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Kohli RK, Haque I, Puri P. Determination of Age in North Indian Pediatric Population using Cervical Vertebral Maturation (CVM) Method. Indian J Pediatr 2024; 91:746. [PMID: 38157114 DOI: 10.1007/s12098-023-05003-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 12/15/2023] [Indexed: 01/03/2024]
Affiliation(s)
- Ravshish Kaur Kohli
- Amity Institute of Forensic Sciences, Amity University, Sector - 125, Noida, Uttar Pradesh, 201301, India
| | - Ikramul Haque
- Department of Biology & Biotechnology, National Forensic Science University, Delhi Campus, New Delhi, India
| | - Pooja Puri
- Amity Institute of Forensic Sciences, Amity University, Sector - 125, Noida, Uttar Pradesh, 201301, India.
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Rutili V, Souki BQ, Nieri M, Carlos ALFM, Pavoni C, Cozza P, McNamara JA, Giuntini V, Franchi L. Long-term effects produced by early treatment of Class III malocclusion with rapid maxillary expansion and facemask followed by fixed appliances: A multicentre retro-prospective controlled study. Orthod Craniofac Res 2024; 27:429-438. [PMID: 38146808 DOI: 10.1111/ocr.12748] [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: 10/16/2023] [Revised: 11/11/2023] [Accepted: 12/14/2023] [Indexed: 12/27/2023]
Abstract
OBJECTIVE To assess the short- and long-term dentoskeletal effects of early Class III treatment with rapid maxillary expansion and facemask (RME/FM) followed by fixed appliances. MATERIALS AND METHODS A total of 44 patients (27 females, 17 males) treated consecutively with RME/FM were included from the archives of 3 centres. Three lateral cephalograms were available: T0 (before the start of RME/FM therapy, mean age 8.1 ± 1.8 years), T1 (immediately after RME/FM, mean age 9.8 ± 1.6 years), and T2 (long-term observation, mean age 19.5 ± 1.6 years). A control group of 17 untreated Class III subjects (12 females and 5 males) also was selected. Between-group statistical comparisons were performed with ANCOVA. RESULTS No statistically significant differences for any of the cephalometric variables were found at T0. In the short term, the treated group showed significant improvements in ANB (+2.9°), Wits appraisal (+2.7 mm), SNA (+1.8°) and SNB (-1.1°). A significant closure of CoGoMe angle (-1.3°) associated with smaller increments along Co-Gn (-2.4 mm) also was found together with a significant increase in intermaxillary divergence (+1.3°). In the long-term, significant improvements in ANB (+2.6°), Wits appraisal (+2.7 mm) and SNB (-1.7°) were recorded together with a significant closure of the CoGoMe angle (-2.9°). No significant long-term changes in vertical skeletal relationships were found. CONCLUSIONS RME/FM therapy was effective in improving Class III dentoskeletal relationships in the short term. These changes remained stable in the long-term due mainly to favourable mandibular changes.
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Affiliation(s)
- Valentina Rutili
- Graduate Orthodontic Program, Department of Experimental and Clinical Medicine, The University of Florence, Florence, Italy
| | - Bernardo Quiroga Souki
- Graduate Orthodontic Program, Pontifical Catholic University of Minas Gerais, Belo Horizonte, Brazil
| | - Michele Nieri
- Graduate Orthodontic Program, Department of Experimental and Clinical Medicine, The University of Florence, Florence, Italy
| | | | - Chiara Pavoni
- Department of Faculty of Medicine and Surgery, UniCamillus, International Medical University, Rome, Italy
| | - Paola Cozza
- Department of Faculty of Medicine and Surgery, UniCamillus, International Medical University, Rome, Italy
| | - James A McNamara
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry and Center for Human Growth and Development, The University of Michigan, Ann Arbor, Michigan, USA
| | - Veronica Giuntini
- Graduate Orthodontic Program, Department of Experimental and Clinical Medicine, The University of Florence, Florence, Italy
| | - Lorenzo Franchi
- Graduate Orthodontic Program, Department of Experimental and Clinical Medicine, The University of Florence, Florence, Italy
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Bulut M, Hezenci Y. Is hand-wrist radiography still necessary in orthodontic treatment planning? BMC Oral Health 2024; 24:616. [PMID: 38802759 PMCID: PMC11131214 DOI: 10.1186/s12903-024-04396-2] [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: 02/09/2024] [Accepted: 05/22/2024] [Indexed: 05/29/2024] Open
Abstract
OBJECTIVES The aim of our study is to compare the relationship between hand-wrist and cervical vertebra maturation stages with chronological age and to investigate the effect of malocclusion type on the relationship between these methods. MATERIALS AND METHODS Hand-wrist and cephalometric radiographs of 1000 patients (526 females, 474 males) with a mean age of 13.41 ± 1.83 were analyzed. The methods of Bacetti et al. were used for the cervical vertebra maturation stage, and Björk, Grave and Brown's methods were used for the hand-wrist maturation stage. One-way ANOVA test was applied to compare skeletal classes between them. Tukey post hoc test was used to determine the differences. The relationship between the malocclusion type, cervical vertebra and hand-wrist maturation stages was evaluated with the Spearman correlation test. RESULTS Spearman's correlation coefficient was 0.831, 0.831 and 0.760 in Class I, II and III females, respectively. In males, it was calculated as 0.844, 0.889 and 0.906, respectively. When sex and malocclusion were not differentiated, the correlation was found to be 0.887. All were statistically significant (P < 0.001). The highest correlation was observed in class III males, while the lowest was found in class III females. CONCLUSION Cervical vertebrae can be used safely to assess pubertal spurt without hand-wrist radiography. Diagnosing growth and development stages from cephalometric images is important in reducing additional workload and preventing radiation risk.
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Affiliation(s)
- Musa Bulut
- Faculty of Dentistry, Department of Orthodontics, Bolu Abant Izzet Baysal University, Bolu, Turkey.
- Diş Hekimliği Fakültesi, Ortodonti A.D. Gölköy Kampüsü, Bolu Abant İzzet Baysal Üniversitesi, Bolu, Turkey.
| | - Yasin Hezenci
- Faculty of Dentistry, Department of Orthodontics, Bolu Abant Izzet Baysal University, Bolu, Turkey
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Ye H, Qin H, Tang Y, Ungvijanpunya N, Gou Y. Mapping an intelligent algorithm for predicting female adolescents' cervical vertebrae maturation stage with high recall and accuracy. Prog Orthod 2024; 25:20. [PMID: 38771402 PMCID: PMC11109046 DOI: 10.1186/s40510-024-00523-5] [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: 01/31/2024] [Accepted: 05/10/2024] [Indexed: 05/22/2024] Open
Abstract
BACKGROUNDS AND OBJECTIVES The present study was designed to define a novel algorithm capable of predicting female adolescents' cervical vertebrae maturation stage with high recall and accuracy. METHODS A total of 560 female cephalograms were collected, and cephalograms with unclear vertebral shapes and deformed scales were removed. 480 films from female adolescents (mean age: 11.5 years; age range: 6-19 years) were used for the model development phase, and 80 subjects were randomly and stratified allocated to the validation cohort to further assess the model's performance. Derived significant predictive parameters from 15 anatomic points and 25 quantitative parameters of the second to fourth cervical vertebrae (C2-C4) to establish the ordinary logistic regression model. Evaluation metrics including precision, recall, and F1 score are employed to assess the efficacy of the models in each identified cervical vertebrae maturation stage (iCS). In cases of confusion and mispredictions, the model underwent modification to improve consistency. RESULTS Four significant parameters, including chronological age, the ratio of D3 to AH3 (D3:AH3), anterosuperior angle of C4 (@4), and distance between C3lp and C4up (C3lp-C4up) were administered into the ordinary regression model. The primary predicting model that implements the novel algorithm was built and the performance evaluation with all stages of 93.96% for accuracy, 93.98% for precision, 93.98% for recall, and 93.95% for F1-score were obtained. Despite the hybrid logistic-based model achieving high accuracy, the unsatisfactory performance of stage estimation was noticed for iCS3 in the primary cohort (89.17%) and validation cohort (85.00%). Through bivariate logistic regression analysis, the posterior height of C4 (PH4) was further selected in the iCS3 to establish a corrected model, thus the evaluation metrics were upgraded to 95.83% and 90.00%, respectively. CONCLUSIONS An unbiased and objective assessment of the cervical vertebrae maturation (CVM) method can function as a decision-support tool, assisting in the evaluation of the optimal timing for treatment in growing adults. Our novel proposed logistic model yielded individual formulas for each specific CVM stage and attained exceptional performance, indicating the capability to function as a benchmark for maturity evaluation in clinical craniofacial orthopedics for Chinese female adolescents.
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Affiliation(s)
- Huayu Ye
- Department of Orthodontics, Stomatological Hospital of Chongqing Medical University, 426#, Songshi North Road, Yubei District, Chongqing, 401147, P.R. China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, 426#, Songshi North Road, Yubei District, Chongqing, 401147, P.R. China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, 426#, Songshi North Road, Yubei District, Chongqing, 401147, P.R. China
| | - Hongrui Qin
- Department of Orthodontics, Stomatological Hospital of Chongqing Medical University, 426#, Songshi North Road, Yubei District, Chongqing, 401147, P.R. China
| | - Ying Tang
- Department of Orthodontics, Stomatological Hospital of Chongqing Medical University, 426#, Songshi North Road, Yubei District, Chongqing, 401147, P.R. China
| | - Nicha Ungvijanpunya
- Faculty of Dentistry, Chulalongkorn University, 34 Henri Dunant Road, Pathumwan, Bangkok, 10330, Thailand
| | - Yongchao Gou
- Department of Orthodontics, Stomatological Hospital of Chongqing Medical University, 426#, Songshi North Road, Yubei District, Chongqing, 401147, P.R. China.
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, 426#, Songshi North Road, Yubei District, Chongqing, 401147, P.R. China.
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, 426#, Songshi North Road, Yubei District, Chongqing, 401147, P.R. China.
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Zhou C, Duan P, He H, Song J, Hu M, Liu Y, Liu Y, Guo J, Jin F, Cao Y, Jiang L, Ye Q, Zhu M, Jiang B, Ruan W, Yuan X, Li H, Zou R, Tian Y, Gao L, Shu R, Chen J, Liu R, Zou S, Li X. Expert consensus on pediatric orthodontic therapies of malocclusions in children. Int J Oral Sci 2024; 16:32. [PMID: 38627388 PMCID: PMC11021504 DOI: 10.1038/s41368-024-00299-8] [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: 01/31/2024] [Revised: 03/08/2024] [Accepted: 04/03/2024] [Indexed: 04/19/2024] Open
Abstract
Malocclusion, identified by the World Health Organization (WHO) as one of three major oral diseases, profoundly impacts the dental-maxillofacial functions, facial esthetics, and long-term development of ~260 million children in China. Beyond its physical manifestations, malocclusion also significantly influences the psycho-social well-being of these children. Timely intervention in malocclusion can foster an environment conducive to dental-maxillofacial development and substantially decrease the incidence of malocclusion or reduce the severity and complexity of malocclusion in the permanent dentition, by mitigating the negative impact of abnormal environmental influences on the growth. Early orthodontic treatment encompasses accurate identification and treatment of dental and maxillofacial morphological and functional abnormalities during various stages of dental-maxillofacial development, ranging from fetal stages to the early permanent dentition phase. From an economic and societal standpoint, the urgency for effective early orthodontic treatments for malocclusions in childhood cannot be overstated, underlining its profound practical and social importance. This consensus paper discusses the characteristics and the detrimental effects of malocclusion in children, emphasizing critical need for early treatment. It elaborates on corresponding core principles and fundamental approaches in early orthodontics, proposing comprehensive guidance for preventive and interceptive orthodontic treatment, serving as a reference for clinicians engaged in early orthodontic treatment.
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Affiliation(s)
- Chenchen Zhou
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Peipei Duan
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Hong He
- State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration & Key Laboratory of Oral Biomedicine Ministry of Education & Hubei Key Laboratory of Stomatology & Department of Orthodontics & Center for Dentofacial Development and Sleep Medicine, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Jinlin Song
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences & Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Stomatological Hospital of Chongqing Medical University, Chongqing Medical University & College of Stomatology, Chongqing Medical University, Chongqing, China
| | - Min Hu
- Department of Orthodontics, Hospital of Stomatology, Jilin University, Changchun, China
| | - Yuehua Liu
- Department of Orthodontic & Oral Biomedical Engineering Laboratory, Shanghai Stomatological Hospital, Fudan University, Shanghai, China
| | - Yan Liu
- Department of Orthodontics, Central Laboratory, Peking University School and Hospital for Stomatology & National 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 & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
| | - Jie Guo
- Department of Orthodontics, School and Hospital of Stomatology, College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Shandong University, Jinan, China
| | - Fang Jin
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, School of Stomatology, Air Force Medical University, Xi'an, China
| | - Yang Cao
- Hospital of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, China
| | - Lingyong Jiang
- Center of Craniofacial Orthodontics, Department of Oral and Cranio-Maxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine & College of Stomatology, Shanghai Jiao Tong University & National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
| | - Qingsong Ye
- Center of Regenerative Medicine, Department of Stomatology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Min Zhu
- Department of Oral and Cranio-maxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine & National Clinical Research Center for Oral Diseases & Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Beizhan Jiang
- Department of Pediatric Dentistry, School and Hospital of Stomatology, Tongji University & Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, China
| | - Wenhua Ruan
- Department of Stomatology, The Children's Hospital, Zhejiang University School of Medicine & National Clinic Research Center for Child Health, Hangzhou, China
| | - Xiao Yuan
- Department of Orthodontics, The Affiliated Hospital of & School of Stomatology, Qingdao University, Qingdao, China
| | - Huang Li
- Department of Orthodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Rui Zou
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases & College of Stomatology, Xi'an Jiaotong University & Department of Orthodontics, Xi'an Jiaotong University, Xi'an, China
| | - Yulou Tian
- Department of Orthodontics, School and Hospital of Stomatology, China Medical University & Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, China
| | - Li Gao
- Department of Pediatric Dentistry, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Rui Shu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jianwei Chen
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Renkai Liu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Shujuan Zou
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
| | - Xiaobing Li
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
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Mariscal JF, Ravelli DB, Dos Santos Pinto A, Dominguez GC, de Arruda Aidar LA, Jacob HB. Comparisons of soft tissue changes after Herbst appliance treatment in three different growth phases. J World Fed Orthod 2024; 13:78-85. [PMID: 38155063 DOI: 10.1016/j.ejwf.2023.11.002] [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: 08/17/2023] [Revised: 10/21/2023] [Accepted: 11/06/2023] [Indexed: 12/30/2023]
Abstract
BACKGROUND This study aimed to compare the soft tissue effects of Herbst appliance in Class II malocclusion patients treated in three different craniofacial growth phases: prepubertal (PRE), circumpubertal (CIR), and postpubertal (POS). METHODS In total, 95 patients with Class II Division 1 malocclusion previously treated with a Herbst appliance were analyzed. Through the cervical vertebral maturation stages method, patients were allocated into three groups depending on the growth craniofacial phase at the beginning of treatment: PRE, CIR, and POS. Seventeen cephalometric measures were evaluated from each lateral radiograph before and after Herbst therapy using the Radiocef 2 software (Radio Memory, Belo Horizonte). Intragroup and intergroup treatment changes were compared statistically using a paired t test and MANOVA test, respectively. RESULTS Soft tissue thickness changes were related only to mandible; all three mandibular measurements (L1_LL, B_B', and Pog_Pog') showed thickening for the PRE group ranging from 0.92 mm (Pog_Pog') to 2.02 mm (B_B'), and only lower lip thickened overtime for the POS group (L1_LL = 0.99 mm). Soft and hard tissue pogonion displaced anteriorly, but only the soft tissue showed differences among groups; PRE group presented more anterior displacement than POS group (3.61 mm and 1.39 mm, respectively). Hard and soft tissue facial convexity decreased more in the PRE and CIR groups than in the POS group. Mentolabial sulcus depth reduced more in the PRE (1.07 mm) and CIR (1.29 mm) groups than in the POS (0.55 mm) group. Horizontal movement of the skeletal and soft pogonion presented a moderate-high positive correlation (r = 0.783), and hard and soft facial convexity showed a moderate-low positive correlation (r = 0.403). CONCLUSIONS Herbst appliance therapy produces soft tissue improvements in the three phases of craniofacial growth, being greater in patients in the PRE and CIR phases.
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Affiliation(s)
- Juan Francisco Mariscal
- Department of Pediatric Dentistry and Orthodontics, Araraquara School of Dentistry, São Paulo State University - UNESP, Araraquara, São Paulo, Brazil.
| | - Dirceu Barnabé Ravelli
- Department of Pediatric Dentistry and Orthodontics, Araraquara School of Dentistry, São Paulo State University - UNESP, Araraquara, São Paulo, Brazil
| | - Ary Dos Santos Pinto
- Department of Pediatric Dentistry and Orthodontics, Araraquara School of Dentistry, São Paulo State University - UNESP, Araraquara, São Paulo, Brazil
| | | | | | - Helder B Jacob
- Department of Orthodontics, The University of Texas Health Science Center at Houston School of Dentistry, Houston, Texas
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Yang X, Wang J, Liao R, Cai Y. A simplified protocol for deep quantitative proteomic analysis of gingival crevicular fluid for skeletal maturity indicators. Anal Chim Acta 2024; 1296:342342. [PMID: 38401943 DOI: 10.1016/j.aca.2024.342342] [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: 08/24/2023] [Revised: 12/18/2023] [Accepted: 02/04/2024] [Indexed: 02/26/2024]
Abstract
Assessment of craniofacial skeletal maturity is of great importance in orthodontic diagnosis and treatment planning. Traditional radiographic methods suffer from clinician subjectivity and low reproducibility. Recent biochemical methods, such as the use of gingival crevicular fluid (GCF) protein biomarkers involved in bone metabolism, have provided new opportunities to assess skeletal maturity. However, mass spectrometry (MS)-based GCF proteomic analysis still faces significant challenges, including the interference of high abundance proteins, laborious sample prefractionation and relatively limited coverage of GCF proteome. To improve GCF sample processing and further discover novel biomarkers, we herein developed a single-pot, solid-phase-enhanced sample-preparation (SP3)-based high-field asymmetric waveform ion mobility spectrometry (FAIMS)-MS protocol for deep quantitative analysis of the GCF proteome for skeletal maturity indicators. SP3 combined with FAIMS could minimize sample loss and eliminate tedious and time-consuming offline fractionation, thereby simplifying GCF sample preparation and improving analytical coverage and reproducibility of the GCF proteome. A total of 5407 proteins were identified in GCF samples from prepubertal and circumpubertal groups, representing the largest dataset of human GCF proteome to date. Compared to the prepubertal group, 61 proteins were differentially expressed (31 up-regulated, 30 down-regulated) in the circumpubertal group. The six-protein marker panel, including ATP5D, CLTA, CLTB, DNM2, HSPA8 and NCK1, showed great potential to predict the circumpubertal stage (ROC-AUC 0.937), which provided new insights into skeletal maturity assessment.
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Affiliation(s)
- Xue Yang
- Department of Pediatric Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200433, PR China
| | - Jun Wang
- Department of Pediatric Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200433, PR China
| | - Rijing Liao
- Shanghai Institute of Precision Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200125, PR China.
| | - Yan Cai
- Shanghai Institute of Precision Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200125, PR China.
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Ong SH, Kim H, Song JS, Shin TJ, Hyun HK, Jang KT, Kim YJ. Correlation between dental and skeletal maturity in Korean children based on dental maturity percentile: a retrospective study. BMC Oral Health 2024; 24:377. [PMID: 38519919 PMCID: PMC10958867 DOI: 10.1186/s12903-024-04015-0] [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: 10/18/2023] [Accepted: 02/12/2024] [Indexed: 03/25/2024] Open
Abstract
BACKGROUND The correlation between dental maturity and skeletal maturity has been proposed, but its clinical application remains challenging. Moreover, the varying correlations observed in different studies indicate the necessity for research tailored to specific populations. AIM To compare skeletal maturity in Korean children with advanced and delayed dental maturity using dental maturity percentile. DESIGN Dental panoramic radiographs and cephalometric radiographs were obtained from 5133 and 395 healthy Korean children aged between 4 and 16 years old. Dental maturity was assessed with Demirjian's method, while skeletal maturity was assessed with the cervical vertebral maturation method. Standard percentile curves were developed through quantile regression. Advanced (93 boys and 110 girls) and delayed (92 boys and 100 girls) dental maturity groups were defined by the 50th percentile. RESULTS The advanced group showed earlier skeletal maturity in multiple cervical stages (CS) in both boys (CS 1, 2, 3, 4, and 6) and girls (CS 1, 3, 4, 5, and 6). Significant differences, as determined by Mann-Whitney U tests, were observed in CS 1 for boys (p = 0.004) and in CS 4 for girls (p = 0.037). High Spearman correlation coefficients between dental maturity and cervical vertebral maturity exceeded 0.826 (p = 0.000) in all groups. CONCLUSION A correlation between dental and skeletal maturity, as well as advanced skeletal maturity in the advanced dental maturity group, was observed. Using percentile curves to determine dental maturity may aid in assessing skeletal maturity, with potential applications in orthodontic diagnosis and treatment planning.
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Affiliation(s)
- Seung-Hwan Ong
- Department of Pediatric Dentistry, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Korea
| | - Hyuntae Kim
- Department of Pediatric Dentistry, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Korea
| | - Ji-Soo Song
- Department of Pediatric Dentistry, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Korea
| | - Teo Jeon Shin
- Department of Pediatric Dentistry, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Korea
| | - Hong-Keun Hyun
- Department of Pediatric Dentistry, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Korea
| | - Ki-Taeg Jang
- Department of Pediatric Dentistry, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Korea
| | - Young-Jae Kim
- Department of Pediatric Dentistry, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Korea.
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Duggal I, Zere E, Kumar Chaudhari P, Duggal R, Singh Rana S, Chauhan A. The challenging management of Moebius syndrome using orthodontic camouflage: A case report. SPECIAL CARE IN DENTISTRY 2024; 44:450-457. [PMID: 37287118 DOI: 10.1111/scd.12888] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 05/08/2023] [Accepted: 05/31/2023] [Indexed: 06/09/2023]
Abstract
Moebius syndrome (MS) is a rare congenital neuromuscular disorder characterized by weakness or paralysis (palsy) of abducens and facial nerves, or other cranial nerves which may be affected. Diagnosis, treatment, and dental management of MS patients are focused on treating manifestations like malocclusion, while catering to associated extraoral (neurologic, dermatologic, ocular) complications, aiming to improve their quality of life. Here, we report the case of a 9-year-old female patient with MS who underwent orthodontic camouflage using combined orthopedic-orthodontic therapy using a high-pull chin cup and fixed orthodontic appliance to improve skeletal mal-relation and facial appearance. The outcome displayed great improvement in function and better esthetics, improving not only the patient's but also the family's quality of life. A year's follow-up showed successful maintenance of the achieved results. A multidisciplinary approach in MS not only helps in overcoming the treatment challenges but also provides great psychosocial benefits to these patients.
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Affiliation(s)
- Isha Duggal
- Division of Orthodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Edlira Zere
- Orthodontic and Craniofacial Department, School of Graduate Dentistry, Rambam Health, Care Campus, Technion, Faculty of Medicine, Haifa, Israel
| | - Prabhat Kumar Chaudhari
- Division of Orthodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Ritu Duggal
- Division of Orthodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | | | - Anuj Chauhan
- Department of Medical Health and Family Welfare, Uttar Pradesh, India
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Geng J, Zhao G, Gu Y. Feasibility of spheno-occipital synchondrosis fusion stages as an indicator for the assessment of maxillomandibular growth: A mixed longitudinal study. Orthod Craniofac Res 2024. [PMID: 38409951 DOI: 10.1111/ocr.12774] [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] [Accepted: 02/17/2024] [Indexed: 02/28/2024]
Abstract
OBJECTIVES This study aimed to assess the relative growth rates (RGRs) of the maxilla and mandible at varying fusion stages of the spheno-occipital synchondrosis (SOS), thereby elucidating the potential of SOS stages in predicting maxillomandibular growth. MATERIALS AND METHODS A total of 320 subjects (171 boys and 149 girls), aged 6 to 18 years, were retrospectively included. Each subject had a minimum of two longitudinal cone-beam computed tomography (CBCT) images, with no more than one interval of SOS fusion stage change between the two scans. Subjects were categorized based on their SOS fusion stages and genders. The RGRs of the maxilla and mandible at various SOS fusion stages were measured and compared using longitudinal CBCT images. RESULTS Significant statistical differences were observed in maxillomandibular RGRs across various SOS fusion stages. In girls, the sagittal growth of the maxilla remained stable and active until SOS 3, subsequently exhibited deceleration in SOS 4-5 (compared to SOS 3-4, P < .05) and continued to decrease in SOS 5-6. Whereas in boys, the sagittal growth of the maxilla remained stable until SOS 4, and a deceleration trend emerged starting from SOS 5 to 6 (P < .01 compared to SOS 4-5). Mandibular growth patterns in both genders exhibited a progression of increasing-accelerating-decelerating rates from SOS 2 to 6. The highest RGRs for total mandibular length were observed in SOS 3-4 and SOS 4-5. CONCLUSION Spheno-occipital synchondrosis fusion stages can serve as a valid indicator of maxillomandibular growth maturation.
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Affiliation(s)
- Jing Geng
- Department of Orthodontics, Peking University School and Hospital of Stomatology, National Center of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health, NMPA Key Laboratory for Dental Materials, Beijing, China
| | - Guangpu Zhao
- Department of Orthodontics, Peking University School and Hospital of Stomatology, National Center of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health, NMPA Key Laboratory for Dental Materials, Beijing, China
| | - Yan Gu
- Department of Orthodontics, Peking University School and Hospital of Stomatology, National Center of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health, NMPA Key Laboratory for Dental Materials, Beijing, China
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11
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Gómez-Gómez SL, Sánchez-Uribe LA, Villarraga-Ossa JA, Llano-Posada MC, Guzmán-Velásquez Y, Arango-Hincapie CA, Ardila CM. A finite element study comparing Advansync® and Twin Block in mandibular anterior repositioning. Orthod Craniofac Res 2024. [PMID: 38247223 DOI: 10.1111/ocr.12758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/12/2024] [Indexed: 01/23/2024]
Abstract
OBJECTIVE This study aims to utilize the finite element method (FEM) to compare the dentoalveolar and mandibular effects associated with anterior mandibular repositioning using AdvanSync® (ADV) and Twin Block (TB). METHODS A patient with Class II skeletal malocclusion and mandibular retrognathism was selected. A TB appliance was subsequently applied. Computed Tomography (CT) scans were acquired at the beginning of treatment (T1) and 8 months later (T2). Concurrently, a numerical TB model was validated through FEM simulations, which were compared with the T2 results. The ADV appliance was virtually simulated to evaluate stress and deformation on the condyle, symphysis, first lower molar and lower central incisors. RESULTS Both simulations demonstrated significant mandibular advancement. However, ADV led to less incisor proclination and more molar intrusion compared to TB. ADV exhibited increased stress in the lower molar area, while TB had higher stress in the lower incisor region. Stress and deformations in the condyle and mandibular symphysis were similar in both simulations, with the highest stress observed at the condylar neck and the lowest at the upper pole of the condylar head. CONCLUSIONS Both appliances achieved similar levels of mandibular advancement, with greater proclination of the lower central incisors and more widespread distribution of stress and molar intrusion when using ADV compared to TB.
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Affiliation(s)
| | | | | | | | - Yeison Guzmán-Velásquez
- Department of Orthodontics, School of Dentistry, University of Antioquia, Medellín, Colombia
| | | | - Carlos M Ardila
- Biomedical Stomatology Research Group, School of Dentistry, University of Antioquia, Medellín, Colombia
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Alhamady AM, Ishaq RAR, Alhammadi MS, Almashraqi AA, Alhashimi N. Evaluation of an objective staging system for assessment of cervical vertebral maturation. BMC Oral Health 2024; 24:97. [PMID: 38233829 PMCID: PMC10792801 DOI: 10.1186/s12903-023-03844-9] [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: 04/02/2023] [Accepted: 12/29/2023] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND The aim of this study was to evaluate an objective method for Cervical Vertebral Maturation (CVM) staging. METHODS An initial sample of 647 Lateral Cephalometric Radiographs (LCR) were staged according to the CVM (Baccetti et al.) by 4 examiners. The final sample (n = 394) included LCR on which the staging of the 4 investigators matched. The objective staging was performed by a single operator. The sample was divided according to the maturational stages into pre-pubertal, pubertal and post-pubertal groups. Measurements were performed on the cervical vertebrae (C2, C3 and C4). The angle between posterior and superior borders for C3 and C4 was the Superior Wall Inclination Angle (SWIA). Concavity Depth (CD) for C2, C3 and C4, and Body Shape (BS) (ratio of width to height of C3 and C4). Measurements of the 3 groups were compared. RESULTS Reliability of subjective staging was high (intra-observer reliability, 0.948; inter-observer reliability, 0.967). Good agreement was observed for the outcomes measured. Intra-observer reliability was good (0.918, 0.885 and 0.722 for CD, BS and SWIA, respectively). The same was for the inter-observer reliability results (0.902, 0.889 and 0.728 for CD, BS and SWIA, respectively). Significant differences were observed for mean values of SWIA and BS and median values of CD within maturational stage. Similar findings were observed when the outcomes were compared at different phases (P < 0.001). CONCLUSIONS A standardized, objective staging system using linear, angular measurements and ratios was applied for the determination of cervical vertebral maturation.
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Affiliation(s)
- Ahlam M Alhamady
- Master of Science, Orthodontics, Faculty of Dentistry, University of Science and Technology, Sana'a Yemen, Sana'a, Republic of Yemen
| | - Ramy Abdul Rahman Ishaq
- Department of Orthodontics, Pedodontics and Preventive Dentistry Faculty of Dentistry, Sana'a University, P. O. Box 271, Mathbah, Sana'a Yemen, Sana'a, Republic of Yemen.
| | - Maged S Alhammadi
- Orthodontics and Dentofacial Orthopedics, Department of Preventive Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Abeer A Almashraqi
- Department of Clinical Oral Health Sciences, College of Dental Medicine, QU Health, Qatar University, Doha, Qatar
| | - Najah Alhashimi
- Unit and Divisional Chief Orthodontics at Hamad Medical Corporation and Associate Professor at College of Dental Medicine, Qatar University, Doha, Qatar
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Marino Merlo M, Quiroga Souki B, Nieri M, Bonanno A, Giuntini V, McNamara JA, Franchi L. Comparison of the effects on facial soft tissues produced by rapid and slow maxillary expansion using stereophotogrammetry: a randomized clinical trial. Prog Orthod 2024; 25:1. [PMID: 38168740 PMCID: PMC10761642 DOI: 10.1186/s40510-023-00498-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 09/28/2023] [Indexed: 01/05/2024] Open
Abstract
OBJECTIVE To compare the effects on facial soft tissues produced by maxillary expansion generated by rapid maxillary expansion (RME) versus slow maxillary expansion (SME). MATERIALS AND METHODS Patients in the mixed dentition were included with a transverse discrepancy between the two arches of at least 3 mm. A conventional RME screw was compared to a new expansion screw (Leaf expander) designed to produce SME. Both screws were incorporated in a fixed expander. The primary outcome was the difference of the facial tissue changes in the nasal area measured on facial 3D images captured immediately before application of the expander (T0) and after one year of retention, immediately after the expander removal (T1). Secondary outcomes were soft tissue changes of other facial regions (mouth, lips, and chin). Analysis of covariance was used for statistical analysis. RESULTS Fourteen patients were allocated to the RME group, and 14 patients were allocated to the SME group. There were no dropouts. Nasal width change showed a difference between the two groups (1.3 mm greater in the RME group, 95% CI from 0.4 to 2.2, P = 0.005). Also, intercanthal width showed a difference between treatments (0.7 mm greater in the RME group, 95% CI from 0.0 to 1.3, P = 0.044). Nasal columella width, mouth width, nasal tip angle, upper lip angle, and lower lip angle did not show any statistically significant differences. The Y-axis (anterior-posterior) components of the nasal landmark showed a statistically significant difference between the two groups (0.5 mm of forward displacement greater in the RME group, 95% CI from 0.0 to 1.2, P = 0.040). Also, Z-axis (superior-inferior) components of the lower lip landmark was statistically significant (0.9 mm of downward displacement in favor of the RME group, 95% CI from 0.1 to 1.7, P = 0.027). All the other comparisons of the three-dimensional assessments were not statistically significant. CONCLUSIONS RME produced significant facial soft tissue changes when compared to SME. RME induced greater increases in both nasal and intercanthal widths (1.3 mm and 0.7 mm, respectively). These findings, though statistically significant, probably are not clinically relevant. Trial registration ISRCTN, ISRCTN18263886. Registered 8 November 2016, https://www.isrctn.com/ISRCTN18263886?q=Franchi&filters=&sort=&offset=2&totalResults=2&page=1&pageSize=10.
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Affiliation(s)
- Matilde Marino Merlo
- Graduate Orthodontic Program, Department of Experimental and Clinical Medicine, The University of Florence, Florence, Italy
| | - Bernardo Quiroga Souki
- Graduate Orthodontic Program, Pontifical Catholic University of Minas Gerais, Belo Horizonte, Brazil
| | - Michele Nieri
- Department of Experimental and Clinical Medicine, Orthodontics, The University of Florence, Florence, Italy
| | - Agnese Bonanno
- Graduate Orthodontic Program, Department of Experimental and Clinical Medicine, The University of Florence, Florence, Italy
| | - Veronica Giuntini
- Graduate Orthodontic Program, Department of Experimental and Clinical Medicine, The University of Florence, Florence, Italy
| | - James A McNamara
- Thomas M. and Doris Graber Endowed Professor of Dentistry Emeritus, Department of Orthodontics and Pediatric Dentistry, School of Dentistry, The University of Michigan, Ann Arbor, MI, USA
- Professor Emeritus of 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
| | - Lorenzo Franchi
- Graduate Orthodontic Program, Department of Experimental and Clinical Medicine, The 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, USA.
- Director of the Division of Dentistry, University Hospital of Careggi, Via del Ponte di Mezzo, 46-48, 50127, Florence, Italy.
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Hartoonian S, Hosseini M, Yousefi I, Mahdian M, Ghazizadeh Ahsaie M. Applications of artificial intelligence in dentomaxillofacial imaging-a systematic review. Oral Surg Oral Med Oral Pathol Oral Radiol 2024:S2212-4403(23)01566-3. [PMID: 38637235 DOI: 10.1016/j.oooo.2023.12.790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 12/02/2023] [Accepted: 12/22/2023] [Indexed: 04/20/2024]
Abstract
BACKGROUND Artificial intelligence (AI) technology has been increasingly developed in oral and maxillofacial imaging. The aim of this systematic review was to assess the applications and performance of the developed algorithms in different dentomaxillofacial imaging modalities. STUDY DESIGN A systematic search of PubMed and Scopus databases was performed. The search strategy was set as a combination of the following keywords: "Artificial Intelligence," "Machine Learning," "Deep Learning," "Neural Networks," "Head and Neck Imaging," and "Maxillofacial Imaging." Full-text screening and data extraction were independently conducted by two independent reviewers; any mismatch was resolved by discussion. The risk of bias was assessed by one reviewer and validated by another. RESULTS The search returned a total of 3,392 articles. After careful evaluation of the titles, abstracts, and full texts, a total number of 194 articles were included. Most studies focused on AI applications for tooth and implant classification and identification, 3-dimensional cephalometric landmark detection, lesion detection (periapical, jaws, and bone), and osteoporosis detection. CONCLUSION Despite the AI models' limitations, they showed promising results. Further studies are needed to explore specific applications and real-world scenarios before confidently integrating these models into dental practice.
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Affiliation(s)
- Serlie Hartoonian
- School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Matine Hosseini
- School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Iman Yousefi
- School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mina Mahdian
- Department of Prosthodontics and Digital Technology, Stony Brook University School of Dental Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Mitra Ghazizadeh Ahsaie
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Atici SF, Ansari R, Allareddy V, Suhaym O, Cetin AE, Elnagar MH. AggregateNet: A deep learning model for automated classification of cervical vertebrae maturation stages. Orthod Craniofac Res 2023; 26 Suppl 1:111-117. [PMID: 36855827 DOI: 10.1111/ocr.12644] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 02/15/2023] [Indexed: 03/02/2023]
Abstract
OBJECTIVE A study of supervised automated classification of the cervical vertebrae maturation (CVM) stages using deep learning (DL) network is presented. A parallel structured deep convolutional neural network (CNN) with a pre-processing layer that takes X-ray images and the age as the input is proposed. METHODS A total of 1018 cephalometric radiographs were labelled and classified according to the CVM stages. The images were separated according to gender for better model-fitting. The images were cropped to extract the cervical vertebrae automatically using an object detector. The resulting images and the age inputs were used to train the proposed DL model: AggregateNet with a set of tunable directional edge enhancers. After the features of the images were extracted, the age input was concatenated to the output feature vector. To have the parallel network not overfit, data augmentation was used. The performance of our CNN model was compared with other DL models, ResNet20, Xception, MobileNetV2 and custom-designed CNN model with the directional filters. RESULTS The proposed innovative model that uses a parallel structured network preceded with a pre-processing layer of edge enhancement filters achieved a validation accuracy of 82.35% in CVM stage classification on female subjects, 75.0% in CVM stage classification on male subjects, exceeding the accuracy achieved with the other DL models investigated. The effectiveness of the directional filters is reflected in the improved performance attained in the results. If AggregateNet is used without directional filters, the test accuracy decreases to 80.0% on female subjects and to 74.03% on male subjects. CONCLUSION AggregateNet together with the tunable directional edge filters is observed to produce higher accuracy than the other models that we investigated in the fully automated determination of the CVM stages.
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Affiliation(s)
- Salih Furkan Atici
- Department of Electrical and Computer Engineering, University of Illinois Chicago, Chicago, Illinois, USA
| | - Rashid Ansari
- Department of Electrical and Computer Engineering, University of Illinois Chicago, Chicago, Illinois, USA
| | - Veerasathpurush Allareddy
- Department of Orthodontics, College of Dentistry, University of Illinois Chicago, Chicago, Illinois, USA
| | - Omar Suhaym
- Department of Oral and Maxillofacial Surgery, College of Dentistry, University of Illinois Chicago, Chicago, Illinois, USA
- King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Ahmet Enis Cetin
- Department of Electrical and Computer Engineering, University of Illinois Chicago, Chicago, Illinois, USA
| | - Mohammed H Elnagar
- Department of Orthodontics, College of Dentistry, University of Illinois Chicago, Chicago, Illinois, USA
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Wang C, Liu C, Mao Q, Zhou L, Xiang X. Skeletal and dentoalveolar modifications in adults with different sagittal facial patterns after personalized miniscrew-assisted rapid palatal expansion: A prospective cone-beam computed tomography study. Am J Orthod Dentofacial Orthop 2023; 164:843-854. [PMID: 37632488 DOI: 10.1016/j.ajodo.2023.05.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 05/01/2023] [Accepted: 05/01/2023] [Indexed: 08/28/2023]
Abstract
INTRODUCTION This study aimed to compare the skeletal and dental modifications in adults with different sagittal facial patterns by a personalized miniscrew-assisted rapid palatal expander (pMARPE). METHODS Forty subjects (aged 18-28 years; 15 females and 25 males) with maxillary transverse deficiency were assigned to 1 of 3 groups (Class I, II, and III relationship) on the basis of their sagittal facial patterns. Each patient was treated with an individually customized expander. A similar expansion protocol was used for all patients. Cone-beam computed tomography scans were obtained before and after expansion. One-way analysis of variance was used to analyze differences among 3 groups in skeletal, dentoalveolar, and periodontal changes (P <0.05). RESULTS The success rates of expansion were higher in patients with a Class I or II relationship than those with a Class III relationship. Patients with a Class I or II relationship had greater changes in the anterior nasal spine and maxillary basal bone widths. A more parallel sutural opening in the anteroposterior direction was seen in those with a Class II relationship. The tipping of the maxillary first molar increased, and the buccal alveolar bone thickness decreased in all groups after expansion, especially in patients with a Class III relationship. CONCLUSIONS The pMARPE effectively split the midpalatal suture among adults. However, midpalatal suture expansion was more difficult, and there were more dentoalveolar side effects and fewer orthopedic effects in patients with a Class III relationship than in those with Class I or II relationships.
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Affiliation(s)
- Chunlin Wang
- Department of Orthodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, Guangdong, China
| | - Conghua Liu
- Department of Orthodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, Guangdong, China
| | - Qin Mao
- Department of Orthodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, Guangdong, China
| | - Lishu Zhou
- Department of Orthodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, Guangdong, China
| | - Xiaosong Xiang
- Department of Orthodontics, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, Guangdong, China.
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Elkalza AR, Yacout YM. Effect of SEC III protocol on upper airway dimensions in growing class III patients: a retrospective study. BMC Oral Health 2023; 23:841. [PMID: 37940933 PMCID: PMC10631026 DOI: 10.1186/s12903-023-03613-8] [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: 07/21/2023] [Accepted: 11/02/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND The primary objective of the study was to evaluate the effects of SEC III (Splints, Class III Elastics, and Chin cup) protocol on the upper airway dimensions using lateral cephalometric radiographs. The secondary objectives were to evaluate the skeletal and dental effects of the SEC III protocol using lateral cephalometric radiographs. METHODS The pre- and post-treatment lateral cephalometric radiographs of 24 patients treated using the SEC III protocol were used to address the aim of the study. Children in the pre-pubertal (CS-1 or CS-2) or circumpubertal (CS-3 or CS-4) skeletal maturation stage and having class III dentoskeletal malocclusion were included in the study. Patients with a history of previous orthodontic treatment, maxillofacial surgery or trauma, tonsillectomy, adenoidectomy, or craniofacial malformations were excluded. The pre-treatment and post-treatment lateral cephalometric radiographs were traced, then airway measurements, skeletal measurements, and dental measurements were performed. The results were analysed using paired samples t-test or Wilcoxon signed rank test according to the data normality. RESULTS Data of 6 males and 18 females were analysed (Mean age = 11.21 ± 1.02 years). Duration of active treatment was 5.75 ± 1.03 months. Treatment using SEC III protocol resulted in a significant increase in ANB angle (2.92 ± 1.50 degrees, p < 0.001) and Wits appraisal (3.31 ± 1.99 mm) (p < 0.001). The increase in the mandibular plane angle (0.75 ± 1.42 degrees, p = 0.02) and the maxillary length (2.29 ± 2.69 mm, p < 0.001) was statistically significant. Contrarily, the mandibular length did not change significantly (p = 0.10). The maxillary incisors were significantly proclined (4.38 ± 4.28 degrees; p < 0.001), while the mandibular incisors were significantly retroclined (-5.79 ± 6.21 degrees; p < 0.001) following treatment. The change in the nasopharyngeal airway and the retropalatal airway was not statistically significant. The middle and inferior pharyngeal space (retroglossal airway) significantly decreased by 1.33 ± 1.97 mm (p = 0.003) and 1.96 ± 2.48 mm (p = 0.001), respectively. CONCLUSIONS Early class III correction using SEC III protocol reduced the retroglossal airway dimensions but did not affect the nasopharyngeal and retropalatal airway dimensions. Correction of the class III dentoskeletal relationship was obtained through both skeletal and dental changes.
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Affiliation(s)
- Ahmed R Elkalza
- Department of Orthodontics, Faculty of Dentistry, Alexandria University, Champollion St, P. O. Box: 21521, Alexandria, Alexandria, Egypt
| | - Yomna M Yacout
- Department of Orthodontics, Faculty of Dentistry, Alexandria University, Champollion St, P. O. Box: 21521, Alexandria, Alexandria, Egypt.
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Rutili V, Quiroga Souki B, Nieri M, Farnese Morais Carlos AL, Pavoni C, Cozza P, McNamara JA, Giuntini V, Franchi L. Long-Term Assessment of Treatment Timing for Rapid Maxillary Expansion and Facemask Therapy Followed by Fixed Appliances: A Multicenter Retro-Prospective Study. J Clin Med 2023; 12:6930. [PMID: 37959395 PMCID: PMC10649687 DOI: 10.3390/jcm12216930] [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: 09/01/2023] [Revised: 10/15/2023] [Accepted: 10/27/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND to determine the role of treatment timing in the long-term effects produced by rapid maxillary expansion and facemask therapy (RME/FM) in Class III patients. METHODS This study compared two sample groups treated with RME/FM followed by fixed appliances: the early prepubertal group (EPG) (17 patients; mean age before treatment (T0), 5.8 ± 0.7 years; range, 4.3-6.9 years) and the late prepubertal group (LPG) (17 patients; mean age at T0, 10.1 ± 0.8 years; range, 9.0-11.1 years). Lateral cephalograms for the two groups were examined before treatment (T0) and at a long-term observation (T1) (EPG, 19.8 ± 1.0 years; LPG, 21.0 ± 2.1 years). Independent sample t-tests were performed to compare the two groups at T0 and T1. RESULTS No statistically significant differences were found for any of the cephalometric variables at T0, except for the total mandibular length, overjet, and inclination of the maxillary incisors to the palatal plane, which were greater in the LPG. At T1, no statistically significant differences were detected for any of the cephalometric variables. CONCLUSIONS There were no significant long-term differences when treating Class III patients with RME/FM, either during an early prepubertal phase (≤7 years of age) or during a late prepubertal phase (≥9 years of age).
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Affiliation(s)
- Valentina Rutili
- Graduate Orthodontic Program, Department of Experimental and Clinical Medicine, The University of Florence, 50121 Florence, Italy; (V.R.); (M.N.); (V.G.)
| | - Bernardo Quiroga Souki
- Graduate Orthodontic Program, Pontifical Catholic University of Minas Gerais, Belo Horizonte 30535-610, Brazil; (B.Q.S.); (A.L.F.M.C.)
| | - Michele Nieri
- Graduate Orthodontic Program, Department of Experimental and Clinical Medicine, The University of Florence, 50121 Florence, Italy; (V.R.); (M.N.); (V.G.)
| | - Ana Luiza Farnese Morais Carlos
- Graduate Orthodontic Program, Pontifical Catholic University of Minas Gerais, Belo Horizonte 30535-610, Brazil; (B.Q.S.); (A.L.F.M.C.)
| | - Chiara Pavoni
- Department of Faculty of Medicine and Surgery, UniCamillus, International Medical University, 00131 Rome, Italy; (C.P.); (P.C.)
| | - Paola Cozza
- Department of Faculty of Medicine and Surgery, UniCamillus, International Medical University, 00131 Rome, Italy; (C.P.); (P.C.)
| | - James A. McNamara
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry and Center for Human Growth and Development, The University of Michigan, Ann Arbor, MI 48109, USA;
| | - Veronica Giuntini
- Graduate Orthodontic Program, Department of Experimental and Clinical Medicine, The University of Florence, 50121 Florence, Italy; (V.R.); (M.N.); (V.G.)
| | - Lorenzo Franchi
- Graduate Orthodontic Program, Department of Experimental and Clinical Medicine, The University of Florence, 50121 Florence, Italy; (V.R.); (M.N.); (V.G.)
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Silva FLBS, Conti ACDCF, Fernandes TMF, Araújo PPBD, Pinzan A. Cephalometric comparison of mandibular growth in Brazilian children with Class II malocclusion and normal occlusion during the growth stages determined by the cervical vertebrae maturation. Dental Press J Orthod 2023; 28:e232358. [PMID: 37937681 PMCID: PMC10627418 DOI: 10.1590/2177-6709.28.5.e232358.oar] [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: 03/12/2023] [Accepted: 07/03/2023] [Indexed: 11/09/2023] Open
Abstract
OBJECTIVE This study compared mandibular growth in children, aged 7 to 12 years, with Class II malocclusion and normal occlusion, between the following stages of cervical vertebrae maturation: initiation (I), acceleration (A), transition (T). MATERIAL AND METHODS A total of 148 lateral cephalograms (78 males, 70 females) of Class II malocclusion patients, and 60 lateral cephalograms (30 males, 30 females) of normal occlusion patients were included. The following linear cephalometric measurements were performed: Co-Gn (effective mandibular length), Co-Go (ramus height), and Go-Gn (length of mandibular body). Mean values of increments between stages (I-A, A-T, I-T) were obtained for each group and gender. Results were compared using the Student t-test, and a significance level of 0.05% was adopted. RESULTS Females group: A-T interval presented a greater increment in Co-Go in the Class II group, which was not significant for the I-T interval, with numerically smaller increments in Co-Gn and Go-Gn, without statistical significance. Males group: intervals I-A, A-T and I-T showed numerically smaller growth increments in the Class II group, with statistical significance for Co-Gn in I-A (p=0.001) and I-T (p=0.003). Comparing genders of the Class II group, Co-Go was higher in males (p=0.002) and I-T interval (p=0.031). In the Normal Occlusion group, the male gender had the greatest Co-Gn (p=0.038) for the I-A interval. In A-T and I-T, Co-Go in males was higher, with statistical significance (p=0.000 and p=0.002, respectively). CONCLUSION Growth phenomenon affects the mandibular dimensions regardless of the character of the malocclusion, with a tendency to be smaller in the presence of Class II malocclusion.
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Affiliation(s)
| | | | | | | | - Arnaldo Pinzan
- Universidade de São Paulo - USP, Faculdade de Odontologia, Departamento de Ortodontia (Bauru/SP, Brazil)
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Ciavarella D, Lorusso M, Fanelli C, Cazzolla AP, Maci M, Ferrara D, Lo Muzio L, Tepedino M. The Correlation between Mandibular Arch Shape and Vertical Skeletal Pattern. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1926. [PMID: 38003975 PMCID: PMC10673071 DOI: 10.3390/medicina59111926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 10/18/2023] [Accepted: 10/20/2023] [Indexed: 11/26/2023]
Abstract
Background and Objectives: The aim of this study was to evaluate the correlation between the mandibular arch shape and the vertical skeletal pattern in growing patients. Materials and Methods: A total of 73 Caucasian patients (33 males and 40 females; mean age 9.4) were retrospectively enrolled from a pool of patients treated in chronological order at the Department of Orthodontics, University of Foggia, Italy, from April 2018 to December 2021. Each patient received a laterolateral radiograph and a digital scan of the dental arch. Eight cephalometric parameters (lower gonial angle, intermaxillary angle, divergence angle, Wits index, Jarabak ratio, OP-MP angle, PP-OP angle, and ANB) and five dental measurements (posterior mandibular arch width, anterior mandibular arch width, mandibular occlusal angle, posterior width on distobuccal molar cusps, and molar angle) were analyzed and then compared. A Spearman's rho correlation test between the cephalometric measurements and the dental measurements was performed. Statistical significance was set at p < 0.05. Results: A negative statistically significant correlation was found between the Jarabak ratio and the intermolar angle; a statistically significant correlation was also observed between the Wits index, the posterior mandibular width, and the occlusal mandibular angle; the ANB angle and the occlusal mandibular angle; the intermaxillary angle (PP-PM) and the mandibular occlusal angle, posterior mandibular width on the disto-vestibular cusp, and the intermolar angle; and the OP-MP angle and mandibular occlusal angle and the posterior mandibular width on the disto-vestibular cusp. Conclusions: The mandibular arch form may be related to certain predisposing features in craniofacial morphology, such as jaw divergence, the Jarabak ratio, and the intermaxillary angle.
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Affiliation(s)
- Domenico Ciavarella
- Department of Clinical and Experimental Medicine, Dental School of Foggia, University of Foggia, Via Rovelli 50, 71122 Foggia, Italy; (D.C.); (C.F.); (A.P.C.); (M.M.); (D.F.); (L.L.M.)
| | - Mauro Lorusso
- Department of Clinical and Experimental Medicine, Dental School of Foggia, University of Foggia, Via Rovelli 50, 71122 Foggia, Italy; (D.C.); (C.F.); (A.P.C.); (M.M.); (D.F.); (L.L.M.)
| | - Carlotta Fanelli
- Department of Clinical and Experimental Medicine, Dental School of Foggia, University of Foggia, Via Rovelli 50, 71122 Foggia, Italy; (D.C.); (C.F.); (A.P.C.); (M.M.); (D.F.); (L.L.M.)
| | - Angela Pia Cazzolla
- Department of Clinical and Experimental Medicine, Dental School of Foggia, University of Foggia, Via Rovelli 50, 71122 Foggia, Italy; (D.C.); (C.F.); (A.P.C.); (M.M.); (D.F.); (L.L.M.)
| | - Marta Maci
- Department of Clinical and Experimental Medicine, Dental School of Foggia, University of Foggia, Via Rovelli 50, 71122 Foggia, Italy; (D.C.); (C.F.); (A.P.C.); (M.M.); (D.F.); (L.L.M.)
| | - Donatella Ferrara
- Department of Clinical and Experimental Medicine, Dental School of Foggia, University of Foggia, Via Rovelli 50, 71122 Foggia, Italy; (D.C.); (C.F.); (A.P.C.); (M.M.); (D.F.); (L.L.M.)
| | - Lorenzo Lo Muzio
- Department of Clinical and Experimental Medicine, Dental School of Foggia, University of Foggia, Via Rovelli 50, 71122 Foggia, Italy; (D.C.); (C.F.); (A.P.C.); (M.M.); (D.F.); (L.L.M.)
| | - Michele Tepedino
- Department of Biotechnological and Applied Clinical Sciences, Dental School of L’Aquila, University of L’Aquila, 67100 L’Aquila, Italy;
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Liu J, Zhang C, Shan Z. Application of Artificial Intelligence in Orthodontics: Current State and Future Perspectives. Healthcare (Basel) 2023; 11:2760. [PMID: 37893833 PMCID: PMC10606213 DOI: 10.3390/healthcare11202760] [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: 08/24/2023] [Revised: 10/11/2023] [Accepted: 10/16/2023] [Indexed: 10/29/2023] Open
Abstract
In recent years, there has been the notable emergency of artificial intelligence (AI) as a transformative force in multiple domains, including orthodontics. This review aims to provide a comprehensive overview of the present state of AI applications in orthodontics, which can be categorized into the following domains: (1) diagnosis, including cephalometric analysis, dental analysis, facial analysis, skeletal-maturation-stage determination and upper-airway obstruction assessment; (2) treatment planning, including decision making for extractions and orthognathic surgery, and treatment outcome prediction; and (3) clinical practice, including practice guidance, remote care, and clinical documentation. We have witnessed a broadening of the application of AI in orthodontics, accompanied by advancements in its performance. Additionally, this review outlines the existing limitations within the field and offers future perspectives.
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Affiliation(s)
- Junqi Liu
- Division of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China;
| | - Chengfei Zhang
- Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China;
| | - Zhiyi Shan
- Division of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China;
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Qureshi T, Kharbanda OP, Duggal R. Assessment of Skeletal Maturation in Nonsyndromic Cleft and Non-cleft Children-A Comparative Study. J Craniofac Surg 2023; 34:1948-1952. [PMID: 37253236 DOI: 10.1097/scs.0000000000009356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 01/17/2023] [Indexed: 06/01/2023] Open
Abstract
The study aims to determine the difference in the skeletal maturation of unilateral cleft lip and palate (UCLP) and non-cleft children. This study also attempts to determine sexual dimorphism in attaining skeletal maturation between UCLP and non-cleft children. This was a retrospective, cross-sectional study. The total sample consisted of the lateral cephalogram of 131 UCLP (62 female and 71 male) children and 500 (274 female and 226 male) non-cleft children. The reviewer used the Baccetti method (2005) to review all the cephalograms for the cervical vertebrae maturation (CVM) stages. T -test was used to compare the mean chronological age and skeletal maturation of cleft and non-cleft children at each CVM stage. There was no significant difference in the mean chronological age and skeletal maturation status of UCLP and non-cleft children. There was no significant difference in skeletal maturation based on sex. The intraobserver assessment showed 80% and 85% kappa agreement, signifying absolute agreement. The correlation coefficient between chronological age and CVMIs was 0.86 ( P <0.001) in cleft children and 0.76 ( P <0.001) in non-cleft children, which was highly significant. The study indicates no significant difference in the skeletal maturation of UCLP and non-cleft children and no sex-related difference.
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Affiliation(s)
- Tabassum Qureshi
- Division of Orthodontics and Dentofacial Deformities, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | | | - Ritu Duggal
- Centre for Dental Education and Research (CDER), Division of Orthodontics & Dentofacial Deformities All India Institute of Medical Sciences, New Delhi, India
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Agani Sabah G, Dinçer B. Association between sella turcica bridging and the impaction severity of palatally displaced canines: A retrospective study. Am J Orthod Dentofacial Orthop 2023; 164:567-574. [PMID: 37656073 DOI: 10.1016/j.ajodo.2023.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 03/01/2023] [Accepted: 03/01/2023] [Indexed: 09/02/2023]
Abstract
INTRODUCTION This retrospective study aimed to investigate the association between the extent of the bridging and dimensions of sella turcica and the impaction severity of palatally displaced canines. Secondarily, any possible association between skeletal age and gender was evaluated. METHODS Panoramic and cephalometric radiographs of 94 patients (63 female, 31 male; 19 pre-peak, 75 post-peak) with palatally displaced canines were evaluated. Sector classification and α angle were used to determine the impaction severity of palatally displaced canines on panoramic radiographs. The distance from the cusp tip of the palatally displaced canines to the occlusal plane (d) and the extent of the bridging and dimensions of the sella turcica were evaluated on cephalometric radiographs. RESULTS Sella turcica bridging and dimensions did not vary regarding the impaction severity of palatally displaced canines, but a significant association was found between sella turcica bridging and skeletal age (P = 0.038). Class II (33.3%) and Class III (12.0%) bridging was higher in postpubertal patients. No differences between females and males were detected for the extent of bridging and dimensions of the sella turcica. CONCLUSIONS These findings indicate no association between sella turcica bridging and dimensions and the impaction severity of palatally displaced canines. Sella turcica bridging is more frequent in the postpubertal period, whereas gender does not influence sella turcica bridging. More studies are needed to evaluate if the extent of sella turcica bridging may be indicative of severely impacted palatal canines, which in turn would allow for careful monitoring of patients from an early age and for the clinician to take preventive measures.
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Affiliation(s)
- Genta Agani Sabah
- Department of Orthodontics, Faculty of Dentistry, Izmir Tinaztepe University, Izmir, Turkey; Department of Oral and Dental Health, Vocational School of Health Services, Izmir Tinaztepe University, Izmir, Turkey.
| | - Banu Dinçer
- Department of Orthodontics, Faculty of Dentistry, Ege University, Izmir, Turkey
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Alzoubi EE, Camilleri S, Al Muzian M, Attard N. The effect of tooth borne versus skeletally anchored Alt-RAMEC protocol in early treatment of Class III malocclusion: a single-centre randomized clinical trial. Eur J Orthod 2023; 45:517-527. [PMID: 37167546 DOI: 10.1093/ejo/cjad018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
TRIAL DESIGN This was a randomized, controlled trial designed to compare outcomes between the use of dental and skeletal anchorage, using the Face mask/Alternate Rapid Maxillary Expansion and Contraction (FM/Alt-RAMEC) protocol. METHODS AND PARTICIPANTS The study was carried out at Mater Dei Hospital, Malta and included prepubertal skeletal Class III malocclusion patients where the aetiology was primarily maxillary hypoplasia. INTERVENTIONS Two groups were assigned. Group I was treated with FM/Alt-RAMEC and group II was treated with skeletally anchored FM/Alt-RAMEC. Wear-time (WT) of the FM was monitored using TheraMon microsensors. Patients were instructed to wear the FM for 12-14 hours/day for 9 months. Changes were evaluated with lateral cephalograms and analysed with Wilcoxon and Mann-Whitney U tests. ANOVA was used to analyse the effect of gender on compliance parameters. Spearman's correlation coefficient was used to assess the correlation between compliance and skeletal changes. OBJECTIVE To compare the skeletal and dentoalveolar changes in patients treated with these two protocols. OUTCOMES The primary outcome was to assess skeletal and dentoalveolar outcomes in patients treated with skeletally anchored FM/RME and tooth-borne FM/RME; utilizing Alt-RAMEC protocol. The secondary outcome was compliance rate and adherence to FM wear among patients. RANDOMIZATION Randomizer software and the sealed envelope technique were used to randomly allocate patients 1:1 into either group I (tooth-borne FM/Alt-RAMEC) or group II (skeletally anchored FM/Alt-RAMEC). BLINDING It was not possible to blind to treatment allocation, but blinding was used when assessing the outcomes. RESULTS Numbers randomized and analysed. Thirty-five patients were allocated. Group I consisted of 18 subjects and group II consisted of 17 subjects. One patient in group I dropped out due to illness, so 17 subjects in each group completed the study. OUTCOMES Post-treatment changes in group I showed significant increases in SNA (2.10°), ANB (3.90°), Wits (4.70 mm), and overjet (5.40 mm). Group II showed significant increases in ANB (3.10°), Wits (3.20 mm), and overjet (4.50 mm). Wearing time for group I patients was 7.87 ± 2.88 hours/day and for group II was 6.98 ± 2.68 hours/day, with no significant difference between the groups. LIMITATIONS Lack of long-term follow-up post-treatment, making the conclusion applicable only in the short term. HARMS No harm was observed in both groups. CONCLUSION Despite the large difference between the measured and the patient-reported daily WT, both tooth-borne and skeletally anchored FM/Alt-RAMEC showed positive, similar, skeletal and dental effects. CLINICAL TRIAL REGISTRATION ISRCTN12197405.
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Affiliation(s)
- Emad Eddin Alzoubi
- Department of Child Dental Health and Orthodontics, University of Malta, Msida, Malta
| | - Simon Camilleri
- Department of Child Dental Health and Orthodontics, University of Malta, Msida, Malta
| | - Mohammed Al Muzian
- Department of Orthodontics, Faculty of Dentistry, University of Edinburgh, Edinburgh, UK
| | - Nikolai Attard
- Department of Restorative Dentistry, University of Malta, Msida, Malta
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Abate A, Ugolini A, Maspero C, Silvestrini-Biavati F, Caprioglio A, Lanteri V. Comparison of the skeletal, dentoalveolar, and periodontal changes after Ni-Ti leaf spring expander and rapid maxillary expansion: a three-dimensional CBCT based evaluation. Clin Oral Investig 2023; 27:5249-5262. [PMID: 37466717 PMCID: PMC10492880 DOI: 10.1007/s00784-023-05144-6] [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: 06/18/2022] [Accepted: 07/05/2023] [Indexed: 07/20/2023]
Abstract
BACKGROUND The aim of the present study was twofold:(1) three-dimensionally evaluate the quantitative skeletal and dentoalveolar changes after Ni-Ti leaf spring expander (leaf expander) and rapid maxillary expansion (RME) in mixed dentition patients;(2) analyze the modifications of the buccal alveolar bone plate of the maxillary first permanent molars. METHODS Patients who underwent CBCT scans before and after maxillary expansion were randomly selected from the records archived at the Department of Biomedical Surgical and Dental Sciences, University of Milan, Italy. Inclusion criteria were the following: no systemic disease or syndromes; maxillary transverse deficiencies (difference between the upper intermolar width and the lower intermolar width of at least 3 mm and/or clinical need based on radiographic evaluation), early mixed dentition with ages between 7 to 10 years old; cervical vertebra maturation stage (CVMS) 1 or 2; no pathologic periodontal status; skeletal class I or II; maxillary expander cemented on the upper second deciduous molars. Exclusion criteria were the following: patients with pubertal or post-pubertal stage of development (CVMS 3-6); late deciduous or late mixed dentition, impossibility to use the second primary molar as anchorage; skeletal class III malocclusion; craniofacial syndromes; patients unable to be followed during the treatment period. Twenty-three patients treated with Leaf Expander, 11 males (mean age 7.8 ± 0.6 years) and 12 females (mean age 8.1 ± 0.8 years), met the inclusion criteria and constituted the case group. Twenty-four (control group) treated with conventional RME, 12 males (mean age 8.4 ± 0.9 years) and 12 females (mean age 8.1 ± 0.7 years). The paired-sample T test was used for intra-group comparison to evaluate the difference between before (T1) and after (T2) maxillary expansion. Independent sample t-test was computed to perform between groups comparison of the skeletal, dentoalveolar, and periodontal changes. RESULTS The Leaf Expander and RME group showed a significant increase between T1 and T2 for most of the skeletal and dentoalveolar variables. Concerning the skeletal variables only the RME demonstrated a significant increase at the level of the posterior nasal (PNW) and apical base width (PABW) and maxillary mid-alveolar width (MMW). Despite this, when compare with the Leaf Expander, the RME group exhibited a statistically larger width increase for only two skeletal parameters: PNW (p = 0.03) and MMW (p = 0.02). No significant changes at the periodontal level were found in either group. CONCLUSIONS According to the current research, the authors confirm the effectiveness of the Leaf Expander and RME to produce similar skeletal and dentoalveolar effects in mixed dentition subjects. Moreover, the devices anchored to deciduous teeth did not reduce the thickness and height of the buccal bone at the level of the maxillary permanent first molars in either of the two groups.
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Affiliation(s)
- Andrea Abate
- Department of Biomedical Surgical and Dental Sciences, University of Milan, 20142, Milan, Italy
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20142, Milan, Italy
| | - Alessandro Ugolini
- Department of Sciences Integrated Surgical and Diagnostic, University of Genova, Genoa, Italy
| | - Cinzia Maspero
- Department of Biomedical Surgical and Dental Sciences, University of Milan, 20142, Milan, Italy.
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20142, Milan, Italy.
| | | | - Alberto Caprioglio
- Department of Biomedical Surgical and Dental Sciences, University of Milan, 20142, Milan, Italy
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20142, Milan, Italy
| | - Valentina Lanteri
- Department of Biomedical Surgical and Dental Sciences, University of Milan, 20142, Milan, Italy
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20142, Milan, Italy
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Park TH, Lin JH, Chung CH, Zheng Z, Li C. The skeletal and dental age advancements of children and adolescents with overweight and obesity: A systematic review and meta-analysis. Am J Orthod Dentofacial Orthop 2023; 164:325-339. [PMID: 37367707 DOI: 10.1016/j.ajodo.2023.05.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Revised: 05/01/2023] [Accepted: 05/01/2023] [Indexed: 06/28/2023]
Abstract
INTRODUCTION Over the past decades, a trend of increasing obesity among children has emerged. This study aimed to evaluate and summarize the impacts of overweight and obesity on children's and adolescents' skeletal and dental developmental advancement that may influence orthodontic management. METHODS Registered with the Prospective Register of Systematic Reviews (registration no. CRD42022347488), this study complies with the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline. Particularly, relevant original studies on skeletal or dental age evaluation were screened from accessible electronic databases and supplemented by hand-searching. Meta-analysis was recruited to calculate differences (and their 95% confidence interval [CI]) between subjects with overweight or obese and normal-weight counterparts. RESULTS After applying the inclusion and exclusion criteria, 17 articles were selected for the final review. Two of the 17 selected studies were found to have a high risk of bias and moderate the other 15. A meta-analysis detected no statistically significant difference in skeletal age between children and adolescents with overweight and normal-weight counterparts (P = 0.24). However, the dental age of children and adolescents with overweight was found to be 0.49 years (95% CI, 0.29-0.70) advanced in comparison with normal-weight counterparts (P <0.00001). In contrast, children and adolescents with obesity were found to have advanced skeletal age by 1.17 (95% CI, 0.48-1.86) years (P = 0.0009) and dental age by 0.56 (95% CI, 0.37-0.76) years (P <0.00001) compared with their normal-weight counterparts. CONCLUSION Because the orthopedic outcomes of the orthodontic intervention are closely tied to the skeletal age of the patients, these results suggest that the orthodontic evaluation and treatment of children and adolescents with obesity might occur earlier than that of the normal-weight population.
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Affiliation(s)
- Tiffany H Park
- School of Dental Medicine, University of Pennsylvania, Philadelphia, Pa
| | - Jia-Hong Lin
- Department of Orthodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, Pa
| | - Chun-Hsi Chung
- Department of Orthodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, Pa
| | - Zhong Zheng
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, Calif.
| | - Chenshuang Li
- Department of Orthodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, Pa.
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Kapoor P, Balachandran R, Chowdhry A, Perinetti G, Kharbanda OP. Biomarkers in Body Fluids as Indicators of Skeletal Maturity: A Systematic Review and Meta-analysis. Rambam Maimonides Med J 2023; 14:RMMJ.10506. [PMID: 37669407 PMCID: PMC10619988 DOI: 10.5041/rmmj.10506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/07/2023] Open
Abstract
OBJECTIVES This review aimed to critically appraise the evidence for biomarkers in blood serum, gingival crevicular fluid (GCF), saliva, and urine in comparison with standard radiographic indices for skeletal maturation assessment. MATERIALS AND METHODS A thorough literature search in multiple databases was conducted for biomarkers in body fluids for skeletal maturation assessed with cervical vertebrae in lateral cephalograms or on hand-wrist radiographs. Different combinations including free text, MeSH terms, and Boolean operators were used. Two researchers used strict inclusion and exclusion criteria to screen title, abstract, and full text, and used the Quality Assessment of Diagnostic Accuracy Studies (QUADAS)-2 instrument for risk of bias assessment of individual studies. Meta-analysis was performed on eligible studies using RevMan 5 software. RESULTS A total of 344 articles were screened, of which 33 met the inclusion criteria and quality assessment. The skeletal maturity indicators included insulin-like growth factors (IGF-1), alkaline phosphatase (ALP), bone-specific alkaline phosphatase (BALP), dehydroepiandrosterone sulfate (DHEAS), vitamin D binding protein (DBP), parathormone-related protein (PTHrP), osteocalcin, metalloproteins, and serotransferrin (TF) along with different metabolites. At puberty, a significant rise was seen in IGF-1, DBP, ALP, osteocalcin, TF, and BALP. However, the serum DHEAS and PTHrP increased from pre-pubertal to post-pubertal stages. Due to the data heterogeneity, a meta-analysis could be performed on seven studies in total on IGF-1 in serum and blood. Of these, five were included for data in males and six in females, and four studies on IGF-1 in serum and blood. A significant difference in IGF-1 levels was seen between stages of peak pubertal growth spurt (CS3 and CS4) and decelerating pubertal growth (CS5) compared with growth initiation stage (CS2). CONCLUSIONS Pubertal growth spurts were correlated with peak serum IGF-1 and BALP in both sexes individually. Peak ALP levels in GCF were correlated with the pubertal spurt in a combined sample of males and females. Standard biofluid collection protocols and homogeneity in sampling and methodology are strongly recommended for future research.
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Affiliation(s)
- Priyanka Kapoor
- School of Dental Sciences, Sharda University, Greater Noida, Uttar Pradesh, India
- Department of Orthodontics, Faculty of Dentistry, Jamia Millia Islamia, New Delhi, India
| | - Rajiv Balachandran
- Department of Orthodontics and Dentofacial Orthopedics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Aman Chowdhry
- School of Dental Sciences, Sharda University, Greater Noida, Uttar Pradesh, India
- Department of Oral Pathology & Microbiology, Faculty of Dentistry, Jamia Millia Islamia, New Delhi, India
| | | | - Om Prakash Kharbanda
- Faculty of Dental Sciences, M.S. Ramaih University of Applied Sciences, Bangalore, India
- Health Sciences, M.S. Ramaih University of Applied Sciences, Bangalore, India
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Lu L, Zhang L, Li C, Yi F, Lei L, Lu Y. Treatment effects after maxillary expansion using invisalign first system vs. acrylic splint expander in mixed dentition: a prospective cohort study. BMC Oral Health 2023; 23:598. [PMID: 37635237 PMCID: PMC10463527 DOI: 10.1186/s12903-023-03312-4] [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: 05/17/2023] [Accepted: 08/14/2023] [Indexed: 08/29/2023] Open
Abstract
BACKGROUND Invisalign First System (First) is a new type of orthodontic appliance for maxillary arch expansion in mixed dentition children. Till now, few studies have evaluated the expansion effects of First versus other appliances. What's more, most studies of arch expansion did not include a natural group to rule out growth effects. This prospective cohort study aimed to evaluate the dental and dentoalveolar effects using First or acrylic splint rapid maxillary expander (RME) in adolescents excluding growth factors. MATERIALS AND METHODS After screening by strict inclusion criteria and propensity score matching (PSM), fifty-one patients were included: First group (n = 17), RME group (n = 17), and natural growth (NG) group (n = 17). Nine indicators including dental arch width, dentoalveolar arch width, and inclination of the molars were measured on digital dental casts at baseline (T0) and six-month follow-up (T1). Paired t-tests were used for intra-group results, and two-sample independent t-tests were used for inter-group comparisons. RESULTS There was no significant increase in all indicators within six months in the NG group (p > 0.05). In the First group and RME group, all width indicators were significantly increased after treatment (p < 0.05). The RME group exhibited greater expansion than the First group in intercanine width, first interpremolar width, second interdeciduous molar width, first intermolar width, arch perimeter, intercanine dentoalveolar width, intermolar dentoalveolar width, and inclination of the molars (p < 0.05). Whereas, there was no significant difference in arch depth between the two treated groups. CONCLUSIONS Both First and RME can expand the maxillary arch in mixed dentition. In case of mild to moderate maxillary transverse deficiency (MTD), Invisalign First System could be a reasonable option. RME shows significant better efficiency of dental arch expansion than First, recommended for patients with severe MTD. TRIAL REGISTRATION This prospective study was registered on ClinicalTrials.gov (01/02/2022, registration number: ChiCTR2200056220). The trial was approved by the Ethical Committee of the Hunan Xiangya Stomatological Hospital Central South University (20,200,088), and informed consent was obtained from all subjects and their legal guardian(s).
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Affiliation(s)
- Lanxin Lu
- Xiangya Stomatological Hospital & Xiangya School of Stomatology, Central South University, 410008, Changsha, Hunan, China
- Hunan Key Laboratory of Oral Health Research, Changsha, China
- Hunan Clinical Research Center of Oral Major Diseases and Oral Health, Changsha, China
| | - Lingling Zhang
- Xiangya Stomatological Hospital & Xiangya School of Stomatology, Central South University, 410008, Changsha, Hunan, China
- Hunan Key Laboratory of Oral Health Research, Changsha, China
- Hunan Clinical Research Center of Oral Major Diseases and Oral Health, Changsha, China
- The Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China
- National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Changsha, China
| | - Chengri Li
- Xiangya Stomatological Hospital & Xiangya School of Stomatology, Central South University, 410008, Changsha, Hunan, China
- Hunan Key Laboratory of Oral Health Research, Changsha, China
- Hunan Clinical Research Center of Oral Major Diseases and Oral Health, Changsha, China
| | - Fang Yi
- Xiangya Stomatological Hospital & Xiangya School of Stomatology, Central South University, 410008, Changsha, Hunan, China
- Hunan Key Laboratory of Oral Health Research, Changsha, China
- Hunan Clinical Research Center of Oral Major Diseases and Oral Health, Changsha, China
| | - Lei Lei
- Xiangya Stomatological Hospital & Xiangya School of Stomatology, Central South University, 410008, Changsha, Hunan, China
- Hunan Key Laboratory of Oral Health Research, Changsha, China
- Hunan Clinical Research Center of Oral Major Diseases and Oral Health, Changsha, China
| | - Yanqin Lu
- Xiangya Stomatological Hospital & Xiangya School of Stomatology, Central South University, 410008, Changsha, Hunan, China.
- Hunan Key Laboratory of Oral Health Research, Changsha, China.
- Hunan Clinical Research Center of Oral Major Diseases and Oral Health, Changsha, China.
- Department of Orthodontics, Hunan Key Laboratory of Oral Health Research & Hunan Clinical Research Center of Oral Major Diseases and Oral Health & Xiangya Stomatological Hospital, Xiangya School of Stomatology, Central South University, 410008, Changsha, Hunan, China.
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Yoon A, Gozal D, Kushida C, Pelayo R, Liu S, Faldu J, Hong C. A roadmap of craniofacial growth modification for children with sleep-disordered breathing: a multidisciplinary proposal. Sleep 2023; 46:zsad095. [PMID: 37014012 PMCID: PMC10424160 DOI: 10.1093/sleep/zsad095] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 03/19/2023] [Indexed: 04/05/2023] Open
Abstract
Craniofacial modification by orthodontic techniques is increasingly incorporated into the multidisciplinary management of sleep-disordered breathing in children and adolescents. With increasing application of orthodontics to this clinical population it is important for healthcare providers, families, and patients to understand the wide range of available treatments. Orthodontists can guide craniofacial growth depending on age; therefore, it is important to work with other providers for a team-based approach to sleep-disordered breathing. From infancy to adulthood the dentition and craniofacial complex change with growth patterns that can be intercepted and targeted at critical time points. This article proposes a clinical guideline for application of multidisciplinary care with emphasis on dentofacial interventions that target variable growth patterns. We also highlight how these guidelines serve as a roadmap for the key questions that will influence future research directions. Ultimately the appropriate application of these orthodontic techniques will not only provide an important therapeutic option for children and adolescents with symptomatic sleep-disordered breathing but may help also mitigate or prevent its onset.
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Affiliation(s)
- Audrey Yoon
- Division of Sleep Medicine, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
- Department of Orthodontics, Arthur A. Dugoni School of Dentistry at the University of the Pacific, San Francisco, CA, USA
| | - David Gozal
- Department of Child Health, and Child Health Research Institute, University of Missouri School of Medicine, Columbia, MO, USA
| | - Clete Kushida
- Division of Sleep Medicine, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Rafael Pelayo
- Division of Sleep Medicine, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Stanley Liu
- Division of Sleep Surgery, Department of Otolaryngology-Head & Neck Surgery, School of Medicine, Stanford University, Stanford, CA, USA
| | - Jasmine Faldu
- Division of Orthodontics, Department of Orofacial Science, School of Dentistry, the University of California San Francisco, San Francisco, CA, USA
| | - Christine Hong
- Division of Orthodontics, Department of Orofacial Science, School of Dentistry, the University of California San Francisco, San Francisco, CA, USA
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Li H, Li H, Yuan L, Liu C, Xiao S, Liu Z, Zhou G, Dong T, Ouyang N, Liu L, Ma C, Feng Y, Zheng Y, Xia L, Fang B. The psc-CVM assessment system: A three-stage type system for CVM assessment based on deep learning. BMC Oral Health 2023; 23:557. [PMID: 37573308 PMCID: PMC10422791 DOI: 10.1186/s12903-023-03266-7] [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: 12/09/2022] [Accepted: 07/29/2023] [Indexed: 08/14/2023] Open
Abstract
BACKGROUND Many scholars have proven cervical vertebral maturation (CVM) method can predict the growth and development and assist in choosing the best time for treatment. However, assessing CVM is a complex process. The experience and seniority of the clinicians have an enormous impact on judgment. This study aims to establish a fully automated, high-accuracy CVM assessment system called the psc-CVM assessment system, based on deep learning, to provide valuable reference information for the growth period determination. METHODS This study used 10,200 lateral cephalograms as the data set (7111 in train set, 1544 in validation set and 1545 in test set) to train the system. The psc-CVM assessment system is designed as three parts with different roles, each operating in a specific order. 1) Position Network for locating the position of cervical vertebrae; 2) Shape Recognition Network for recognizing and extracting the shapes of cervical vertebrae; and 3) CVM Assessment Network for assessing CVM according to the shapes of cervical vertebrae. Statistical analysis was conducted to detect the performance of the system and the agreement of CVM assessment between the system and the expert panel. Heat maps were analyzed to understand better what the system had learned. The area of the third (C3), fourth (C4) cervical vertebrae and the lower edge of second (C2) cervical vertebrae were activated when the system was assessing the images. RESULTS The system has achieved good performance for CVM assessment with an average AUC (the area under the curve) of 0.94 and total accuracy of 70.42%, as evaluated on the test set. The Cohen's Kappa between the system and the expert panel is 0.645. The weighted Kappa between the system and the expert panel is 0.844. The overall ICC between the psc-CVM assessment system and the expert panel was 0.946. The F1 score rank for the psc-CVM assessment system was: CVS (cervical vertebral maturation stage) 6 > CVS1 > CVS4 > CVS5 > CVS3 > CVS2. CONCLUSIONS The results showed that the psc-CVM assessment system achieved high accuracy in CVM assessment. The system in this study was significantly consistent with expert panels in CVM assessment, indicating that the system can be used as an efficient, accurate, and stable diagnostic aid to provide a clinical aid for determining growth and developmental stages by CVM.
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Affiliation(s)
- Hairui Li
- Department of Orthodontics, Shanghai Ninth People's Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Haizhen Li
- Department of Orthodontics, Shanghai Ninth People's Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Lingjun Yuan
- Department of Orthodontics, Shanghai Ninth People's Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Chao Liu
- Department of Orthodontics, Shanghai Ninth People's Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Shengzhao Xiao
- Department of Orthodontics, Shanghai Ninth People's Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Zhen Liu
- Department of Orthodontics, Shanghai Ninth People's Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Guoli Zhou
- Department of Orthodontics, Shanghai Ninth People's Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Ting Dong
- Department of Orthodontics, Shanghai Ninth People's Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Ningjuan Ouyang
- Department of Orthodontics, Shanghai Ninth People's Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Lu Liu
- Department of Orthodontics, Shanghai Ninth People's Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | | | - Yang Feng
- Translational Medicine Research Platform of Oral Biomechanics and Artificial Intelligence, Department of Orthodontics, Shanghai Ninth People's Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Youyi Zheng
- State Key Lab of CAD&CG, Zhejiang University, Hangzhou, China.
| | - Lunguo Xia
- Department of Orthodontics, Shanghai Ninth People's Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China.
| | - Bing Fang
- Department of Orthodontics, Shanghai Ninth People's Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China.
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Xing K, Mei H, Feng Q, Quan S, Zhang G, Jia A, Ge H, Mei D, Li J. Accuracy in predicting soft tissue changes of orthodontic class III cases using Dolphin® software. Clin Oral Investig 2023; 27:4531-4539. [PMID: 37285103 DOI: 10.1007/s00784-023-05077-0] [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: 12/15/2022] [Accepted: 05/19/2023] [Indexed: 06/08/2023]
Abstract
OBJECTIVES The prediction of posttreatment outcomes is conducive to the final determination of ideal therapeutic options. However, the prediction accuracy in orthodontic class III cases is unclear. Therefore, this study conducted exploration on prediction accuracy in orthodontic class III patients using the Dolphin® software. MATERIALS AND METHODS In this retrospective study, lateral cephalometric radiographs of pre- and posttreatment were collected from 28 angle class III adults who received completed non-orthognathic orthodontic therapy (8 males, 20 females; mean age = 20.89 ± 4.26 years). The values of 7 posttreatment parameters were recorded and inserted into the Dolphin® Imaging software to generate a predicted outcome, and then the prediction radiograph and actual posttreatment radiograph were superimposed and compared in terms of soft tissue parameters and landmarks. RESULTS The prediction showed significant differences with the actual outcomes in nasal prominence (the difference between the prediction and the actual value was - 0.78 ± 1.82 mm), the distance from the lower lip to the H line (0.55 ± 1.11 mm), and the distance from the lower lip to the E line (0.77 ± 1.62 mm) (p < 0.05). Point subnasale (Sn) (an accuracy of 92.86% in the horizontal direction and 100% in the vertical direction in 2 mm) and point soft tissue A (ST A) (an accuracy of 92.86% in the horizontal direction and 85.71% in the vertical direction in 2 mm) were proven to be the most accurate landmarks, while the predictions in the chin region were relatively inaccurate. Furthermore, the predictions in the vertical direction were of higher accuracy compared to the horizontal direction except for the points around the chin. CONCLUSIONS The Dolphin® software demonstrated acceptable prediction accuracy in midfacial changes in class III patients. However, there were still limitations for changes in the chin and lower lip prominence. CLINICAL RELEVANCE Clarifying the accuracy of Dolphin® software in predicting soft tissue changes of orthodontic class III cases will facilitate physician-patient communication and clinical treatment.
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Affiliation(s)
- Ke Xing
- State Key Laboratory of Oral Diseases & National Center of Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Hongxiang Mei
- State Key Laboratory of Oral Diseases & National Center of Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Qingchen Feng
- State Key Laboratory of Oral Diseases & National Center of Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Shuqi Quan
- State Key Laboratory of Oral Diseases & National Center of Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Guanning Zhang
- State Key Laboratory of Oral Diseases & National Center of Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Ao Jia
- The Key Laboratory of Oral Biomedicine & Jiangxi Province Clinical Research Center for Oral Diseases & the Second Department of Orthodontics, the Affiliated Stomatological Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Hongshan Ge
- The Key Laboratory of Oral Biomedicine & Jiangxi Province Clinical Research Center for Oral Diseases & the Second Department of Orthodontics, the Affiliated Stomatological Hospital of Nanchang University, Nanchang, Jiangxi, China.
| | - Dan Mei
- State Key Laboratory of Oral Diseases & National Center of Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Juan Li
- State Key Laboratory of Oral Diseases & National Center of Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China.
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Liu H, Feng L, Wang L. Diagnostic value of cervical vertebral maturation stages for midpalatal suture maturation assessment: a study in the Chinese population. BMC Oral Health 2023; 23:504. [PMID: 37474915 PMCID: PMC10360312 DOI: 10.1186/s12903-023-03220-7] [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: 03/02/2023] [Accepted: 07/11/2023] [Indexed: 07/22/2023] Open
Abstract
PURPOSE To evaluate the correlation between cervical vertebral maturation stages (CVMS) and midpalatal suture maturation stages (MPSMS), and to analyze the diagnostic value of CVMS for the assessment of MPSMS. METHODS Cone beam computed tomography (CBCT) images of 233 subjects (8-20 years) were selected. The CVMS was determined using the McNamara and Franchi method, while the MPSMS was evaluated using the Angelieri method. Spearman rank correlation was used to analyze the results, and positive likelihood ratios were calculated to evaluate the diagnostic value of CVMS in identifying MPSMS. RESULTS Spearman rank correlation results showed a strong positive correlation (r = 0.867, P < 0.001) between CVMS and MPSMS. The positive likelihood ratios of CS12, CS4, and CS56 for the identification of stages AB, C, and DE were 12.17, 7.64, and 7.79, respectively. The values of the positive likelihood ratios of the other groups were less than five. CONCLUSION CS12 of the CVMS can be used as a reliable indicator for the assessment of MPSMS stage AB. From CVMS stage 4 forward, midpalatal suture maturation should be evaluated using CBCT.
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Affiliation(s)
- Henglang Liu
- Department of Stomatology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, 32# W. Sec 2, 1st Ring Rd., Chengdu, Sichuan Province, 610072, China
| | - Linjing Feng
- Chengdu Stomatological Hospital, No.17 Chunxi Road South, Chengdu, Sichuan Province, 610000, China
| | - Lili Wang
- Department of Stomatology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, 32# W. Sec 2, 1st Ring Rd., Chengdu, Sichuan Province, 610072, China.
- School of Medicine, University of electronic science and technology of china, No.4, Section 2, North Jianshe Road, Chengdu, 610054, China.
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Ramirez-Diaz RE, Watanabe Kanno GA. [Skeletal maturation of the hand and wrist and ossification of the mid palate suture in adolescents: a literature review]. REVISTA CIENTÍFICA ODONTOLÓGICA 2023; 11:e167. [PMID: 38287998 PMCID: PMC10809972 DOI: 10.21142/2523-2754-1103-2023-167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 09/05/2023] [Indexed: 01/31/2024] Open
Abstract
Introduction The evaluation of skeletal age is an important factor in orthodontic planning to anticipate changes in growth, with the analysis of hand and wrist radiographs showing the degree of bone and facial growth potential. The objective was to evaluate the relationship between skeletal maturation of the hand and wrist and ossification of the midpalatal suture (MPS) in adolescents. Materials and methods A search was carried out in four databases such as Pubmed, Scopus, Science Direct and Embase were reviewed until December 13, 2022. The included studies were descriptive and comparative articles on the skeletal maturation of the hand and wrist and ossification of the midpalatal suture of patients aged 7 to 18 years. Two researchers carefully selected the articles evaluated and analyzed the different key topics related to the topic. Results Four articles were included in this study; According to the studies, it was found that the greater the degree of bone maturation there is an increase in the approximation of the SMP, especially in late stages, with high and positive correlations; Furthermore, there were greater evaluation results with the Fishman analysis method as opposed to the Hagg and Taranger and Björk methods. The critical limit stages in SMI7-9, a greater approach to the closure of SMP compatible with stage D-E was found. The completion of maturation in women occurs up to 2 years earlier than in men. Conclusions Diagnostic evaluation methods using carpal analysis can be used for predictive evaluations of the maturation stage of SMP; However, the results were not absolute in all cases so they cannot be generalized.
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Affiliation(s)
- Ruth Elizabeth Ramirez-Diaz
- . Division of Orthodontic, School of Dentistry, Universidad Científica del Sur. Lima, Perú. , Universidad Científica del Sur Division of Orthodontic School of Dentistry Universidad Científica del Sur Lima Peru
| | - Gustavo Adolfo Watanabe Kanno
- . Division of Orthodontic, School of Dentistry, Universidad Científica del Sur. Lima, Perú. , Universidad Científica del Sur Division of Orthodontic School of Dentistry Universidad Científica del Sur Lima Peru
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Bazzani M, Cevidanes LHS, Al Turkestani NN, Annarumma F, McMullen C, Ruellas ACO, Massaro C, Rego MVNN, Yatabe MS, Kim-Berman H, McNamara JA, Franchi L, Ngan P, He H, Angelieri F, Aghazada H, Migliorati M. Three-dimensional comparison of bone-borne and tooth-bone-borne maxillary expansion in young adults with maxillary skeletal deficiency. Orthod Craniofac Res 2023; 26:151-162. [PMID: 35737876 PMCID: PMC10257795 DOI: 10.1111/ocr.12595] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 06/01/2022] [Accepted: 06/04/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To compare the transverse dental and skeletal changes in patients treated with bone-anchored palatal expander (bone-borne, BB) compared to patients treated with tooth and bone-anchored palatal expanders (tooth-bone-borne, TBB) using cone-beam computer tomography (CBCT) and 3D image analysis. METHODS The sample comprised 30 patients with transverse maxillary discrepancy treated with two different types of appliances: bone-borne (Group BB) and tooth-bone-borne (Group TBB) expanders. CBCT scans were acquired before (T1) and after completion of maxillary expansion (T2); the interval was 5.4 ± 3.4 and 6.2 ± 2.1 months between the T1 and the T2 scans of Group TBB (tooth-bone-borne) and Group BB (bone-borne), respectively. Transverse, anteroposterior and vertical linear and angular three-dimensional dentoskeletal changes were assessed after cranial base superimposition. RESULTS Both groups displayed marked transverse skeletal expansion with a greater ratio of skeletal to dental changes. Greater changes at the nasal cavity, zygoma and orbital levels were found in Group BB. A relatively parallel sutural opening in an anterior-posterior direction was observed in Group TBB; however, the Group BB presented a somewhat triangular (V-shaped) opening of the suture that was wider anteriorly. Small downward-forward displacements were observed in both groups. Asymmetric expansion occurred in approximately 50% of the patients in both groups. CONCLUSION Greater skeletal vs dental expansion ratio and expansion of the circummaxillary regions were found in Group BB, the group in which a bone-borne expander was used. Both groups presented skeletal and dental changes, with a similar amount of posterior palate expansion. Asymmetric expansion was observed in both groups.
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Affiliation(s)
| | - Lucia H S Cevidanes
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
| | - Najla N Al Turkestani
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
- Department of Restorative and Aesthetic Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | | | - Craig McMullen
- Private Practice of Orthodontics, Brighton, Michigan, USA
| | - Antonio C O Ruellas
- Department of Orthodontics, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Camila Massaro
- Department of Orthodontics, Bauru Dental School, University of São Paulo, São Paulo, Brazil
| | - Marcus V N N Rego
- Department of Orthodontics, Centero Universitário Uninovafapi, Teresina, Brazil
| | - Marilia S Yatabe
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
| | - Hera Kim-Berman
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
| | - James A McNamara
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
| | - Lorenzo Franchi
- Department of Surgery and Translational Medicine, University of Florence, Florence, Italy
| | - Peter Ngan
- Department of Orthodontics, West Virginia University School of Dentistry, Morgantown, West Virginia, USA
| | - Hong He
- Department of Orthodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Fernanda Angelieri
- Department of Orthodontics, Methodist University of São Paulo, São Paulo, Brazil
| | | | - Marco Migliorati
- Department of Orthodontics, Genoa University School of Dentistry, Genoa, Italy
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Gurgel ML, de Oliveira Ruellas AC, Bianchi J, McNamara JA, Tai S, Franchi L, Deleat-Besson R, Le C, Logan C, Turkestani NA, Massaro C, Del Castillo AA, Arruda KEM, Benavides E, Yatabe M, Cevidanes L. Clear aligner mandibular advancement in growing patients with Class II malocclusion. AJO-DO CLINICAL COMPANION 2023; 3:93-109. [PMID: 37636594 PMCID: PMC10454533 DOI: 10.1016/j.xaor.2023.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
Abstract
Treatment effects occurring during Class II malocclusion treatment with the clear aligner mandibular advancement protocol were evaluated in two growing patients: one male (12 years, 3 months) and one female (11 years, 9 months). Both patients presented with full cusp Class II molar and canine relationships. Intraoral scans and cone-beam computed tomography were acquired before treatment and after mandibular advancement. Three-dimensional skeletal and dental long-axis changes were quantified, in which the dental long axis was determined by registering the dental crowns obtained from intraoral scans to the root canals in cone-beam computed tomography scans obtained at the same time points. Class II correction was achieved by a combination of mandibular skeletal and dental changes. A similar direction of skeletal and dental changes was observed in both patients, with downward and forward displacement of the mandible resulting from the growth of the mandibular condyle and ramus. Dental changes in both patients included mesialization of the mandibular posterior teeth with flaring of mandibular anterior teeth. In these two patients, clear aligner mandibular advancement was an effective treatment modality for Class II malocclusion correction with skeletal and dental effects and facial profile improvement.
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Affiliation(s)
- Marcela Lima Gurgel
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Mich
| | - Antonio Carlos de Oliveira Ruellas
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Mich
- Department of Orthodontics, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Jonas Bianchi
- Department of Orthodontics, University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, Calif
| | - James A. McNamara
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Mich
| | - Sandra Tai
- Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Lorenzo Franchi
- Department of Experimental and Clinical Medicine, School of Dentistry, University of Florence, Florence, Tuscany, Italy
| | - Romain Deleat-Besson
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Mich
| | - Celia Le
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Mich
| | - Candice Logan
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Mich
| | - Najla Al Turkestani
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Mich
- Department of Restorative and Aesthetic Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah, Makkah, Saudi Arabia
| | - Camila Massaro
- Department of Orthodontics, School of Dentistry, Federal University of Goiás, Goiânia, Goiás, Brazil
| | - Aron Aliaga Del Castillo
- Department of Orthodontics, Bauru Dental School, University of São Paulo, Bauru, São Paulo, Brazil
| | | | - Erika Benavides
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Mich
| | - Marilia Yatabe
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Mich
| | - Lucia Cevidanes
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Mich
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Mandall N, Littlewood S, Shah J, Watkinson S, Glossop S, Dugdale C, Curran E, Walsh T. The effect of treatment timing on clinical and psychological outcomes with Twin Block therapy: A multicentre two-arm parallel randomised controlled trial. J Orthod 2023; 50:45-54. [PMID: 36062574 DOI: 10.1177/14653125221117845] [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] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To evaluate whether delaying treatment with a twin block appliance affects treatment outcomes, in terms of skeletal and dental change and psychological disadvantage. DESIGN Multicentre, two-arm parallel randomised controlled trial. SETTING Three UK hospital orthodontic units. METHODS A total of 75 participants were randomly allocated into an Immediate Treatment Group (ITG) (n= 41) and an 18-month delayed Later Treatment Group (LTG) (n=34). OUTCOMES Dentofacial changes were recorded from lateral cephalograms and study models, psychological impact was measured using a child perception questionnaire (CPQ11-14) and an Oral Aesthetic Subjective Impact Score (OASIS) at registration (DC1), 18 months (DC2) and 3 years (DC3). RESULTS The ITG initial effect was a mean ANB reduction was 1.6° (P<0.001) (95% confidence interval [CI] = 0.89-2.29), and an overjet reduction of 5.06 mm (P<0.001) (95% CI = 3.96-6.16) (boys: aged 12 years 8 months; girls: aged 11 years 8 months). There were no statistically significant differences between the ITG and LTG for twin block treatment outcomes, but the ITG active treatment time was longer (P=0.004) (ITG: 13.1 months; LTG: 9.8 months). There was insufficient evidence to state that patients were psychologically disadvantaged by waiting 18 months for active twin block treatment (P>0.05). CONCLUSION Participants achieved similar clinical and psychological outcomes irrespective of whether they started their twin block at the age of referral (ITG) or 18 months later (LTG). This suggests that boys aged 12 years 8 months and girls aged 11 years 8 months, on average, are not disadvantaged by waiting 18 months for active twin block treatment.
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Affiliation(s)
| | | | - Jinesh Shah
- University Hospitals of North Midlands, Staffordshire, UK
| | | | | | | | - Edith Curran
- Tameside Hospital, Ashton-u-Lyne, Lancashire, UK
| | - Tanya Walsh
- University Dental Hospital of Manchester, Manchester, UK
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Florez BM, Tagawa DT, Inoue DP, Yamashita HK, Aidar LADA, Dominguez GC. Associations between skeletal discrepancies, breathing pattern, and upper airway obstruction in Class III malocclusions. Int J Pediatr Otorhinolaryngol 2023; 166:111471. [PMID: 36764078 DOI: 10.1016/j.ijporl.2023.111471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 01/25/2023] [Accepted: 01/30/2023] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To verify the associations between sagittal and vertical skeletal discrepancies, changes in upper airways, and breathing pattern in children and adolescents with Angle Class III and Class III subdivision malocclusions. METHODS Eighty-five children and adolescents with a mean age of 9.5 ± 1.74 years were selected. Cephalometry assessed the sagittal relationship (AO-BO measurement), facial types (Ricketts VERT index), nasopharynx, and oropharynx. An otorhinolaryngologist analyzed the breathing pattern and upper airway obstruction during anamnesis, physical examination, anterior rhinoscopy, and nasofibroscopy. Medical records were also reviewed. For statistical analysis, ordinary one-way ANOVA, Kruskal-Wallis (Tukey's post-hoc), unpaired t-test, Pearson's correlation, chi-square, and Fisher's exact tests (p < 0.05) were used. RESULTS The nasopharyngeal cephalometric dimension and pharyngeal tonsil hypertrophy were associated, whereas the oropharyngeal cephalometric dimension and palatine tonsils hypertrophy were not. Sagittal discrepancies were associated with septum deviation, while facial type was associated with inferior turbinate and palatine tonsils hypertrophy. However, facial type was not associated with breathing pattern, septum deviation, and pharyngeal tonsils hypertrophy. CONCLUSIONS Sagittal discrepancies and type of malocclusion were not associated with breathing pattern and changes in upper airways, except for the severity of septum deviation and Class III malocclusions, which were associated with large sagittal discrepancies. Although the facial types analyzed presented signs of airway obstruction, the highest prevalence of inferior turbinate and palatine tonsils hypertrophy were found in patients with dolichofacial type.
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Affiliation(s)
- Bruna Maluza Florez
- Department of Diagnostic Imaging, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil; Department of Orthodontics, Universidade Santa Cecília, Santos, SP, Brazil.
| | | | - Daniel Paganini Inoue
- Department of Otorhinolaryngology, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
| | - Helio Kiitiro Yamashita
- Department of Diagnostic Imaging, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
| | | | - Gladys Cristina Dominguez
- Department of Orthodontics, School of Dentistry, Universidade de São Paulo (USP), São Paulo, SP, Brazil.
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Shioyasono R, Yoshinaga K, Shioyasono A, Ito A, Watanabe K, Hiasa M, Horiuchi S, Tanaka E. Nonsurgical orthodontic treatment for a patient with Sotos syndrome. Am J Orthod Dentofacial Orthop 2023; 163:426-442. [PMID: 36437146 DOI: 10.1016/j.ajodo.2021.11.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 10/13/2021] [Accepted: 11/01/2021] [Indexed: 11/25/2022]
Abstract
Sotos syndrome is a genetic disorder characterized by overgrowth in childhood, specific facial manifestations, advanced bone age, and mental retardation. The purpose of this article is to describe the nonsurgical orthodontic treatment of a 10-year-old boy with a skeletal mandibular protrusion, unilateral posterior crossbite, and Sotos syndrome. After maxillary lateral expansion, the skeletal Class III relationship with an anterior crossbite improved because of mandibular clockwise rotation, whereas the facemask had a marginal effect. After growth at 16 years, he had a skeletal Class I relationship, and thus, conventional orthodontic treatment with preadjusted edgewise appliances was initiated. After 41 months of multibracket treatment, acceptable occlusion with a functional Class I relationship was obtained. One year postretention, few changes in occlusion and facial features were observed. Our results demonstrate that considering the maxillofacial vertical growth during the peripubertal period associated with Sotos syndrome, more attention should be paid to the early orthopedic treatment with the facemask and/or chincap.
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Affiliation(s)
- Ryoko Shioyasono
- Department of Orthodontics and Dentofacial Orthopedics, Tokushima University Hospital, Tokushima, Japan
| | - Kaoru Yoshinaga
- Department of Orthodontics and Dentofacial Orthopedics, Tokushima University Graduate School of Oral Sciences, Tokushima, Japan
| | - Atsushi Shioyasono
- Department of Oral and Maxillofacial Surgery, Kagawa University Hospital, Kagawa, Japan
| | - Ayami Ito
- Department of Orthodontics and Dentofacial Orthopedics, Tokushima University Hospital, Tokushima, Japan
| | - Keiichiro Watanabe
- Department of Orthodontics and Dentofacial Orthopedics, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Masahiro Hiasa
- Department of Orthodontics and Dentofacial Orthopedics, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Shinya Horiuchi
- Department of Orthodontics and Dentofacial Orthopedics, Tokushima University Hospital, Tokushima, Japan
| | - Eiji Tanaka
- Department of Orthodontics and Dentofacial Orthopedics, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan.
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Alsawaf DH, Rajah N. Evaluation of efficacy of utility arch with inter-maxillary elastics for treating skeletal deep bite with retroclined upper incisors in the mixed dentition: a clinical randomized controlled trial. Angle Orthod 2023; 93:490513. [PMID: 36735497 PMCID: PMC10117215 DOI: 10.2319/072722-520.1] [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: 07/01/2022] [Accepted: 11/01/2022] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVES To investigate the effectiveness of utility arch (UA) with inter-maxillary elastics compared with fixed anterior bite plane (FABP) for treating deep bite in brachy-facial children. MATERIALS AND METHODS This was a single-center, randomized controlled trial. Participants were children aged between 9 and 12 years with deep bite and a hypodivergent skeletal pattern. The sample was divided into the following two groups: (1) a UA group that was composed of patients with UAs with posterior inter-maxillary elastics and (2) an FABP group as a control. Outcomes were skeletal and dentoalveolar variables on cephalometric X-rays. RESULTS A total of 28 patients (13 boys, 15 girls) with a mean age of 10.66 years were enrolled. The treatment duration was 8.16 months in the UA group and 7.22 months in the FABP group. After treatment, the angle between the anterior cranial base and the mandible in the vertical plane increased significantly (P = .000) in both groups (about 1.97 degrees in the UA group and 2.75 degrees in the FABP group). Overbite decreased significantly in both groups (-2.1 m in the UA group and -3.64 m in the FABP group), but it decreased less significantly in the UA group than in the FABP group. The upper incisors flared significantly after treatment with both appliances (6.6 degrees in the UA group and 5.9 degrees in the FABP group). CONCLUSIONS Treatment of deep bite in children with a horizontal growth pattern by each of the appliances used in this study is effective. The mandible showed minor, significant backward rotation after treatment. The overbite decreased less in the UA group than in the FABP group.
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Seo H, Hwang J, Jung YH, Lee E, Nam OH, Shin J. Deep focus approach for accurate bone age estimation from lateral cephalogram. J Dent Sci 2023; 18:34-43. [PMID: 36643224 PMCID: PMC9831852 DOI: 10.1016/j.jds.2022.07.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 07/22/2022] [Accepted: 07/22/2022] [Indexed: 01/18/2023] Open
Abstract
Background/purpose Bone age is a useful indicator of children's growth and development. Recently, the rapid development of deep-learning technique has shown promising results in estimating bone age. This study aimed to devise a deep-learning approach for accurate bone-age estimation by focusing on the cervical vertebrae on lateral cephalograms of growing children using image segmentation. Materials and methods We included 900 participants, aged 4-18 years, who underwent lateral cephalogram and hand-wrist radiograph on the same day. First, cervical vertebrae segmentation was performed from the lateral cephalogram using DeepLabv3+ architecture. Second, after extracting the region of interest from the segmented image for preprocessing, bone age was estimated through transfer learning using a regression model based on Inception-ResNet-v2 architecture. The dataset was divided into train:test sets in a ratio of 4:1; five-fold cross-validation was performed at each step. Results The segmentation model possessed average accuracy, intersection over union, and mean boundary F1 scores of 0.956, 0.913, and 0.895, respectively, for the segmentation of cervical vertebrae from lateral cephalogram. The regression model for estimating bone age from segmented cervical vertebrae images yielded average mean absolute error and root mean squared error values of 0.300 and 0.390 years, respectively. The coefficient of determination of the proposed method for the actual and estimated bone age was 0.983. Our method visualized important regions on cervical vertebral images to make a prediction using the gradient-weighted regression activation map technique. Conclusion Results showed that our proposed method can estimate bone age by lateral cephalogram with sufficiently high accuracy.
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Affiliation(s)
- Hyejun Seo
- Department of Pediatric Dentistry, School of Dentistry, Pusan National University, Yangsan, South Korea,Department of Dentistry, Ulsan University Hospital, Ulsan, South Korea
| | - JaeJoon Hwang
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Pusan National University, Yangsan, South Korea,Dental and Life Science Institute & Dental Research Institute, School of Dentistry, Pusan National University, Yangsan, South Korea
| | - Yun-Hoa Jung
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Pusan National University, Yangsan, South Korea,Dental and Life Science Institute & Dental Research Institute, School of Dentistry, Pusan National University, Yangsan, South Korea
| | - Eungyung Lee
- Department of Pediatric Dentistry, School of Dentistry, Pusan National University, Yangsan, South Korea,Dental and Life Science Institute & Dental Research Institute, School of Dentistry, Pusan National University, Yangsan, South Korea
| | - Ok Hyung Nam
- Department of Pediatric Dentistry, School of Dentistry, Kyung Hee University, Seoul, South Korea,Corresponding author. Department of Pediatric Dentistry, Kyung Hee University School of Dentistry, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, South Korea.
| | - Jonghyun Shin
- Department of Pediatric Dentistry, School of Dentistry, Pusan National University, Yangsan, South Korea,Dental and Life Science Institute & Dental Research Institute, School of Dentistry, Pusan National University, Yangsan, South Korea,Corresponding author. Department of Pediatric Dentistry, School of Dentistry, Pusan National University, Geumo-ro 20, Mulgeum-eup, Yangsan-si, 50612, South Korea.
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Oh SL, Choi SK. Management of a prosthetic complication on an implant restoration placed when the patient was 10 years old: A case report. J Prosthodont 2023; 32:5-9. [PMID: 36272533 DOI: 10.1111/jopr.13614] [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: 09/01/2022] [Accepted: 10/17/2022] [Indexed: 01/25/2023] Open
Abstract
The use of dental implants in pediatric patients may create unique complications. A 38-year-old patient presented with a mobile, cement-retained implant crown due to an abutment screw loosening. The maxillary right central incisor implant was placed when the patient was 10 years old. Pus discharge from the peri-implant sulcus was observed. The mucosal margin of the implant was at the level of the mucogingival junction of neighboring teeth. Radiographically, the platform of the implant appeared to be at the level of the apical third of the adjacent roots. After removing the existing implant-retained crown, the inflamed peri-implant tissue covering the implant platform was removed and the stability of the implant was confirmed. A new screw-retained implant crown was made using an angulated screw channel to correct the labiopalatal angulation of the implant and allow for retrievability. Pink porcelain was used to match the mucosal margin of the implant crown to that of the maxillary left central incisor. This case report highlights the risk of implant placement in pediatric patients and agrees with previous reports that implants should be delayed until growth is complete.
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Affiliation(s)
- Se-Lim Oh
- Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, Maryland
| | - Seung Kee Choi
- Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, Maryland
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Occlusal Plane Modification in Clear Aligners Treatment: Three Dimensional Retrospective Longitudinal Study. Dent J (Basel) 2022; 11:dj11010008. [PMID: 36661545 PMCID: PMC9857834 DOI: 10.3390/dj11010008] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 12/15/2022] [Accepted: 12/19/2022] [Indexed: 12/28/2022] Open
Abstract
The purpose of the present study was to evaluate: (i) maxillary occlusal plane changes after clear aligners therapy with a 3D measurement technique; and (ii) as a secondary outcome, if such changes were correlated to the patient’s 1axilla-mandibular divergence. 3D maxillary models of 32 patients (7 males and 25 females; mean age 22.3 +/− 3.4 year) treated with clear aligners were analyzed. The angle (α) between a reference palatine plane and a maxillary occlusal plane was measured. Five angular cephalometric measurements (NSL/MP; PP-OP; OP-MP; PP-MP; PFH/AFH%) were performed and related to Δα. The subjects were further divided into three groups according to facial divergence. After aligner treatment, Δα increased in hyperdivergent patients and decreased in hypodivergent patients (p < 0.05). Δα showed a significant positive correlation with NSL/MP (rho = 0.44) and negative correlation with PFH/AFH% (rho = −0.53). Aligners treatment produced a counterlockwise rotation of the maxillary occlusal plane, even if this rotation occurs differently depending on divergence.
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Tageldin MA, Yacout YM, Marzouk ES. Skeletal and dentoalveolar characteristics of maxillary lateral incisor agenesis patients: a comparative cross-sectional study. BMC Oral Health 2022; 22:608. [PMID: 36522742 PMCID: PMC9753366 DOI: 10.1186/s12903-022-02656-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 12/09/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The aim of the study was to evaluate the cephalometric and dentoalveolar characteristics of maxillary lateral incisor agenesis patients, and to compare the findings to a matched control group without tooth agenesis, excluding third molars, from the same population. METHODS The pre-orthodontic records of 72 non-growing patients, who were treated at the Orthodontic Department, Faculty of Dentistry, Alexandria University, were used to address the aim of this retrospective study. Patients having unilateral or bilateral maxillary lateral incisor agenesis, with no history of previous orthodontic treatment, congenital craniofacial malformations, facial trauma, or surgeries were divided into two test groups based on the pattern of maxillary lateral incisors agenesis (group I: unilateral (UMLIA), group II: bilateral (BMLIA)). A control group (group III (CTRL)) having a complete set of permanent dentition (excluding third molars), and having no dental anomalies was age-matched with the test groups. Measurements were performed on the pre-orthodontic lateral cephalometric radiographs and the pre-orthodontic digital dental casts. The measured variables were compared between the groups using one-way ANOVA and Kruskal Wallis tests according to the normality of the variable. In case of significant results, both tests were followed by multiple pairwise comparisons using Bonferroni adjusted significance level. Significance level was set at P < 0.05. RESULTS BMLIA group showed a smaller SNA angle and maxillary length, a more negative ANB angle and Wits appraisal, and a larger Maxillo-mandibular differential than UMLIA and/or CTRL group. The dental and soft tissue cephalometric measurements did not show any significant differences between the groups. Dentoalveolar cast measurements showed that BMLIA patients presented with significantly smaller maxillary inter-canine width than UMLIA and CTRL patients. CONCLUSIONS Cephalometric analysis has shown that subjects with BMLIA have a statistically significant reduced ANB and maxillary length. Tooth eruption may play a role in the development of the maxillary arch.
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Affiliation(s)
- Mostafa A. Tageldin
- grid.7155.60000 0001 2260 6941Department of Orthodontics, Faculty of Dentistry, Alexandria University, Champollion St., Azarita, P. O. Box: 21521, Alexandria, Egypt
| | - Yomna M. Yacout
- grid.7155.60000 0001 2260 6941Department of Orthodontics, Faculty of Dentistry, Alexandria University, Champollion St., Azarita, P. O. Box: 21521, Alexandria, Egypt
| | - Eiman S. Marzouk
- grid.7155.60000 0001 2260 6941Department of Orthodontics, Faculty of Dentistry, Alexandria University, Champollion St., Azarita, P. O. Box: 21521, Alexandria, Egypt
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Booij JW, Fontana M, Serafin M, Fastuca R, Kuijpers-Jagtman AM, Caprioglio A. Treatment outcome of class II malocclusion therapy including extraction of maxillary first molars: a cephalometric comparison between normodivergent and hyperdivergent facial types. PeerJ 2022; 10:e14537. [PMID: 36530416 PMCID: PMC9753754 DOI: 10.7717/peerj.14537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 11/17/2022] [Indexed: 12/14/2022] Open
Abstract
Background The dentoalveolar component of a Class II division 1 malocclusion can be orthodontically treated either with extractions or by distalization of the molars. This study aimed to compare skeletal, dentoalveolar and profile changes in normodivergent and hyperdivergent Class II Division I growing patients orthodontically treated with fixed appliances including maxillary first molar extraction. Methods Sixty-four patients treated orthodontically with full fixed appliances including maxillary first molar extractions were retrospectively analyzed. Patients were divided into a normodivergent group (Group N; 30° ≤ SN^GoGn < 36°) consisting of 38 patients (17M, 21F; mean age 13.2 ± 1.3 years) and a hyperdivergent (Group H; SN^GoGn ≥ 36°) including 26 patients (12M, 14F; mean age 13.7 ± 1.1 years). Lateral cephalograms were available before (T0) and after treatment (T1) and cephalometric changes were calculated for 10 linear and 13 angular variables. The Shapiro-Wilk test confirmed a normal distribution of data, hence parametric tests were employed. The Student t-test was used to compare groups at baseline. The paired t-test was used to analyze intragroup changes between timepoints, and the Student t-test for intergroup comparisons. The level of significance was set at 0.05. Results The Class II division 1 malocclusion was successfully corrected, and the facial profile improved both in normodivergent and hyperdivergent patients. Divergency increased by 0.76 ± 1.99° in Group N (p = 0.02) while it decreased -0.23 ± 2.25° (p = 0.60); These changes were not significant between groups after treatment (p = 0.680). Most dentoskeletal measurements changed significantly within groups but none of them showed statistically significant differences between groups after treatment. Dental and soft tissue changes were in accordance with the biomechanics used for this Class II orthodontic therapy. Discussion The effect of orthodontic treatment of Class II division 1 malocclusion including extraction of the maxillary first molars in growing patients can be considered clinically equivalent in normodivergent and hyperdivergent patients. For this reason, this orthodontic treatment can be considered a viable option in the armamentarium of the Class II Division I therapy for both facial types.
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Affiliation(s)
| | | | - Marco Serafin
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | | | - Anne Marie Kuijpers-Jagtman
- Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia,Department of Orthodontics and Dentofacial Orthopedics, University of Berne, Berne, Switzerland,Department of Orthodontics, University of Groningen, Groningen, Netherlands
| | - Alberto Caprioglio
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy,Fondazione IRCCS Cà Granda, Milan, Italy
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Agarwal S, Agarwal S. Bone age assessment from lateral cephalograms using deep learning algorithms in the Indian population. Indian J Dent Res 2022; 33:402-407. [PMID: 37006005 DOI: 10.4103/ijdr.ijdr_955_21] [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: 04/04/2023] Open
Abstract
Purpose The assessment of bone age has applications in a wide variety of fields: from orthodontics to immigration. The traditional non-automated methods are time-consuming and subject to inter- and intra-observer variability. This is the first study of its kind done on the Indian population. In this study, we analyse different pre-processing techniques and architectures to determine the degree of maturation (i.e. cervical vertebral maturation [CVM]) from cephalometric radiographs using machine learning algorithms. Methods Cephalometric radiographs-labelled with the correct CVM stage using Baccetti et al. method-from 383 individuals aged between 10 and 36 years were used in the study. Data expansion and in-place data augmentation were used to handle high data imbalances. Different pre-processing techniques like Sobel filters and canny edge detectors were employed. Several deep learning convolutional neural network (CNN) architectures along with numerous pre-trained models like ResNet-50 and VGG-19 were analysed for their efficacy on the dataset. Results Models with 6 and 8 convolutional layers trained on 64 × 64-size grayscale images trained the fastest and achieved the highest accuracy of 94%. Pre-trained ResNet-50 with the first 49 layers frozen and VGG-19 with 10 layers frozen to training had remarkable performances on the dataset with accuracies of 91% and 89%, respectively. Conclusions Custom deep CNN models with 6-8 layers on 64 × 64-sized greyscale images were successfully used to achieve high accuracies to classify the majority classes. This study is a launchpad in the development of an automated method for bone age assessment from lateral cephalograms for clinical purposes.
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Affiliation(s)
- Sandhita Agarwal
- Department of Computer Science, Liverpool John Moores University, Liverpool, UK
| | - Sonahita Agarwal
- Department of Orthodontics and Dentofacial Orthopaedics, Sardar Patel Post Graduate Institute of Dental and Medical Sciences, Lucknow, Uttar Pradesh, India
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Nguyen A, Caplin J, Avenetti D, Durfee S, Kusnoto B, Sciote JJ, Nicholas CL. A longitudinal assessment of sex differences in the growth of the mandibular retromolar space. Arch Oral Biol 2022; 143:105547. [PMID: 36162340 DOI: 10.1016/j.archoralbio.2022.105547] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 08/25/2022] [Accepted: 09/17/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To assess longitudinal variation in patterns of retromolar space growth, with regard to sex and cervical vertebrae maturation. DESIGN We utilized serial lateral cephalograms from three craniofacial growth studies (Denver, Iowa, Oregon), measuring retromolar space and cervical vertebrae maturation in 99 subjects (56% male) from 8 to 18 years of age for each subject. Repeated measures ANOVA and a linear mixed effects model were used to assess retromolar space growth through time. RESULTS Our analyses revealed an average increase in retromolar space of 8.73 mm from 8 to 18 years. While t-tests failed to find differences in retromolar space growth between males and females at the measured age points, repeated measures ANOVA and linear mixed effects models revealed modest differences in growth trends between sexes, with females having more growth earlier but a younger age of deceleration of growth (between 12 and 14 years of age). CONCLUSIONS Our results confirm large increases in retromolar space through growth, reaching an average of 1.38 mm/year around puberty. Importantly, we add to the conversation regarding sex differences, showing differences in timing of growth. This highlights the importance of using longitudinal data and analytical approaches to address questions of this nature.
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Affiliation(s)
- Annie Nguyen
- Craniofacial Orthodontics, Seattle Children's Hospital, Seattle, WA 98105, USA.
| | - Jennifer Caplin
- Department of Preventive, Pediatric, and Community Dentistry, University of New England, Portland, ME, USA.
| | - David Avenetti
- Department of Pediatric Dentistry, University of Illinois Chicago, Chicago, IL 60612, USA.
| | - Sharon Durfee
- Department of Orthodontics, University of Illinois Chicago, Chicago, IL 60612, USA.
| | - Budi Kusnoto
- Department of Orthodontics, University of Illinois Chicago, Chicago, IL 60612, USA.
| | - James J Sciote
- Department of Orthodontics, Temple University, Philadelphia, PA 19122, USA.
| | - Christina L Nicholas
- Department of Orthodontics, University of Illinois Chicago, Chicago, IL 60612, USA; Department of Anthropology, University of Illinois Chicago, Chicago, IL 60612, USA.
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Lim HJ, Kim Y, Park JH, Lee NK, Kim KB, Kook YA. Cephalometric and model evaluations after molar distalization using modified C-palatal plates in patients with severe arch length discrepancy. Am J Orthod Dentofacial Orthop 2022; 162:870-880. [PMID: 36117031 DOI: 10.1016/j.ajodo.2021.07.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 07/01/2021] [Accepted: 07/01/2021] [Indexed: 11/26/2022]
Abstract
INTRODUCTION This study aimed to evaluate the dentoskeletal and soft-tissue changes after molar distalization using modified C-palatal plates in patients with severe maxillomandibular arch length discrepancies. METHODS Twenty-four patients with Class I and II malocclusion (19.0 ± 7.3 years; 17 females and 8 males), who had severe maxillary crowding of >10 mm, and moderate mandibular crowding of >6 mm, underwent molar distalization using modified C-palatal plates and buccal miniscrews with approximately 300 g of force per side. Models were made, and cephalograms were taken before and after treatment. Cephalometric variables and arch dimensions were measured. Paired t test and Wilcoxon rank sum test were used for statistical analysis. RESULTS In the maxillary dentition, an average of 12.4 mm of crowding was resolved by molar distalization of 4.4 mm, interproximal stripping of 0.7 mm, and arch expansion. In the mandibular dentition, crowding of 6.7 mm was alleviated by molar distalization of 2.4 mm, an interproximal of 1.5 mm, and additional arch expansion. The incisor positions were maintained (SN-U1, 101.3°; IMPA, 88.8°), and soft-tissue profiles were improved (LL/E-line -1.1 mm; P < 0.001) after treatment. CONCLUSIONS Maxillary and mandibular tooth-size arch length discrepancy of 12.4 mm and 6.7 mm, respectively, were resolved by molar distalization, interproximal reduction, and arch expansion, whereas incisor positions were maintained, and soft-tissue profiles were improved. This could be a viable treatment option in patients with moderate-to-severe crowding.
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Affiliation(s)
- Hee Jin Lim
- Department of Orthodontics, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Yoonji Kim
- Department of Orthodontics, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Jae Hyun Park
- Postgraduate Orthodontic Program, Arizona School of Dentistry & Oral Health, A.T. Still University, Mesa, Ariz Graduate School of Dentistry, Kyung Hee University, Seoul, South Korea
| | - Nam-Ki Lee
- Department of Orthodontics, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Ki Beom Kim
- Department of Orthodontics, Saint Louis University, St Louis, Mo
| | - Yoon-Ah Kook
- Department of Orthodontics, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
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Tripathi T, Ganesh G, Singh N, Rai P. Serum biomarkers associated with radiographic skeletal maturity indicators: A systematic review and meta-analysis. J Orthod 2022; 50:127-147. [DOI: 10.1177/14653125221118934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective: To evaluate the relevant scientific literature to determine the association between different serum biomarker levels and radiographic skeletal maturity indicators. Data Search, Screening and Eligibility: A literature search was carried out on PubMed, Cochrane Library, Google Scholar, Semantic Scholar, Science Direct and Opengrey.eu up to November 2021 and 7466 records were retrieved via the electronic search. Study selection, data extraction and subsequent risk of bias assessment (RoB) was carried out independently by two authors. In case of any discrepancy, a third author was consulted. Results: After the exclusion of duplicates and the application of inclusion exclusion criteria, 19 studies (published in 25 articles) were included in the systematic review out of which 17 had a cross-sectional and two had a cohort study design. For the meta-analysis, based on the homogeneity, five cross-sectional studies measuring serum IGF-1 levels were incorporated. The meta-analysis revealed that the serum IGF-1 levels peak at the CS4 stage (401.77 ng/mL [333.50 – 470.05]) in the pooled group. However, in the subgroup analysis, it was found that the serum IGF-1 levels peak at CS3 in women (422.82 ng/mL [377.46–468.18]) and CS4 in men (487.04 ng/mL [391.83–582.25]). Conclusion: Among the various biomarkers evaluated, serum IGF-1 was the most associated with different stages of radiographic skeletal maturity indicators with its levels peaking at CS3 in women and CS4 in men.
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Affiliation(s)
- Tulika Tripathi
- Department of Orthodontics and Dentofacial Orthopaedics, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - Gayatri Ganesh
- Department of Orthodontics and Dentofacial Orthopaedics, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - Navneet Singh
- Department of Orthodontics and Dentofacial Orthopaedics, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - Priyank Rai
- Department of Orthodontics and Dentofacial Orthopaedics, Maulana Azad Institute of Dental Sciences, New Delhi, India
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Li H, Chen Y, Wang Q, Gong X, Lei Y, Tian J, Gao X. Convolutional neural network-based automatic cervical vertebral maturation classification method. Dentomaxillofac Radiol 2022; 51:20220070. [PMID: 35612567 PMCID: PMC10043621 DOI: 10.1259/dmfr.20220070] [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: 02/23/2022] [Revised: 05/05/2022] [Accepted: 05/10/2022] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES This study aimed to develop a fully automated artificial intelligence-aided cervical vertebral maturation (CVM) classification method based on convolutional neural networks (CNNs) to provide an auxiliary diagnosis for orthodontists. METHODS This study consisted of cephalometric images from patients aged between 5 and 18 years. After grouping them into six cervical stages (CSs) by orthodontists, a data set was constructed for analyzing CVM using CNNs. The data set was divided into training, validation, and test sets in the ratio of 70, 15, and 15%. Four CNN models namely, VGG16, GoogLeNet, DenseNet161, and ResNet152 were selected as the candidate models. After training and validation, the models were evaluated to determine which of them is most suitable for CVM analysis. Heat maps were analyzed for a deeper understanding of what the CNNs had learned. RESULTS The final classification accuracy ranking was ResNet152>DenseNet161>GoogLeNet>VGG16, as evaluated on the test set. ResNet152 proved to be the best model among the four models for CVM classification with a weighted κ of 0.826, an average AUC of 0.933 and total accuracy of 67.06%. The F1 score rank for each subgroup was: CS6>CS1>CS4>CS5>CS3>CS2. The area of the third (C3) and fourth (C4) cervical vertebrae were activated when CNNs were assessing the images. CONCLUSION CNN models proved to be a convenient, fast and reliable method for CVM analysis. CNN models have the potential to provide automatic auxiliary diagnostic tools in the future.
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Affiliation(s)
- Haizhen Li
- Department of Orthodontics, Peking University School and Hospital of Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing, P.R. China
| | - Yanlong Chen
- Department of Orthodontics, Peking University School and Hospital of Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing, P.R. China
| | | | - Xu Gong
- Department of Orthodontics, Peking University School and Hospital of Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing, P.R. China
| | - Yi Lei
- School of Software Engineering, Faculty of Information Technology, No.100 Pingleyuan, Chaoyang District, Beijing, P.R. China
| | - Jialiang Tian
- School of Artificial Intelligence, Beijing University of Posts and Telecommunications, No.10 Xitucheng Road, Haidian District, Beijing, P.R. China
| | - Xuemei Gao
- Department of Orthodontics, Peking University School and Hospital of Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing, P.R. China
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Türker G, Öztürk Yaşar M. Evaluation of associations between condylar morphology, ramus height, and mandibular plane angle in various vertical skeletal patterns: a digital radiographic study. BMC Oral Health 2022; 22:330. [PMID: 35941596 PMCID: PMC9361641 DOI: 10.1186/s12903-022-02365-1] [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: 01/26/2022] [Accepted: 07/29/2022] [Indexed: 12/02/2022] Open
Abstract
Background To evaluate condylar morphology, ramus height, and asymmetry indexes in patients with different vertical skeletal patterns and to determine the association between condylar and ramal measurements with the mandibular plane angle. Methods Dental panoramic radiographs of 60 patients with different skeletal patterns were evaluated. According to the cranial base (Sella-Nasion)-mandibular plane (SN-MP) angle, the patients were divided into three groups: normal angle (NA), low angle (LA), and high angle (HA). The condylar area, condylar perimeter, condylar heights, and ramus height were measured, and the asymmetry index value of each measurement was calculated. A one-way analysis of variance as well as a post hoc Tukey and Kruskall-Wallis tests were used to determine intergroup differences. Pearson’s correlation coefficient was used to determine the relationship between all measurements and SN-MP. Results The intergroup comparison of condylar area, condylar perimeter, condylar heights, and ramus height measurements showed that the patients in the LA group have statistically significantly greater values compared to those in the HA group. A statistically significant difference was detected between the NA and LA groups only in the condylar area measurements. There was no statistical difference only in the ramus height measurements between the NA and HA groups. Asymmetry index values of the groups were similar. The negative correlations were found between all measurements and the SN-MP angle. Conclusion HA individuals have lower ramus heights and smaller condylar morphologies than NA and LA individuals. In addition, as the SN-MP angle increases, the condyle dimensions and ramus height decrease, and this is a clinically important finding.
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Affiliation(s)
- Gökhan Türker
- Department of Orthodontics, Faculty of Dentistry, Mersin University, Mersin, Turkey.
| | - Meriç Öztürk Yaşar
- Department of Orthodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
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