes
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, The University of Michigan, Ann Arbor, MI, USA
| | - M Ali Darendeliler
- Discipline of Orthodontics, Faculty of Dentistry, University of Sydney, Sydney, Australia
- Sydney Dental Hospital, Sydney South West Area Health Service, Sydney, Australia
| | - Paola Cozza
- Department of Clinical Sciences and Translational Medicine, University of Rome "Tor Vergata", Rome, Italy
- Department of Dentistry, UNSBC, Tirana, Albania
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