Biomechanical analysis for different mandibular total distalization methods with clear aligners: A finite element study

Objective

: The purpose of this finite element method (FEM) study was to analyze the biomechanical differences and tooth displacement patterns according to the traction direction, methods, and sites for total distalization of the mandibular dentition using clear aligner treatment (CAT).

Methods

: A finite element analysis was performed on four FEM models using different traction methods (via a precision cut hook or button) and traction sites (mandibular canine or first premolar). A distalization force of 1.5 N was applied to the traction site by changing the direction from -30 to +30° to the occlusal plane. The initial tooth displacement and von Mises stress on the clear aligners were analyzed.

Results

: All CAT-based total distalization groups showed an overall trend of clockwise or counterclockwise rotation of the occlusal plane as the force direction varied. Mesiodistal tipping of individual teeth was more prominent than that of bodily movements. The initial displacement pattern of the mandibular teeth was more predominant based on the traction site than on the traction method. The elastic deformation of clear aligners is attributed to unintentional lingual tipping or extrusion of the mandibular anterior teeth.

Conclusions

: The initial tooth displacement can vary according to different distalization strategies for CAT-based total distalization. Discreet application and biomechanical understanding of traction sites and directions are necessary for appropriate mandibular total distalization.

Comparison of the skeletodental effects of miniscrew-anchored and tooth-anchored facemask treatment in growing patients with skeletal class III malocclusions

INTRODUCTION

This retrospective study aimed to evaluate the skeletal and dental effects of the miniscrew-anchored facemask in skeletal Class III growing patients and compare them with those of conventional tooth-anchored facemasks.

METHODS

Retrospectively a total of 50 patients with skeletal Class III (mean ANB: -1.12°) were investigated and divided into two groups according to the treatment modality. Twenty-five patients were treated using the conventional tooth-anchored facemask (T group: mean age 9.3 ± 1.1 years, mean ANB: -0.93°) whereas the other 25 were treated using a miniscrew-anchored facemask (M group: mean age 9.7 ± 1.3 years. mean ANB: -1.61°). Two miniscrews were placed on the palate for bone anchorage. In both T and M groups, facemasks applied a force of 20-30° down on the occlusal plane, and the force increased from 200 g to 300-350 g per side throughout the treatments. The patients were instructed to wear facemasks for at least 14 h per day. A total of 16 angular and 11 linear cephalometric measurements were analysed to determine the skeletal and dental changes before and after facemask treatment. A paired t-test was used to verify the effects before and after treatment in each group.

RESULTS

All miniscrews were well maintained during treatment. The values of SNA, SN-ANS, ANB and A to N-Perp, which indicate anterior protraction of the maxilla, were significantly higher in the M group compared with the T group (P < .05). Proclination of the maxillary incisors, extrusion and mesialization of the maxillary molars were significantly greater in the T group (P < .05).

CONCLUSIONS

Miniscrew-anchored facemask treatment increased the amount of maxillary protraction and reduced the dental side effects compared with conventional tooth-anchored facemask treatment in growing patients with skeletal Class III malocclusion.

The Effect of Biomimetic Remineralization of Calcium Phosphate Ion Clusters-Treated Enamel Surfaces on Bracket Shear Bond Strength

Purpose

To evaluate the remineralization effect of calcium phosphate ion clusters (CPICs) on demineralized enamel surfaces and their effects on bracket shear bond strength.

Patients and Methods

Extracted premolars were prepared in resin blocks. The samples in the form of resin blocks were divided into five experimental groups: control group, demineralized group, and groups of CPIC solution treatment for 30, 60, and 90s. The specimens were examined using scanning electron microscopy (SEM), energy-dispersive spectroscopy (EDX), microhardness testing, micro-computed tomography (micro-CT) assessment, shear bond strength (SBS) test, and adhesive remnant index (ARI) score.

Results

The SEM images revealed epitaxial growth of enamel and a decrease in the thickness of the demineralized enamel layer when treated with CPIC solution. The EDX analysis revealed an increase in the Ca/P ratio in the CPIC-treated groups. The microhardness value significantly increased when treated with CPICs; however, it showed a lower value than that of the sound enamel groups. As a result of the micro-CT test, radiolucency decreased gradually as the CPIC treatment time increased. The SBS test and ARI score results showed an improvement in bonding stability after treatment with CPICs.

Conclusion

We demonstrated an enamel biomodification approach using CPIC solution treatment, which is a promising strategy for enamel remineralization. Specifically, remineralization of demineralized enamel improves the orthodontic bracket SBS.

Effects of different distalization directions and methods on maxillary total distalization with clear aligners: a finite element study

OBJECTIVES

To analyze the effects of maxillary tooth distalization by clear aligner (CA) treatment with variations in the angular direction of the distalization force, presence of attachments, and force-application method used.

MATERIALS AND METHODS

A finite element model containing alveolar bone, dentition, and periodontal ligament was constructed. Analytical model groups were as follows: (1) distalization with buttons (without attachments), (2) buttons on canines (with attachments), (3) precision cuts on the canines (without attachments), and (4) precision cuts on the canines (with attachments). A distalization force of 1.5 N was applied to the button or precision cut at -30°, -20°, -10°, 0°, 10°, 20°, and 30° to the occlusal plane.

RESULTS

As the direction of force approached +30°, the dentition inclined posteriorly. The posterior movement pattern was significantly influenced by the presence of an attachment and the direction of force, rather than the area where the force was applied. Distal inclination was dramatically reduced with attachments. A disengagement or deformation of the CA may reduce the distalization efficiency of the dentition or move the dentition in an inappropriate direction.

CONCLUSIONS

Attachments for efficient distalization by the CA are necessary. The use of miniscrews in the direction of force parallel to the occlusal plane is more advantageous than the use of Class II elastics. Due to CA deformation, distalization with the button on the canines can be more effective for distal movement of the maxillary dentition.

Is it worth applying self-irrigation after third molar extraction? A randomised controlled trial

In this study, we aimed to examine the effectiveness of self-irrigation following the extraction of mandibular third molars. A randomised controlled clinical trial was conducted with 155 patients who had undergone extraction of a mandibular third molar. The irrigation group was instructed to self-irrigate the extraction socket with tap water using a syringe three times a day, starting seven days after the tooth extraction. The incidence of complications and mouth opening, halitosis, plaque/gingival index, and oral health-related quality of life (OHRQoL) were measured. The irrigation group showed a lower incidence of complications than the non-irrigation group. The halitosis, plaque, and gingival scores were lower by mean (SD) 19.66 (5.19), 0.58 (0.06), and 0.62 (0.08), respectively, in the irrigation group than in the non-irrigation group (p = 0.0001). A greater amount of food packing was associated with higher halitosis, plaque, and gingival scores and poorer OHRQoL (p < 0.05). Further, more frequent irrigation was associated with lower halitosis, plaque, and gingival scores and better OHRQoL (p ≤ 0.016). Self-irrigation of the extraction socket using a syringe containing tap water is a very effective method for keeping the extraction socket clean. This technique reduced halitosis, improved plaque and gingival indices, and increased OHRQoL.

A remineralizing orthodontic etchant that utilizes calcium phosphate ion clusters

This study aimed to investigate whether a phosphoric acid (H3PO4) solution containing calcium phosphate ion clusters (CPICs) could minimize enamel damage during long-term bracket bonding by dissolving the enamel surface and promoting enamel remineralization. The experimental design is as follows: first, three experimental etchants (H3PO4, CPICs-incorporated H3PO4 solution-I, and CPICs-incorporated H3PO4 solution-II) and two bonding resins (conventional orthodontic resin and self-adhesive orthodontic resin) were used in combination to create six groups, respectively. Each of these six groups was then divided into two sub-groups based on the presence or absence of thermocycling (TC). Twenty samples were assigned to each of the 12 groups (independent variables), and thus a total of 240 metal bracket-attached human premolars were used in this experiment. Bracket debonding was performed on each of 20 premolars in 12 groups, and shear bond strength (SBS) and adhesive remnant index (ARI) values were measured as dependent variables. Next, the three experimental etchants were applied (independent variables) to each of the three enamel samples, and the remineralization of the enamel surface was investigated as a dependent variable. The enamel surface was observed using electron scanning and atomic force microscopy. Furthermore, X-ray diffraction, energy dispersive spectroscopy (EDX) spectrum X-ray spectroscopy, and elemental mapping were performed, and the Knoop microhardness scale was measured. Therefore, the experiment was performed in two steps: SBS and ARI measurements for 12 groups, followed by observation of the enamel surface and microhardness measurements, according to the three types of etchants. As a result of the experiment, first, when the bracket was debonded, SBS did not decrease, and residual adhesive was hardly observed in the C2A group (before TC), C2A, and C1C groups (after TC) (p &lt; 0.001). Second, the experimental etchant containing CPICs achieved remineralization while demineralizing the enamel. This was verified through SEM/EDX, element mapping, XRD, and AFM. Also, the roughness and microhardness of the enamel surface were better in the remineralized surface by the experimental etchant containing CPICs (p &lt; 0.017). The CPICs-incorporated H3PO4 solution reduced ARI while maintaining SBS during bracket debonding, regardless of whether TC was performed or the type of resin. The etchant containing CPICs was also shown to remineralize the enamel and increase its microhardness.

Enhanced antimicrobial and remineralizing properties of self-adhesive orthodontic resin containing mesoporous bioactive glass and zwitterionic material

Abstract Background/purpose

Self-adhesive resins (SARs) do not require additional restorative adhesives and provide adequate adhesion to mineralized dental structures by shortening the bonding time in clinics where moisture control and isolation are difficult. The aim of this study was to evaluate the mechanical and biological properties of SARs containing mesoporous bioactive glass nanoparticles (MBNs) and 2-methacryloyloxyethyl phosphorylcholine (MPC) and to determine their antibacterial and remineralization effects.

Materials and methods

MBNs and MPC were added to SARs to improve their physical properties and remineralization ability. The experimental resins assessed in this study were SARs mixed with 3%MPC, 5%MPC, 1%MBN+3%MPC, or 3%MBN+3%MPC. The shear bond strength, microhardness, adhesive remnant index, ion dissolution, degree of conversion, and antibacterial properties of the SARs were evaluated. To assess the remineralization properties, micro-computed tomography analysis was performed after pH cycling.

Results

Increasing the MBN content in SAR resulted in higher microhardness compared to the control SAR. The shear bond strength decreased in the SAR+5%MPC group and increased in the SAR+1%MBN+3%MPC and SAR+3%MBN+5%MPC groups.

Conclusion

Our findings suggest that SARs containing MBNs and MPC have antibacterial and remineralization effects on the enamel.

Current trends in orthognathic surgery

Orthognathic surgery has steadily evolved, gradually expanding its scope of application beyond its original purpose of simply correcting malocclusion and the facial profile. For instance, it is now used to treat obstructive sleep apnea and to achieve purely cosmetic outcomes. Recent developments in three-dimensional digital technology are being utilized throughout the entire process of orthognathic surgery, from establishing a surgical plan to printing the surgical splint. These processes have made it possible to perform more sophisticated surgery. The goal of this review article is to introduce current trends in the field of orthognathic surgery and controversies that are under active discussion. The role of a plastic surgeon is not limited to performing orthognathic surgery itself, but also encompasses deep involvement throughout the entire process, including the set-up of surgical occlusion and overall surgical planning. The authors summarize various aspects in the field of orthognathic surgery with the hope of providing helpful information both for plastic surgeons and orthodontists who are interested in orthognathic surgery.

Demetylation of the sex-determining region Y gene promoter and incidence of disorder of sex development in cloned dog males

Canine cloning is occasionally accompanied by abnormal sexual development. Some male donor cells produce cloned pups with female external genitalia and complete male gonadal dysgenesis, which is classified as an XY disorder of sex development (XY DSD). In this study, we examine the potential of 5-aza-2'-deoxycytidine (5-aza-dC), a DNA methyltransferase inhibitor, to reduce the phenotypic abnormality XY DSD in somatic cell nuclear transfer (SCNT)- derived pups. We used a 9-year-old normal male German Shepherd dog as a cell donor. Donor cells were treated with 10 nM 5-aza-dC for 4 days before being used for SCNT. At the same stage of cell development, significantly lower levels of DNA methylation of the sex-determining region Y (SRY) promoter was observed in the treated donor cells compared to that in the untreated cells (95.2% versus 53.3% on day 4 for the control and treated groups, respectively). No significant differences were observed in the control or treatment groups concerning fusion rate, pregnancy rate (30 days or entire period), the number of pups, or the incidence of XY DSD. However, more XY DSD dogs were observed in the control group (31.25%) than in the treatment group (14.29%). Hypermethylation of the SRY promoter was observed in the XY DSD cloned pups in both the treatment (84.8%) and control groups (91.1 ± 1.4%) compared to the methylation level in the phenotypically normal male pups of the treatment (23.2 ± 20.9%) and control groups (39.1 ± 20.1%). These results suggest that 5-aza-dC treatment of donor cells can reduce the methylation level of the SRY promoter in donor cells, and thus, 5-aza-dC is advantageous for reducing the incidence of XY DSD in canine cloning.

Qualitative correlation between postoperatively increased vertical dimension and mandibular position in skeletal class III using partial-least-square path modeling

Background

This study constructed a partial-least-square path-modeling (PLS-PM) model and found the pathway by which the postsurgical vertical dimension (VD) affects the extent of the final mandibular setback on the B point at the posttreatment stage for the skeletal class III surgery-first approach (SFA).

Methods

This study re-analyzed the data from the retrospective study by Lee et al. on 40 patients with skeletal class III bimaxillary SFA. Variables were obtained from cone beam computed tomography (CBCT)-generated cephalograms. Authors investigated all variables at each time point to build a PLS-PM model to verify the effect of the VD on the final setback of the mandible.

Results

From PLS-PM, an increase in VD₁₀ was found to decrease the absolute value of the final setback amount of the mandible, which reflects the postsurgical physiological responses to both surgery and orthodontic treatment, which, in turn, can be interpreted as an increase in postoperative mandibular changes.

Conclusions

To resolve the issue of collinear cephalometric data, the present study adopted PLS-PM to assess the orthodontic treatment. From PLS-PM, it was able to summarize the effect of increased postsurgery occlusal vertical dimension on the increased changeability of the B point position at the posttreatment stage.

The estimation of skeletal maturity of patients with cleft lip and palate using statistical shape analysis: a preliminary study

OBJECTIVES

To propose a skeletal maturity assessment method by developing a statistical regression analysis model through the integration of lateral and axial images of the cervical vertebrae of patients with cleft lip and palate obtained through CBCT.

METHODS

49 patients with cleft lip and palate (28 females, 21 males; age range, 4-16 years) underwent CBCT examination, and the hand-wrist radiographic data were selected. With coordinates of landmarks from lateral and axial images of the cervical vertebrae, Procrustes analysis and principal component (PC) analysis yielded PC scores of each cervical vertebra, with the centroid size as the size factor. The meaningful PC scores from these were used for multiple regression models.

RESULTS

When both axial and lateral cervical vertebrae were used together, there was a 6.7% increase in the Sempé maturation level explanatory power for skeletal maturation estimation in females and an 11.4% increase in males compared with that when only the chronological age was used.

CONCLUSIONS

This study improved the estimating regression models using statistical shape analysis with lateral and axial cervical vertebral shapes. The obtained models had improved explanatory power for skeletal maturity estimation than previous studies with healthy people.

Properties of Dye-Sensitized Solar Cells Using Carbon Nanowall Counter Electrodes

This research investigates plasma-treated and metal-coated carbon nanowalls (CNWs) for use as counter electrodes of dye-sensitized solar cells (DSSCs). The CNWs were synthesized on a fluorine-tin-oxide (FTO) glass substrate using the microwave plasma-enhanced chemical vapor deposition (PECVD) system with methane (CH4) gas. The post-plasma treatment was performed on the CNWs with hydrogen (H2) plasma using PECVD, and the CNWs were sputter-coated with metal films using the RF magnetron sputtering system with a four-inch tungsten (W) target. Then the post-plasma-treated and metal-coated CNWs were used as counter electrodes for the fabrication of the DSSCs. Field-emission scanning electron microscopy (FE-SEM) was performed to obtain cross-sectional and planar images of the grown CNWs. The energy conversion efficiencies of the DSSCs manufactured using the post-plasma-treated and metal-layer-coated CNWs as the counter electrodes were measured.

Reaction Gas Ratio Effect on the Growth of a Diamond Film Using Microwave Plasma-Enhanced Chemical Vapor Deposition

In this study, diamond films were prepared using the microwave plasma-enhanced chemical vapor deposition (PECVD) system, which included a DC bias system to enhance the nucleation of the films. The films were synthesized on Si wafers with different ratios of methane (CH4) and hydrogen (H2) gases. We have studied the effects of the CH4-to-H2 ratio on the structural and optical properties of diamond films. The thickness and surface profile of the films were characterized via field emission scanning electron microscopy (FE-SEM). Raman was used to investigate the structural properties of the diamond films. The refractive indexes as functions of the CH4-to-H2 ratio were measured using an ellipsometer. The FE-SEM analysis showed that the 3 and 5 sccm CH4 created diamond films. The Raman analysis indicated that a nanocrystalline diamond film was formed at 3 sccm; a general diamond film, at 5 sccm; and films similar to the a-C:H film, at 7 sccm. The ellipsometer measurement showed that the refractive index of the synthesized diamond film was around 2.42 at 3 sccm. This value decreased as the CH4 volume increased.

Study of B Meson Production in p+Pb Collisions at √[S(NN)]=5.02 TeV Using Exclusive Hadronic Decays

The production cross sections of the B^{+}, B^{0}, and B_{s}^{0} mesons, and of their charge conjugates, are measured via exclusive hadronic decays in p+Pb collisions at the center-of-mass energy sqrt[s_{NN}]=5.02  TeV with the CMS detector at the CERN LHC. The data set used for this analysis corresponds to an integrated luminosity of 34.6  nb^{-1}. The production cross sections are measured in the transverse momentum range between 10 and 60  GeV/c. No significant modification is observed compared to proton-proton perturbative QCD calculations scaled by the number of incoherent nucleon-nucleon collisions. These results provide a baseline for the study of in-medium b quark energy loss in Pb+Pb collisions.

Association between prolonged breastfeeding and bone mineral density and osteoporosis in postmenopausal women: KNHANES 2010-2011

This study showed that a negative correlation between duration of breastfeeding and bone mineral density (BMD) in the lumbar spine and prolonged breastfeeding is an independent risk for osteoporosis in postmenopausal women. The present study suggests that postmenopausal women with a history of prolonged breastfeeding require more careful screening for osteoporosis.

INTRODUCTION

Several studies suggest that breastfeeding and childbirth lead to maternal calcium loss and a decline in BMD. While the association between breastfeeding and BMD immediately after weaning is well-established, the effects of breastfeeding on postmenopausal women have been controversial. The aim of this study was to examine the effects of breastfeeding on bone mineral density (BMD) and the prevalence of osteoporosis in postmenopausal women.

METHODS

The present study was a cross-sectional survey based on the Korea National Health and Nutrition Examination Survey (KNHANES) 2010 and 2011 data. The association between breastfeeding and BMD and osteoporosis was examined in 1222 postmenopausal women.

RESULTS

The duration of breastfeeding and BMD in the lumbar spine showed a negative correlation. The association between duration of breastfeeding and BMD remained significant after adjustment for reproductive factors and other confounding factors (P = 0.008). However, the number of deliveries and age at the time of delivery did not correlate with BMD at any site after adjustment. Moreover, the prevalence of osteoporosis in postmenopausal women with a history of prolonged breastfeeding was significantly higher than that in women with a short history of breastfeeding (≥37 months, OR = 3.292; 95 % CI 1.485-7.299). The prevalence of lumbar spine fracture showed a significant increasing trend with the increase in the duration of breastfeeding.

CONCLUSION

Prolonged breastfeeding was significantly associated with low BMD in the lumbar spine and higher prevalence of osteoporosis. However, the number of deliveries or age at the time of childbirth did not influence BMD.

Evidence for Collective Multiparticle Correlations in p-Pb Collisions

The second-order azimuthal anisotropy Fourier harmonics, v2, are obtained in p-Pb and PbPb collisions over a wide pseudorapidity (η) range based on correlations among six or more charged particles. The p-Pb data, corresponding to an integrated luminosity of 35  nb-1, were collected during the 2013 LHC p-Pb run at a nucleon-nucleon center-of-mass energy of 5.02  TeV by the CMS experiment. A sample of semiperipheral PbPb collision data at √sNN=2.76  TeV, corresponding to an integrated luminosity of 2.5  μb-1 and covering a similar range of particle multiplicities as the p-Pb data, is also analyzed for comparison. The six- and eight-particle cumulant and the Lee-Yang zeros methods are used to extract the v2 coefficients, extending previous studies of two- and four-particle correlations. For both the p-Pb and PbPb systems, the v2 values obtained with correlations among more than four particles are consistent with previously published four-particle results. These data support the interpretation of a collective origin for the previously observed long-range (large Δη) correlations in both systems. The ratios of v2 values corresponding to correlations including different numbers of particles are compared to theoretical predictions that assume a hydrodynamic behavior of a p-Pb system dominated by fluctuations in the positions of participant nucleons. These results provide new insights into the multiparticle dynamics of collision systems with a very small overlapping region.

Measurement of J/ψ and ψ(2S) Prompt Double-Differential Cross Sections in pp Collisions at sqrt[s]=7 TeV

The double-differential cross sections of promptly produced J/ψ and ψ(2S) mesons are measured in pp collisions at sqrt[s]=7 TeV, as a function of transverse momentum p_{T} and absolute rapidity |y|. The analysis uses J/ψ and ψ(2S) dimuon samples collected by the CMS experiment, corresponding to integrated luminosities of 4.55 and 4.90 fb^{-1}, respectively. The results are based on a two-dimensional analysis of the dimuon invariant mass and decay length, and extend to p_{T}=120 and 100 GeV for the J/ψ and ψ(2S), respectively, when integrated over the interval |y|<1.2. The ratio of the ψ(2S) to J/ψ cross sections is also reported for |y|<1.2, over the range 10<p_{T}<100 GeV. These are the highest p_{T} values for which the cross sections and ratio have been measured.

Responses of osteoblastic cell line MC3T3-E1 cell to the calcium channel blocker diltiazem and verapamil

The effects of the calcium channel blockers, diltiazem and verapamil, on osteoblastic functions were investigated in cultured osteoblastic cells MC3T3-E1. DNA synthesis was evaluated by the incorporation of [3H]thymidine, and collagen synthesis by measuring the incorporation of [3H]proline into collagenase-digestible protein (CDP) and noncollagen protein (NCP). Diltiazem inhibited the DNA synthesis of osteoblastic cells by up to 57.6 and 54.6% at concentrations of 25 and 50 microM. Verapamil also significantly inhibited DNA synthesis by up to 61.6 and 40.9% at concentrations of 25 and 50 microM. The percent control of CDP formation were decreased by up to 76.7% in 5 microM and 44.3% in 50 microM of diltiazem. Verapamil also decreased CDP synthesis to 49.7% at 10 microM and 32.6% at 50 microM. NCP synthesis was decreased by the calcium channel blocker but inhibition of the CDP formation was greater than that of NCP. The calculated percent collagen synthesis was decreased at a calcium channel blocker concentration of 10 microM. The inhibitory effects of diltiazem and verapamil on percent collagen synthesis were not reversed by increasing the calcium concentration of culture media by either 1 or 5 mM. From this study, we conclude that calcium channel blockers have a direct inhibitory effect on osteoblastic function. Long-term administration of diltiazem or verapamil produces adverse effects on normal bone metabolism.

Correlation between skeletal and dental changes after mandibular setback surgery-first orthodontic treatment: Cone-beam computed tomography-generated half-cephalograms

Objective

To investigate skeletal and dental changes after application of a mandibular setback surgery-first orthodontic treatment approach in cases of skeletal Class III malocclusion.

Methods

A retrospective study of 34 patients (23 men, 11 women; mean age, 26.2 ± 6.6 years) with skeletal Class III deformities, who underwent surgery-first orthodontic treatment, was conducted. Skeletal landmarks in the maxilla and mandible at three time points, pre-treatment (T0), immediate-postoperative (T1), and post-treatment (T2), were analyzed using cone-beam computed tomography (CBCT)-generated half-cephalograms.

Results

The significant T0 to T1 mandibular changes occurred -9.24 ± 3.97 mm horizontally. From T1 to T2, the mandible tended to move forward 1.22 ± 2.02 mm, while the condylar position (Cd to Po-perpendicular plane) shifted backward, and the coronoid process (Cp to FH plane) moved vertically. Between T1 and T2, the vertical dimension changed significantly (p < 0.05). Changes in the vertical dimension were significantly correlated to T1 to T2 changes in the Cd to Po-perpendicular plane (r = -0.671, p = 0.034), and in the Cp to FH plane (r = 0.733, p = 0.016), as well as to T0 to T1 changes in the Cp to Po-perpendicular plane (r = 0.758, p = 0.011).

Conclusions

Greater alterations in the vertical dimension caused larger post-treatment (T2) stage skeletal changes. Studying the mandibular position in relation to the post-surgical vertical dimension emphasized the integral importance of vertical dimension control and proximal segment management to the success of surgery-first orthodontic treatment.

Search for monotop signatures in proton-proton collisions at √s=8 TeV

Results are presented from a search for new decaying massive particles whose presence is inferred from an imbalance in transverse momentum and which are produced in association with a single top quark that decays into a bottom quark and two light quarks. The measurement is performed using 19.7  fb^{-1} of data from proton-proton collisions at a center-of-mass energy of 8 TeV, collected with the CMS detector at the CERN LHC. No deviations from the standard model predictions are observed and lower limits are set on the masses of new invisible bosons. In particular, scalar and vector particles, with masses below 330 and 650 GeV, respectively, are excluded at 95% confidence level, thereby substantially extending a previous limit published by the CDF Collaboration.

Search for displaced supersymmetry in events with an electron and a muon with large impact parameters

A search for new long-lived particles decaying to leptons is presented using proton-proton collisions produced by the LHC at √[s]=8  TeV. Data used for the analysis were collected by the CMS detector and correspond to an integrated luminosity of 19.7  fb(-1). Events are selected with an electron and muon with opposite charges that both have transverse impact parameter values between 0.02 and 2 cm. The search has been designed to be sensitive to a wide range of models with nonprompt e-μ final states. Limits are set on the "displaced supersymmetry" model, with pair production of top squarks decaying into an e-μ final state via R-parity-violating interactions. The results are the most restrictive to date on this model, with the most stringent limit being obtained for a top squark lifetime corresponding to cτ=2  cm, excluding masses below 790 GeV at 95% confidence level.

Study of vector boson scattering and search for new physics in events with two same-sign leptons and two jets

A study of vector boson scattering in pp collisions at a center-of-mass energy of 8 TeV is presented. The data sample corresponds to an integrated luminosity of 19.4  fb(-1) collected with the CMS detector. Candidate events are selected with exactly two leptons of the same charge, two jets with large rapidity separation and high dijet mass, and moderate missing transverse energy. The signal region is expected to be dominated by electroweak same-sign W-boson pair production. The observation agrees with the standard model prediction. The observed significance is 2.0 standard deviations, where a significance of 3.1 standard deviations is expected based on the standard model. Cross section measurements for W(±)W(±) and WZ processes in the fiducial region are reported. Bounds on the structure of quartic vector-boson interactions are given in the framework of dimension-eight effective field theory operators, as well as limits on the production of doubly charged Higgs bosons.

Implementation of secondary stroke prevention protocol for ischaemic stroke patients in primary care

OBJECTIVE

To investigate the effectiveness of a secondary stroke prevention protocol in the general out-patient clinic.

DESIGN

Cohort study with pre- and post-intervention comparisons.

SETTING

Two general out-patient clinics in Hong Kong.

PATIENTS

Ischaemic stroke patients who had long-term follow-up in two clinics were recruited. The patients of one clinic received the intervention (intervention group) and the patients of the second clinic did not receive the intervention (control group). The recruitment period lasted for 6 months from 1 September 2008 to 28 February 2009. The pre-intervention phase data collection started within this 6-month period. The protocol implementation started at the intervention clinic on 1 April 2009. The post-intervention phase data collection started 9 months after the protocol implementation, and ran for 6 months from 1 January 2010 to 30 June 2010.

MAIN OUTCOME MEASURES

Clinical data before and after the intervention, including blood pressure, glycated haemoglobin level, low-density lipoprotein level and prescription pattern, were compared between the two groups to see whether there was enhancement of secondary stroke management.

RESULTS

A total of 328 patients were recruited into the intervention group and 249 into the control group; data of 256 and 210 patients from these groups were analysed, respectively. After intervention, there were significant reductions in mean (± standard deviation) systolic blood pressure (135.2 ± 17.5 mm Hg to 127.7 ± 12.2 mm Hg), glycated haemoglobin level (7.2 ± 1.0% to 6.5 ± 0.8%), and low-density lipoprotein level (3.4 ± 0.8 mmol/L to 2.8 ± 1.3 mmol/L) in the intervention group (all P<0.01). There were no significant reductions in mean systolic blood pressure, glycated haemoglobin level, or low-density lipoprotein level in the control group. There was a significant increase in statin use (P<0.01) in both clinics.

CONCLUSION

Through implementation of a clinic protocol, the standard of care of secondary stroke prevention for ischaemic stroke patients could be improved in a general out-patient clinic.

Measurement of prompt ψ(2S) to J/ψ yield ratios in Pb-Pb and p-p collisions at sqrt[sNN]=2.76 TeV

The ratio between the prompt ψ(2S) and J/ψ yields, reconstructed via their decays into μ+ μ-, is measured in Pb-Pb and p-p collisions at sqrt[sNN]=2.76  TeV. The analysis is based on Pb-Pb and p-p data samples collected by CMS at the Large Hadron Collider, corresponding to integrated luminosities of 150  μb(-1) and 5.4  pb(-1), respectively. The double ratio of measured yields (Nψ(2S)/N(J/ψ))(Pb-Pb)/(Nψ(2S)/N(J/ψ))(p-p) is computed in three Pb-Pb collision centrality bins and two kinematic ranges: one at midrapidity, |y|<1.6, covering the transverse momentum range 6.5<pT<30  GeV/c, and the other at forward rapidity, 1.6<|y|<2.4, extending to lower pT values, 3<pT<30  GeV/c. The centrality-integrated double ratio changes from 0.45±0.13(stat)±0.07(syst) in the first range to 1.67±0.34(stat)±0.27(syst) in the second. This difference is most pronounced in the most central collisions.

Evidence of b-jet quenching in PbPb collisions at √(s(NN))=2.76 TeV

The production of jets associated to bottom quarks is measured for the first time in PbPb collisions at a center-of-mass energy of 2.76 TeV per nucleon pair. Jet spectra are reported in the transverse momentum (p(T)) range of 80-250  GeV/c, and within pseudorapidity |η|<2. The nuclear modification factor (R(AA)) calculated from these spectra shows a strong suppression in the b-jet yield in PbPb collisions relative to the yield observed in pp collisions at the same energy. The suppression persists to the largest values of p(T) studied, and is centrality dependent. The R(AA) is about 0.4 in the most central events, similar to previous observations for inclusive jets. This implies that jet quenching does not have a strong dependence on parton mass and flavor in the jet p(T) range studied.

Observation of the associated production of a single top quark and a W boson in pp collisions at sqrt[s] = 8 TeV

The first observation of the associated production of a single top quark and a W boson is presented. The analysis is based on a data set corresponding to an integrated luminosity of 12.2 fb(-1) of proton-proton collisions at sqrt[s] = 8 TeV recorded by the CMS experiment at the LHC. Events with two leptons and a jet originating from a b quark are selected. A multivariate analysis based on kinematic and topological properties is used to separate the signal from the dominant tt background. An excess consistent with the signal hypothesis is observed, with a significance which corresponds to 6.1 standard deviations above a background-only hypothesis. The measured production cross section is 23.4 ± 5.4 pb, in agreement with the standard model prediction.

Measurement of inclusive W and Z boson production cross sections in pp collisions at sqrt[s] = 8 TeV

A measurement of total and fiducial inclusive W and Z boson production cross sections in pp collisions at sqrt[s] = 8 TeV is presented. Electron and muon final states are analyzed in a data sample collected with the CMS detector corresponding to an integrated luminosity of 18.2 ± 0.5 pb(-1). The measured total inclusive cross sections times branching fractions are σ(pp → WX)×B(W → ℓν) = 12.21 ± 0.03(stat) ± 0.24(syst) ± 0.32(lum) nb and σ(pp → ZX) × B(Z → ℓ+ℓ-) = 1.15 ± 0.01(stat) ± 0.02(syst) ± 0.03(lum) nb for the dilepton mass in the range of 60-120 GeV. The measured values agree with next-to-next-to-leading-order QCD cross section calculations. Ratios of cross sections are reported with a precision of 2%. This is the first measurement of inclusive W and Z boson production in proton-proton collisions at sqrt[s] = 8 TeV.

Measurements of tt spin correlations and top-quark polarization using dilepton final states in pp collisions at sqrt[s]=7 TeV

Spin correlations and polarization in the top quark-antiquark system are measured using dilepton final states produced in pp collisions at the LHC at sqrt[s]=7  TeV. The data correspond to an integrated luminosity of 5.0  fb(-1) collected with the CMS detector. The measurements are performed using events with two oppositely charged leptons (electrons or muons), a significant imbalance in transverse momentum, and two or more jets, where at least one of the jets is identified as originating from a b quark. The spin correlations and polarization are measured through asymmetries in angular distributions of the two selected leptons, unfolded to the parton level. All measurements are found to be in agreement with predictions of the standard model.

Search for top-quark partners with charge 5/3 in the same-sign dilepton final state

A search for the production of heavy partners of the top quark with charge 5/3 is performed in events with a pair of same-sign leptons. The data sample corresponds to an integrated luminosity of 19.5 fb(-1) and was collected at sqrt[s] = 8 TeV by the CMS experiment. No significant excess is observed in the data above the expected background, and the existence of top-quark partners with masses below 800 GeV is excluded at a 95% confidence level, assuming they decay exclusively to tW. This is the first limit on these particles from the LHC, and it is significantly more restrictive than previous limits.

Search for flavor-changing neutral currents in top-quark decays t → Zq in pp collisions at sqrt[s] = 8 TeV

A search for flavor-changing neutral currents in top-quark decays t → Zq is performed in events produced from the decay chain tt → Zq+Wb, where both vector bosons decay leptonically, producing a final state with three leptons (electrons or muons). A data set collected with the CMS detector at the LHC is used, corresponding to an integrated luminosity of 19.7 fb(-1) of proton-proton collisions at a center-of-mass energy of 8 TeV. No excess is seen in the observed number of events relative to the standard model prediction; thus, no evidence for flavor-changing neutral currents in top-quark decays is found. A combination with a previous search at 7 TeV excludes a t → Zq branching fraction greater than 0.05% at the 95% confidence level.

Search for top squark and Higgsino production using diphoton Higgs boson decays

Results are presented of a search for a "natural" supersymmetry scenario with gauge mediated symmetry breaking. It is assumed that only the supersymmetric partners of the top quark (the top squark) and the Higgs boson (Higgsino) are accessible. Events are examined in which there are two photons forming a Higgs boson candidate, and at least two b-quark jets. In 19.7  fb-1 of proton-proton collision data at s=8  TeV, recorded in the CMS experiment, no evidence of a signal is found and lower limits at the 95% confidence level are set, excluding the top squark mass below 360 to 410 GeV, depending on the Higgsino mass.

Relationship between prosthodontic status and nutritional intake in the elderly in Korea: National Health and Nutrition Examination Survey (NHANES IV)

OBJECTIVES

Many health issues have been reported to be associated with poor nutritional status. We sought to examine the association between nutritional intake and oral health status in elderly people.

METHODS

The association between perceived disability in mastication and prosthodontic status was analysed using multiple logistic regression. Multiple linear regression was used to analyse the association between prosthodontic status and nutritional intake.

RESULTS

The elderly subjects with partial or full dentures reported chewing difficulties 1.62-fold more frequently (95% CI: 1.06-2.49) than those with natural teeth or a fixed prosthesis after adjusting for gender, TMD (temporomandibular disorder), household income and education level. Additionally, daily nutritional intakes of energy, protein, fat, ash, calcium, phosphorus and thiamine were decreased significantly in elderly with partial or full dentures compared with those with no prosthesis or with a fixed prosthesis (P < 0.05).

CONCLUSIONS

Our findings underline oral health status and perceived disability in mastication are associated with dietary imbalances in the elderly. We suggest that the evaluation of patients' nutritional status should be considered as a part of an overall plan for dental hygiene care.

Search for top squarks in R-parity-violating supersymmetry using three or more leptons and b-tagged jets

A search for anomalous production of events with three or more isolated leptons and bottom-quark jets produced in pp collisions at √s=8 TeV is presented. The analysis is based on a data sample corresponding to an integrated luminosity of 19.5 fb(-1) collected by the CMS experiment at the LHC in 2012. No excess above the standard model expectations is observed. The results are interpreted in the context of supersymmetric models with signatures that have low missing transverse energy arising from light top-squark pair production with R-parity-violating decays of the lightest supersymmetric particle. In two models with different R-parity-violating couplings, top squarks are excluded below masses of 1020 GeV and 820 GeV when the lightest supersymmetric particle has a mass of 200 GeV.

Searches for new physics using the tt¯ invariant mass distribution in pp collisions at √s=8 TeV

Searches for anomalous top quark-antiquark production are presented, based on pp collisions at √s=8 TeV. The data, corresponding to an integrated luminosity of 19.7 fb(-1), were collected with the CMS detector at the LHC. The observed tt¯ invariant mass spectrum is found to be compatible with the standard model prediction. Limits on the production cross section times branching fraction probe, for the first time, a region of parameter space for certain models of new physics not yet constrained by precision measurements.

Measurement of the Bs(0)→μ+ μ- branching fraction and search for B(0)→μ+ μ- with the CMS experiment

Results are presented from a search for the rare decays Bs(0)→μ+ μ- and B(0)→μ+ μ- in pp collisions at sqrt[s]=7 and 8 TeV, with data samples corresponding to integrated luminosities of 5 and 20  fb(-1), respectively, collected by the CMS experiment at the LHC. An unbinned maximum-likelihood fit to the dimuon invariant mass distribution gives a branching fraction B(Bs(0)→μ+ μ-)=(3.0(-0.9)(+1.0))×10(-9), where the uncertainty includes both statistical and systematic contributions. An excess of Bs(0)→μ+ μ- events with respect to background is observed with a significance of 4.3 standard deviations. For the decay B(0)→μ+ μ- an upper limit of B(B(0)→μ+ μ-)<1.1×10(-9) at the 95% confidence level is determined. Both results are in agreement with the expectations from the standard model.

Inclusive search for supersymmetry using razor variables in pp collisions at √s=7 TeV

An inclusive search is presented for new heavy particle pairs produced in √s=7 TeV proton-proton collisions at the LHC using 4.7±0.1 fb(-1) of integrated luminosity. The selected events are analyzed in the 2D razor space of M(R), an event-by-event indicator of the heavy particle mass scale, and R, a dimensionless variable related to the missing transverse energy. The third-generation sector is probed using the event heavy-flavor content. The search is sensitive to generic supersymmetry models with minimal assumptions about the superpartner decay chains. No excess is observed in the number of events beyond that predicted by the standard model. Exclusion limits are derived in the CMSSM framework as well as for simplified models. Within the CMSSM parameter space considered, gluino masses up to 800 GeV and squark masses up to 1.35 TeV are excluded at 95% confidence level depending on the model parameters. The direct production of pairs of top or bottom squarks is excluded for masses as high as 400 GeV.

Three-dimensional evaluation of midfacial asymmetry in patients with nonsyndromic unilateral cleft lip and palate by cone-beam computed tomography

Objective

To compare three-dimensionally the midfacial hard- and soft-tissue asymmetries between the affected and the unaffected sides and determine the relationship between the hard tissue and the overlying soft tissue in patients with nonsyndromic complete unilateral cleft lip and palate (UCLP) by cone-beam computed tomography (CBCT) analysis.

Methods

The maxillofacial regions of 26 adults (18 men, 8 women) with nonsyndromic UCLP were scanned by CBCT and reconstructed by three-dimensional dental imaging. The frontal-view midfacial analysis was based on a 3 × 3 grid of vertical and horizontal lines and their intersecting points. Two additional points were used for assessing the dentoalveolar area. Linear and surface measurements from three reference planes (Basion-perpendicular, midsagittal reference, and Frankfurt horizontal planes) to the intersecting points were used to evaluate the anteroposterior, transverse, and vertical asymmetries as well as convexity or concavity.

Results

Anteroposteriorly, the soft tissue in the nasolabial and dentoalveolar regions was significantly thicker and positioned more anteriorly on the affected side than on the unaffected side (p < 0.05). The hard tissue in the dentoalveolar region was significantly retruded on the affected side compared with the unaffected side (p < 0.05). The other midfacial regions showed no significant differences.

Conclusions

With the exception of the nasolabial and dentoalveolar regions, no distinctive midfacial hard- and soft-tissue asymmetries exist between the affected and the unaffected sides in patients with nonsyndromic UCLP.

Measurement of associated production of vector bosons and top quark-antiquark pairs in pp collisions at sqrt[s]=7 TeV

The first measurement of vector-boson production associated with a top quark-antiquark pair in proton-proton collisions at sqrt[s] = 7  TeV is presented. The results are based on a data set corresponding to an integrated luminosity of 5.0  fb(-1), recorded by the CMS detector at the LHC in 2011. The measurement is performed in two independent channels through a trilepton analysis of ttZ events and a same-sign dilepton analysis of ttV (V = W or Z) events. In the trilepton channel a direct measurement of the ttZ cross section σ(ttZ) = 0.28(-0.11)(+0.14) (stat)(-0.03)(+0.06) (syst)  pb is obtained. In the dilepton channel a measurement of the ttV cross section yields σ(ttV) = 0.43(-0.15)(+0.17) (stat)(-0.07)(+0.09) (syst)  pb. These measurements have a significance, respectively, of 3.3 and 3.0 standard deviations from the background hypotheses and are compatible, within uncertainties, with the corresponding next-to-leading order predictions of 0.137(-0.016)(+0.012) and 0.306(-0.053)(+0.031)  pb.

Search for pair-produced dijet resonances in four-jet final states in pp collisions at sqrt[s] = 7 TeV

A search for the pair production of a heavy, narrow resonance decaying into two jets has been performed using events collected in sqrt[s] = 7 TeV pp collisions with the CMS detector at the LHC. The data sample corresponds to an integrated luminosity of 5.0 fb(-1). Events are selected with at least four jets and two dijet combinations with similar dijet mass. No resonances are found in the dijet mass spectrum. The upper limit at 95% confidence level on the product of the resonance pair production cross section, the branching fractions into dijets, and the acceptance varies from 0.22 to 0.005 pb, for resonance masses between 250 and 1200 GeV. Pair-produced colorons decaying into qq are excluded for coloron masses between 250 and 740 GeV.

Search for pair production of third-generation leptoquarks and top squarks in pp collisions at sqrt[s] = 7 TeV

Results are presented from a search for the pair production of third-generation scalar and vector leptoquarks, as well as for top squarks in R-parity-violating supersymmetric models. In either scenario, the new, heavy particle decays into a τ lepton and a b quark. The search is based on a data sample of pp collisions at sqrt[s] = 7 TeV, which is collected by the CMS detector at the LHC and corresponds to an integrated luminosity of 4.8 fb(-1). The number of observed events is found to be in agreement with the standard model prediction, and exclusion limits on mass parameters are obtained at the 95% confidence level. Vector leptoquarks with masses below 760 GeV are excluded and, if the branching fraction of the scalar leptoquark decay to a τ lepton and a b quark is assumed to be unity, third-generation scalar leptoquarks with masses below 525 GeV are ruled out. Top squarks with masses below 453 GeV are excluded for a typical benchmark scenario, and limits on the coupling between the top squark, τ lepton, and b quark, λ(333)(') are obtained. These results are the most stringent for these scenarios to date.

Measurement of the Υ1S, Υ2S, and Υ3S polarizations in pp collisions at sqrt[s] = 7 TeV

The polarizations of the Υ(1S), Υ(2S), and Υ(3S) mesons are measured in proton-proton collisions at sqrt[s] = 7 TeV, using a data sample of Υ(nS) → μ +μ- decays collected by the CMS experiment, corresponding to an integrated luminosity of 4.9 fb(-1). The dimuon decay angular distributions are analyzed in three different polarization frames. The polarization parameters λ[symbol see text], λ(φ), and λ([symbol see text]φ), as well as the frame-invariant quantity λ, are presented as a function of the Υ(nS) transverse momentum between 10 and 50 GeV, in the rapidity ranges |y|<0.6 and 0.6<|y|<1.2. No evidence of large transverse or longitudinal polarizations is seen in the explored kinematic region.

Study of the mass and spin-parity of the Higgs boson candidate via its decays to Z boson pairs

A study is presented of the mass and spin-parity of the new boson recently observed at the LHC at a mass near 125 GeV. An integrated luminosity of 17.3 fb(-1), collected by the CMS experiment in proton-proton collisions at center-of-mass energies of 7 and 8 TeV, is used. The measured mass in the ZZ channel, where both Z bosons decay to e or μ pairs, is 126.2 ± 0.6(stat) ± 0.2(syst) GeV. The angular distributions of the lepton pairs in this channel are sensitive to the spin-parity of the boson. Under the assumption of spin 0, the present data are consistent with the pure scalar hypothesis, while disfavoring the pure pseudoscalar hypothesis.

Measurement of the azimuthal anisotropy of neutral pions in Pb-Pb collisions at sqrt[s](NN)] = 2.76 TeV

First measurements of the azimuthal anisotropy of neutral pions produced in Pb-Pb collisions at a center-of-mass energy of sqrt[s(NN)] = 2.76 TeV are presented. The amplitudes of the second Fourier component (v(2)) of the π(0) azimuthal distributions are extracted using an event-plane technique. The values of v(2) are studied as a function of the neutral pion transverse momentum (p(T)) for different classes of collision centrality in the kinematic range 1.6<p(T) <8.0 GeV/c, within the pseudorapidity interval |η|<0.8. The CMS measurements of v(2) (p(T)) are similar to previously reported π(0) azimuthal anisotropy results from sqrt[s(NN)] = 200 GeV Au-Au collisions at RHIC, despite a factor of ∼ 14 increase in the center-of-mass energy. In the momentum range 2.5<p(T)<5.0 GeV/c, the neutral pion anisotropies are found to be smaller than those observed by CMS for inclusive charged particles.

Evidence for associated production of a single top quark and W boson in pp collisions at sqrt[s]=7 TeV

Evidence is presented for the associated production of a single top quark and W boson in pp collisions at sqrt[s]=7  TeV with the CMS experiment at the LHC. The analyzed data correspond to an integrated luminosity of 4.9  fb(-1). The measurement is performed using events with two leptons and a jet originated from a b quark. A multivariate analysis based on kinematic properties is utilized to separate the tt background from the signal. The observed signal has a significance of 4.0σ and corresponds to a cross section of 16(-4)(+5)  pb, in agreement with the standard model expectation of 15.6±0.4(-1.2)(+1.0)  pb.

Search for heavy neutrinos and W(R) bosons with right-handed couplings in a left-right symmetric model in pp collisions at sqrt[s]=7 TeV

Results are presented from a search for heavy, right-handed muon neutrinos, N(μ), and right-handed W(R) bosons, which arise in the left-right symmetric extensions of the standard model. The analysis is based on a 5.0  fb(-1) sample of proton-proton collisions at a center-of-mass energy of 7 TeV, collected by the CMS detector at the Large Hadron Collider. No evidence is observed for an excess of events over the standard model expectation. For models with exact left-right symmetry, heavy right-handed neutrinos are excluded at 95% confidence level for a range of neutrino masses below the W(R) mass, dependent on the value of M(W(R)). The excluded region in the two-dimensional (M(W(R)), M(N(μ)) mass plane extends to M(W(R))=2.5  TeV.

Study of the Dijet mass spectrum in pp → W+jets events at sqrt[s] = 7 TeV

We report an investigation of the invariant mass spectrum of the two jets with highest transverse momentum in pp → W+2-jet and W+3-jet events to look for resonant enhancement. The data sample corresponds to an integrated luminosity of 5.0 fb(-1) collected with the CMS detector at sqrt[s] = 7 TeV. We find no evidence for the anomalous structure reported by the CDF Collaboration, and establish an upper limit of 5.0 pb at 95% confidence level on the production cross section for a generic Gaussian signal with mass near 150 GeV. Additionally, we exclude two theoretical models that predict a CDF-like dijet resonance near 150 GeV.