This study evaluated the effect of maxillary advancement of less than 6 mm versus 6 mm or more on soft tissue changes in 53 patients treated for Class III malocclusion. For advancements under 6 mm, there were no significant changes in the nasolabial angle but significant changes in lip and chin positions. For advancements of 6 mm or more, submental and nasolabial soft tissues significantly improved, indicating better aesthetics. The degree of maxillary advancement significantly impacts soft tissue changes and should be considered in treatment planning.
Fixed and removable orthodontic appliance application for class III malocclus...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
This study evaluated the effect of different amounts of mandibular setback surgery on the submental region and aesthetics. The study examined 38 patients who underwent mandibular setback surgery, distinguishing those with less than 5mm of setback from those with 5mm or more. The results found no significant changes in the submental region or aesthetics for patients with less than 5mm of setback. However, for patients with 5mm or more of setback, there were significant decreases in cervical length and changes to the lip-chin-throat angle, lower lip length, and upper lip length. The study suggests these factors should be considered in surgical planning to avoid undesirable aesthetic impacts of mandibular setback surgery.
Gingival recession—can orthodontics be a cure? evidence from a case presentationEdwardHAngle
A 35-year-old woman presented with severe gingival recession and a unilateral Class II malocclusion. Her treatment plan involved orthodontic correction of the malocclusion using brackets that torqued roots more onto the bone. It also involved changing her dental hygiene methods to use an oscillating toothbrush gently. After 28 months of orthodontic treatment, her malocclusion was corrected and her gingival recession improved without needing grafting. Three months later, her teeth had settled well into their new positions.
Long term clinical and bacterial effetcx of xylitol on paitnets with fixed or...EdwardHAngle
Background: The objective of this study was to evaluate long-term clinical and bacterial effects of using 6 g of
xylitol per day for 3 months on patients with full fixed orthodontic appliances.
Methods: The study was a pilot clinical trial that included 41 subjects who were undergoing orthodontic
treatment. The subjects were randomly divided into three groups. Group A received xylitol chewing gum, group B
received xylitol dissolvable chewable tablets, and Group C served as the control group and did not receive xylitol
gums or tablets. Clinical examination and the collection of plaque and saliva samples were carried out at baseline
and 3, 6, and 12 months. All three groups were given oral hygiene instruction and were put on a 6-month cleaning
and topical fluoride schedule. Plaque scores and bacterial counts were used to evaluate the effectiveness of the
different approaches at reducing the caries risk.
Results: Xylitol groups did not experience any more reduction in plaque score, plaque MS counts, or salivary MS
counts than the control group nor did they have lower values at any of the time points. Chewing gum did not
significantly increase the incidence of debonded brackets over the other groups.
Conclusions: Xylitol does not have a clinical or bacterial benefit in patients with fixed orthodontic appliances. Oral
hygiene instructions and 6-month topical fluoride application were effective at reducing plaque scores and bacterial
counts in patients with full fixed appliances regardless of whether or not xylitol was used.
Modification of Distal Shoe- A Systematic Review & Meta AnalysisDrHeena tiwari
The document summarizes a systematic review of modifications to the distal shoe space maintainer. It analyzes 6 studies on modified distal shoe designs. The studies showed that the modifications provided stability, adjustability, and were well-accepted by patients. However, the quality of the studies was low and conclusions about the efficacy of the modifications were inconclusive due to a lack of clear reporting on outcomes. Further high-quality research is needed to establish the effectiveness of modified distal shoe space maintainers.
Subjective classification and objective analysis of the mandibular dental arc...EdwardHAngle
Our objective was to evaluate the relationship between subjective classification of dental-arch shape, objective analyses via arch-width measurements, and the fitting with the fourth-order polynomial equation.
ABSTRACT
Objective: To evaluate the role of age as a moderator of bone regeneration patterns and
symphysis remodeling after genioplasty.
Method: Fifty-four patients who underwent genioplasty at the end of their orthodontic treatment
were divided into three age groups: younger than 15 years at the time of surgery (group 1), 15 to
19 years (group 2), and 20 years or older (group 3). Twenty-three patients who did not accept
genioplasty and had a follow-up radiograph 2 years after the end of their orthodontic treatment
were used as a control group. Patients were evaluated at three time points: immediate preoperative
(T1), immediate postoperative (T2,) and 2 years postsurgery (T3).
Results: The mean genial advancement at surgery was similar for the three age groups, but the
extent of remodeling around the repositioned chin was greater in group 1, less in group 2, and still
less in group 3. Symphysis thickness increased significantly during the 2-year postsurgery interval
for the three groups, and this increase was significantly greater in group 1 than in group 3.
Remodeling above and behind the repositioned chin also was greater in the younger patients. This
was related to greater vertical growth of the dentoalveolar process in the younger patients. There
was no evidence of a deleterious effect on mandibular growth.
Conclusion: The outcomes of forward-upward genioplasty include increased symphysis
thickness, bone apposition above B point, and remodeling at the inferior border. When indications
for this type of genioplasty are recognized, early surgical correction (before age 15) produces a
better outcome in terms of bone remodeling. (Angle Orthod. 0000;00:000–000.)
Fixed and removable orthodontic appliance application for class III malocclus...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
This study evaluated the effect of different amounts of mandibular setback surgery on the submental region and aesthetics. The study examined 38 patients who underwent mandibular setback surgery, distinguishing those with less than 5mm of setback from those with 5mm or more. The results found no significant changes in the submental region or aesthetics for patients with less than 5mm of setback. However, for patients with 5mm or more of setback, there were significant decreases in cervical length and changes to the lip-chin-throat angle, lower lip length, and upper lip length. The study suggests these factors should be considered in surgical planning to avoid undesirable aesthetic impacts of mandibular setback surgery.
Gingival recession—can orthodontics be a cure? evidence from a case presentationEdwardHAngle
A 35-year-old woman presented with severe gingival recession and a unilateral Class II malocclusion. Her treatment plan involved orthodontic correction of the malocclusion using brackets that torqued roots more onto the bone. It also involved changing her dental hygiene methods to use an oscillating toothbrush gently. After 28 months of orthodontic treatment, her malocclusion was corrected and her gingival recession improved without needing grafting. Three months later, her teeth had settled well into their new positions.
Long term clinical and bacterial effetcx of xylitol on paitnets with fixed or...EdwardHAngle
Background: The objective of this study was to evaluate long-term clinical and bacterial effects of using 6 g of
xylitol per day for 3 months on patients with full fixed orthodontic appliances.
Methods: The study was a pilot clinical trial that included 41 subjects who were undergoing orthodontic
treatment. The subjects were randomly divided into three groups. Group A received xylitol chewing gum, group B
received xylitol dissolvable chewable tablets, and Group C served as the control group and did not receive xylitol
gums or tablets. Clinical examination and the collection of plaque and saliva samples were carried out at baseline
and 3, 6, and 12 months. All three groups were given oral hygiene instruction and were put on a 6-month cleaning
and topical fluoride schedule. Plaque scores and bacterial counts were used to evaluate the effectiveness of the
different approaches at reducing the caries risk.
Results: Xylitol groups did not experience any more reduction in plaque score, plaque MS counts, or salivary MS
counts than the control group nor did they have lower values at any of the time points. Chewing gum did not
significantly increase the incidence of debonded brackets over the other groups.
Conclusions: Xylitol does not have a clinical or bacterial benefit in patients with fixed orthodontic appliances. Oral
hygiene instructions and 6-month topical fluoride application were effective at reducing plaque scores and bacterial
counts in patients with full fixed appliances regardless of whether or not xylitol was used.
Modification of Distal Shoe- A Systematic Review & Meta AnalysisDrHeena tiwari
The document summarizes a systematic review of modifications to the distal shoe space maintainer. It analyzes 6 studies on modified distal shoe designs. The studies showed that the modifications provided stability, adjustability, and were well-accepted by patients. However, the quality of the studies was low and conclusions about the efficacy of the modifications were inconclusive due to a lack of clear reporting on outcomes. Further high-quality research is needed to establish the effectiveness of modified distal shoe space maintainers.
Subjective classification and objective analysis of the mandibular dental arc...EdwardHAngle
Our objective was to evaluate the relationship between subjective classification of dental-arch shape, objective analyses via arch-width measurements, and the fitting with the fourth-order polynomial equation.
ABSTRACT
Objective: To evaluate the role of age as a moderator of bone regeneration patterns and
symphysis remodeling after genioplasty.
Method: Fifty-four patients who underwent genioplasty at the end of their orthodontic treatment
were divided into three age groups: younger than 15 years at the time of surgery (group 1), 15 to
19 years (group 2), and 20 years or older (group 3). Twenty-three patients who did not accept
genioplasty and had a follow-up radiograph 2 years after the end of their orthodontic treatment
were used as a control group. Patients were evaluated at three time points: immediate preoperative
(T1), immediate postoperative (T2,) and 2 years postsurgery (T3).
Results: The mean genial advancement at surgery was similar for the three age groups, but the
extent of remodeling around the repositioned chin was greater in group 1, less in group 2, and still
less in group 3. Symphysis thickness increased significantly during the 2-year postsurgery interval
for the three groups, and this increase was significantly greater in group 1 than in group 3.
Remodeling above and behind the repositioned chin also was greater in the younger patients. This
was related to greater vertical growth of the dentoalveolar process in the younger patients. There
was no evidence of a deleterious effect on mandibular growth.
Conclusion: The outcomes of forward-upward genioplasty include increased symphysis
thickness, bone apposition above B point, and remodeling at the inferior border. When indications
for this type of genioplasty are recognized, early surgical correction (before age 15) produces a
better outcome in terms of bone remodeling. (Angle Orthod. 0000;00:000–000.)
The document summarizes a journal club presentation on a 3-year study evaluating the clinical performance of short expandable dental implants in highly atrophic alveolar bone. The study found a 94.7% implant success rate in the mandible and 83.6% in the maxilla over a mean follow-up of 42.6 months, with median 3-year crestal bone changes demonstrating maintenance of peri-implant alveolar bone. The conclusion was that the short expandable implant system provided reliable oral rehabilitation, especially for elderly patients with difficult implantation conditions.
This document describes a case report of a 23-year-old male patient who presented with facial asymmetry and flattening of the right side of the face due to childhood temporomandibular joint ankylosis. Treatment involved a two-stage procedure, first using orthognathic surgery (Le Fort I osteotomy) to correct occlusal cant, followed by orthomorphic surgery (extended lateral sliding genioplasty) 6 months later to correct the facial asymmetry and underdevelopment of the mandible. The combination of orthognathic and orthomorphic surgery successfully achieved functional and aesthetic goals by correcting the jaw deviation and restoring facial symmetry.
Transverse growth of the maxilla and mandible in untreated girls with low, av...EdwardHAngle
The purpose of this study was to investigate maxillary and mandibular transverse growth in
untreated female subjects with low, average, and high mandibular plane angles longitudinally from ages 6 to 18.
The document discusses the importance of occlusion aspects in completing orthodontic treatment. It emphasizes establishing criteria like centric relation, vertical dimension, guidance patterns, and occlusal contacts to achieve stability. The study evaluated 20 patients 5 years after treatment, finding all maintained their corrected molar relationship and overjet, indicating occlusion aspects support stability. Adhering to functional occlusion principles helps orthodontists obtain proper treatment completion.
In 1989, Shetty and Freymiller [7] reviewed indications for removal of teeth in the line of fracture. They recommended the following indications:
1. Significant periodontal disease with gross mobility and periapical pathology
2. Partially erupted third molars with pericoronitis or cystic areas
3. Teeth preventing the reduction of fractures
4. Teeth with fractured roots
5. Teeth with exposed root apices or teeth in which the entire root surface from the apex to the gingival margin is exposed
6. Excessive delay from the time of fracture to the time of definitive treatment
In addition to these indications, another indication that requires extraction of teeth in the line of fracture is an acute, recurring abscess at the site of the fracture despite antibiotic therapy(8)
Segmental Fractures of the Forearm- Outcome Analysis of Various Management St...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Malposition of unerupted mandibular second premolar in children with cleft li...EdwardHAngle
Objective: To determine whether distoangular malposition of the unerupted mandibular second
premolar (MnP2) is more frequent in children with unilateral clefts of the lip and palate.
Materials and Methods: This retrospective study examined panoramic radiographs from 45 patients
with unilateral clefts of the lip and/or palate who had no previous orthodontics. A control
sample consisted of age- and sex-matched patients. The distal angle formed between the long
axis of MnP2 and the tangent to the inferior border was measured. The mean, standard deviation,
and range were calculated for the angles measured in the cleft and the control groups. The
significance of the differences between the means was evaluated by the paired t-test. The angles
of the cleft and noncleft sides were also measured and compared.
Results: The mean inclination of the MnP2 on the cleft side was 73.6°, compared with 84.6° in
the control group. This difference was highly significant statistically (P < .0001). The difference
in angles from the cleft and noncleft sides was 0.7°, not statistically significant. A significant association
was found between clefting and distoangular malposition of the developing MnP2, suggesting
a shared genetic etiology. This association is independent of the clefting side, ruling out
possible local mechanical effects.
Conclusion: Clinicians should be aware of the potential for anomalous development of MnP2 in
children with clefts.
Effect of Calcium Hydroxide on Deep Caries Dentin: A Clinical Studyasclepiuspdfs
Objective: The aim of this study was to evaluate the clinical efficacy of calcium hydroxide on arresting deep carious lesions in permanent teeth. Methods: A total of 190 patients aged between 15 and 55 years old were selected for this clinical study. Calcium hydroxide was applied to fully matured permanent anterior or posterior teeth clinically and radiographically after 2 weeks, 3–4 weeks, 3 months, 6 months, and 1-year follow-up. Results: The overall survival rate was 89.4%. The findings of this study showed that calcium hydroxide is effective in arresting deep carious lesions and formation tertiary dentine as well as preservation teeth vitality. Conclusion: Calcium hydroxide is effective in reducing the risk of pulp exposure in deep carious lesion.
This case series examines a new surgical technique for regenerating interimplant papillae using subepithelial connective tissue grafts. 10 patients with missing papillae between implant restorations received the new procedure involving buccal and palatal incisions made away from the papilla to preserve blood supply, and tunneling performed with a specialized instrument. The papillae scores improved on average from 0.8 to 2.4 after 16 months, demonstrating regeneration of the papillae over 11-30 months. However, long-term studies are still needed to validate the technique and outcomes.
Role of polycystin 1 in bone remodeling- orthodontic tooth movement study in ...EdwardHAngle
Objective: To test the hypothesis that polycystin-1 (PC1) is involved in orthodontic tooth movement as a mechanical sensor.
Materials and Methods: The response to force application was compared between three mutant and four wild-type 7-week-old mice. The mutant mice were PC1/Wnt1-cre, lacking PC1 in the craniofacial region. An orthodontic closed coil spring was bonded between the incisor and the left first molar, applying 20 g of force for 4 days. Micro–computed tomography, hematoxylin and eosin staining, and tartrate-resistent acid phosphatase (TRAP) staining were used to study the differences in tooth movement among the groups.
Results: In the wild-type mice the bonded molar moved mesially, and the periodontal ligament (PDL) was compressed in the compression side. The compression side showed a hyalinized zone, and osteoclasts were identified there using TRAP staining. In the mutant mice, the molar did not move, the incisor tipped palatally, and there was slight widening of the PDL in the tension area. Osteoclasts were not seen on the bone surface or on the compression side. Osteoclasts were only observed on the other side of the bone—in the bone marrow.
Conclusions: These results suggest a difference in tooth movement and osteoclast activity between PC1 mutant mice and wild-type mice in response to orthodontic force. The impaired tooth movement and the lack of osteoclasts on the bone surface in the mutant working side may be related to lack of signal from the PDL due to PC1 deficiency.
The document discusses various methods for predicting facial growth, including Johnston's grid method, Bjork's structural method, and Fishman's maturational method. It compares the accuracy of short-term and long-term predictions between these methods. While growth prediction remains difficult due to variability, the maturationally oriented Fishman method was found to be generally superior to chronologically based methods like Johnston's grid and Ricketts analysis. No single method can accurately predict growth for all individuals, especially those with extreme growth patterns.
Angular changes and their rates in concurrence to developmental stages of the...EdwardHAngle
In the early developmental stage of the mandibular second premolar (MnP2), it is not unusual to find the tooth extremely angulated to the lower border of the mandible, as seen in the panoramic roentgenogram. On eruption, the tooth, in most cases, is close to being upright. However, impaction or other types of malocclusions due to its ectopic eruption are not rare.
New insights on age related association between nasopharyngeal airway clearan...EdwardHAngle
This document summarizes a study that evaluated the relationship between adenoid hypertrophy (enlarged adenoids) and facial morphology in children. The study examined 200 children referred for suspected adenoid obstruction, dividing them into two age groups and four subgroups based on facial divergence. Measurements were made from lateral cephalograms to assess airway clearance and facial morphology. Results found smaller airway measurements and more divergent facial patterns in children aged 6 and under and those with severe facial divergence. The findings suggest earlier airway clearance may be needed in severely affected young children to prevent irreversible facial changes.
This study investigated the skeletal changes in the facial structures of 30 patients with Class II Division 1 malocclusions who were treated using functional jaw orthopedic appliances. Cephalometric analyses before and after treatment showed that treatment resulted in reduced overjet, mandibular advancement, and increased total mandibular length. Specifically, overjet decreased by an average of 2.46 mm, mandible advanced by an average of 2.72 mm, and total mandibular length increased by an average of 4.17 mm. While maxillary development was inhibited by an average of 1.57 degrees, the correction of the anterior-posterior discrepancy was mainly due to changes in mandibular position and growth rather than changes to the maxilla
Objective: To evaluate the role of age as a moderator of bone regeneration patterns and
symphysis remodeling after genioplasty.
Method: Fifty-four patients who underwent genioplasty at the end of their orthodontic treatment
were divided into three age groups: younger than 15 years at the time of surgery (group 1), 15 to
19 years (group 2), and 20 years or older (group 3). Twenty-three patients who did not accept
genioplasty and had a follow-up radiograph 2 years after the end of their orthodontic treatment
were used as a control group. Patients were evaluated at three time points: immediate preoperative
(T1), immediate postoperative (T2,) and 2 years postsurgery (T3).
Results: The mean genial advancement at surgery was similar for the three age groups, but the
extent of remodeling around the repositioned chin was greater in group 1, less in group 2, and still
less in group 3. Symphysis thickness increased significantly during the 2-year postsurgery interval
for the three groups, and this increase was significantly greater in group 1 than in group 3.
Remodeling above and behind the repositioned chin also was greater in the younger patients. This
was related to greater vertical growth of the dentoalveolar process in the younger patients. There
was no evidence of a deleterious effect on mandibular growth.
Conclusion: The outcomes of forward-upward genioplasty include increased symphysis
thickness, bone apposition above B point, and remodeling at the inferior border. When indications
for this type of genioplasty are recognized, early surgical correction (before age 15) produces a
better outcome in terms of bone remodeling.
This document discusses the biological rationale for early treatment of dentofacial deformities. It addresses the growth potential of sutures and condylar cartilage, implications for modifying facial growth, and future directions. Specifically:
1) Sutures and condylar cartilage have stem cells that allow growth throughout life and can be influenced by biomechanical factors, making modification of facial growth possible.
2) The best time to intervene is debated, but growth is most modifiable early in development. Treatment effects depend on available stem cells and growth factor expression, which vary over time.
3) Future work will integrate developmental biology principles with treatment, using genetics to assess growth potential and possibly targeting growth factors for more
CARNOY’S SOLUTION AS A SURGICAL MEDICAMENT IN THETREATMENT OF KERATOCYSTIC O...DrKamini Dadsena
The term keratocyst was coined by Philipsen in 1956.
Unlike the other cystic lesion KOT, has got strong tendency for recurrence.
Treatment of these lesions remains controversial and has a number of dilemmas about the choice of treatment whether to use carnoys solution as an adjunct therapy after removal of the lesion.
2011 clinical outcome of dental implants placed with high insertion torquesMuaiyed Mahmoud Buzayan
This study evaluated 42 dental implants placed with high insertion torques of 70 Ncm or greater. All implants successfully integrated clinically and were stable after 1 year of loading. Marginal bone loss after 1 year was similar between implants placed with high torques (mean 1.24 mm) and low torques (mean 1.09 mm), indicating that high insertion torques did not negatively impact osseointegration or bone stability. The use of high insertion torques up to 176 Ncm did not prevent osseointegration and resulted in similar bone stability outcomes compared to lower torque implants.
1. There are several methods for predicting surgical outcomes of orthognathic surgery, including manual tracings, computer software programs, and video imaging.
2. Studies have found that current prediction methods tend to be inaccurate, especially in predicting soft tissue changes like lip and chin positions. Predictions often differ from actual outcomes by 2mm or more.
3. While prediction images can help communicate treatment plans to patients, they may also unintentionally create unrealistic expectations that are not always achieved. More accurate prediction methods are still needed.
This study retrospectively evaluated 34 patients with class III dentofacial deformities who underwent either maxillary advancement or mandibular setback surgery. Pre- and post-operative lateral cephalograms were analyzed to compare changes in 14 soft tissue parameters between the two surgical approaches. Statistically significant differences were found for cervical length, which increased after maxillary advancement but decreased after mandibular setback. Some other aesthetic parameters were found to be superior after maxillary advancement compared to mandibular setback. The study aims to help determine the best surgical approach for correcting class III deformities while optimizing aesthetic outcomes.
68.Dr. Afreen Kauser; Dr. Rahul VC Tiwari; Dr. Ankita Khandelwal; Dr. Heena Tiwari; Dr. Sourabh Ramesh Joshi; Dr. Fawaz Abdul Hamid Baig; Dr. Anil Managutti. "Preference Of Orthodontic Treatment Versus Orthognathic Surgery In Class Iii Malocclusion Cases: A Research Survey". European Journal of Molecular & Clinical Medicine, 8, 1, 2021, 1271-1276.
The document summarizes a journal club presentation on a 3-year study evaluating the clinical performance of short expandable dental implants in highly atrophic alveolar bone. The study found a 94.7% implant success rate in the mandible and 83.6% in the maxilla over a mean follow-up of 42.6 months, with median 3-year crestal bone changes demonstrating maintenance of peri-implant alveolar bone. The conclusion was that the short expandable implant system provided reliable oral rehabilitation, especially for elderly patients with difficult implantation conditions.
This document describes a case report of a 23-year-old male patient who presented with facial asymmetry and flattening of the right side of the face due to childhood temporomandibular joint ankylosis. Treatment involved a two-stage procedure, first using orthognathic surgery (Le Fort I osteotomy) to correct occlusal cant, followed by orthomorphic surgery (extended lateral sliding genioplasty) 6 months later to correct the facial asymmetry and underdevelopment of the mandible. The combination of orthognathic and orthomorphic surgery successfully achieved functional and aesthetic goals by correcting the jaw deviation and restoring facial symmetry.
Transverse growth of the maxilla and mandible in untreated girls with low, av...EdwardHAngle
The purpose of this study was to investigate maxillary and mandibular transverse growth in
untreated female subjects with low, average, and high mandibular plane angles longitudinally from ages 6 to 18.
The document discusses the importance of occlusion aspects in completing orthodontic treatment. It emphasizes establishing criteria like centric relation, vertical dimension, guidance patterns, and occlusal contacts to achieve stability. The study evaluated 20 patients 5 years after treatment, finding all maintained their corrected molar relationship and overjet, indicating occlusion aspects support stability. Adhering to functional occlusion principles helps orthodontists obtain proper treatment completion.
In 1989, Shetty and Freymiller [7] reviewed indications for removal of teeth in the line of fracture. They recommended the following indications:
1. Significant periodontal disease with gross mobility and periapical pathology
2. Partially erupted third molars with pericoronitis or cystic areas
3. Teeth preventing the reduction of fractures
4. Teeth with fractured roots
5. Teeth with exposed root apices or teeth in which the entire root surface from the apex to the gingival margin is exposed
6. Excessive delay from the time of fracture to the time of definitive treatment
In addition to these indications, another indication that requires extraction of teeth in the line of fracture is an acute, recurring abscess at the site of the fracture despite antibiotic therapy(8)
Segmental Fractures of the Forearm- Outcome Analysis of Various Management St...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Malposition of unerupted mandibular second premolar in children with cleft li...EdwardHAngle
Objective: To determine whether distoangular malposition of the unerupted mandibular second
premolar (MnP2) is more frequent in children with unilateral clefts of the lip and palate.
Materials and Methods: This retrospective study examined panoramic radiographs from 45 patients
with unilateral clefts of the lip and/or palate who had no previous orthodontics. A control
sample consisted of age- and sex-matched patients. The distal angle formed between the long
axis of MnP2 and the tangent to the inferior border was measured. The mean, standard deviation,
and range were calculated for the angles measured in the cleft and the control groups. The
significance of the differences between the means was evaluated by the paired t-test. The angles
of the cleft and noncleft sides were also measured and compared.
Results: The mean inclination of the MnP2 on the cleft side was 73.6°, compared with 84.6° in
the control group. This difference was highly significant statistically (P < .0001). The difference
in angles from the cleft and noncleft sides was 0.7°, not statistically significant. A significant association
was found between clefting and distoangular malposition of the developing MnP2, suggesting
a shared genetic etiology. This association is independent of the clefting side, ruling out
possible local mechanical effects.
Conclusion: Clinicians should be aware of the potential for anomalous development of MnP2 in
children with clefts.
Effect of Calcium Hydroxide on Deep Caries Dentin: A Clinical Studyasclepiuspdfs
Objective: The aim of this study was to evaluate the clinical efficacy of calcium hydroxide on arresting deep carious lesions in permanent teeth. Methods: A total of 190 patients aged between 15 and 55 years old were selected for this clinical study. Calcium hydroxide was applied to fully matured permanent anterior or posterior teeth clinically and radiographically after 2 weeks, 3–4 weeks, 3 months, 6 months, and 1-year follow-up. Results: The overall survival rate was 89.4%. The findings of this study showed that calcium hydroxide is effective in arresting deep carious lesions and formation tertiary dentine as well as preservation teeth vitality. Conclusion: Calcium hydroxide is effective in reducing the risk of pulp exposure in deep carious lesion.
This case series examines a new surgical technique for regenerating interimplant papillae using subepithelial connective tissue grafts. 10 patients with missing papillae between implant restorations received the new procedure involving buccal and palatal incisions made away from the papilla to preserve blood supply, and tunneling performed with a specialized instrument. The papillae scores improved on average from 0.8 to 2.4 after 16 months, demonstrating regeneration of the papillae over 11-30 months. However, long-term studies are still needed to validate the technique and outcomes.
Role of polycystin 1 in bone remodeling- orthodontic tooth movement study in ...EdwardHAngle
Objective: To test the hypothesis that polycystin-1 (PC1) is involved in orthodontic tooth movement as a mechanical sensor.
Materials and Methods: The response to force application was compared between three mutant and four wild-type 7-week-old mice. The mutant mice were PC1/Wnt1-cre, lacking PC1 in the craniofacial region. An orthodontic closed coil spring was bonded between the incisor and the left first molar, applying 20 g of force for 4 days. Micro–computed tomography, hematoxylin and eosin staining, and tartrate-resistent acid phosphatase (TRAP) staining were used to study the differences in tooth movement among the groups.
Results: In the wild-type mice the bonded molar moved mesially, and the periodontal ligament (PDL) was compressed in the compression side. The compression side showed a hyalinized zone, and osteoclasts were identified there using TRAP staining. In the mutant mice, the molar did not move, the incisor tipped palatally, and there was slight widening of the PDL in the tension area. Osteoclasts were not seen on the bone surface or on the compression side. Osteoclasts were only observed on the other side of the bone—in the bone marrow.
Conclusions: These results suggest a difference in tooth movement and osteoclast activity between PC1 mutant mice and wild-type mice in response to orthodontic force. The impaired tooth movement and the lack of osteoclasts on the bone surface in the mutant working side may be related to lack of signal from the PDL due to PC1 deficiency.
The document discusses various methods for predicting facial growth, including Johnston's grid method, Bjork's structural method, and Fishman's maturational method. It compares the accuracy of short-term and long-term predictions between these methods. While growth prediction remains difficult due to variability, the maturationally oriented Fishman method was found to be generally superior to chronologically based methods like Johnston's grid and Ricketts analysis. No single method can accurately predict growth for all individuals, especially those with extreme growth patterns.
Angular changes and their rates in concurrence to developmental stages of the...EdwardHAngle
In the early developmental stage of the mandibular second premolar (MnP2), it is not unusual to find the tooth extremely angulated to the lower border of the mandible, as seen in the panoramic roentgenogram. On eruption, the tooth, in most cases, is close to being upright. However, impaction or other types of malocclusions due to its ectopic eruption are not rare.
New insights on age related association between nasopharyngeal airway clearan...EdwardHAngle
This document summarizes a study that evaluated the relationship between adenoid hypertrophy (enlarged adenoids) and facial morphology in children. The study examined 200 children referred for suspected adenoid obstruction, dividing them into two age groups and four subgroups based on facial divergence. Measurements were made from lateral cephalograms to assess airway clearance and facial morphology. Results found smaller airway measurements and more divergent facial patterns in children aged 6 and under and those with severe facial divergence. The findings suggest earlier airway clearance may be needed in severely affected young children to prevent irreversible facial changes.
This study investigated the skeletal changes in the facial structures of 30 patients with Class II Division 1 malocclusions who were treated using functional jaw orthopedic appliances. Cephalometric analyses before and after treatment showed that treatment resulted in reduced overjet, mandibular advancement, and increased total mandibular length. Specifically, overjet decreased by an average of 2.46 mm, mandible advanced by an average of 2.72 mm, and total mandibular length increased by an average of 4.17 mm. While maxillary development was inhibited by an average of 1.57 degrees, the correction of the anterior-posterior discrepancy was mainly due to changes in mandibular position and growth rather than changes to the maxilla
Objective: To evaluate the role of age as a moderator of bone regeneration patterns and
symphysis remodeling after genioplasty.
Method: Fifty-four patients who underwent genioplasty at the end of their orthodontic treatment
were divided into three age groups: younger than 15 years at the time of surgery (group 1), 15 to
19 years (group 2), and 20 years or older (group 3). Twenty-three patients who did not accept
genioplasty and had a follow-up radiograph 2 years after the end of their orthodontic treatment
were used as a control group. Patients were evaluated at three time points: immediate preoperative
(T1), immediate postoperative (T2,) and 2 years postsurgery (T3).
Results: The mean genial advancement at surgery was similar for the three age groups, but the
extent of remodeling around the repositioned chin was greater in group 1, less in group 2, and still
less in group 3. Symphysis thickness increased significantly during the 2-year postsurgery interval
for the three groups, and this increase was significantly greater in group 1 than in group 3.
Remodeling above and behind the repositioned chin also was greater in the younger patients. This
was related to greater vertical growth of the dentoalveolar process in the younger patients. There
was no evidence of a deleterious effect on mandibular growth.
Conclusion: The outcomes of forward-upward genioplasty include increased symphysis
thickness, bone apposition above B point, and remodeling at the inferior border. When indications
for this type of genioplasty are recognized, early surgical correction (before age 15) produces a
better outcome in terms of bone remodeling.
This document discusses the biological rationale for early treatment of dentofacial deformities. It addresses the growth potential of sutures and condylar cartilage, implications for modifying facial growth, and future directions. Specifically:
1) Sutures and condylar cartilage have stem cells that allow growth throughout life and can be influenced by biomechanical factors, making modification of facial growth possible.
2) The best time to intervene is debated, but growth is most modifiable early in development. Treatment effects depend on available stem cells and growth factor expression, which vary over time.
3) Future work will integrate developmental biology principles with treatment, using genetics to assess growth potential and possibly targeting growth factors for more
CARNOY’S SOLUTION AS A SURGICAL MEDICAMENT IN THETREATMENT OF KERATOCYSTIC O...DrKamini Dadsena
The term keratocyst was coined by Philipsen in 1956.
Unlike the other cystic lesion KOT, has got strong tendency for recurrence.
Treatment of these lesions remains controversial and has a number of dilemmas about the choice of treatment whether to use carnoys solution as an adjunct therapy after removal of the lesion.
2011 clinical outcome of dental implants placed with high insertion torquesMuaiyed Mahmoud Buzayan
This study evaluated 42 dental implants placed with high insertion torques of 70 Ncm or greater. All implants successfully integrated clinically and were stable after 1 year of loading. Marginal bone loss after 1 year was similar between implants placed with high torques (mean 1.24 mm) and low torques (mean 1.09 mm), indicating that high insertion torques did not negatively impact osseointegration or bone stability. The use of high insertion torques up to 176 Ncm did not prevent osseointegration and resulted in similar bone stability outcomes compared to lower torque implants.
1. There are several methods for predicting surgical outcomes of orthognathic surgery, including manual tracings, computer software programs, and video imaging.
2. Studies have found that current prediction methods tend to be inaccurate, especially in predicting soft tissue changes like lip and chin positions. Predictions often differ from actual outcomes by 2mm or more.
3. While prediction images can help communicate treatment plans to patients, they may also unintentionally create unrealistic expectations that are not always achieved. More accurate prediction methods are still needed.
This study retrospectively evaluated 34 patients with class III dentofacial deformities who underwent either maxillary advancement or mandibular setback surgery. Pre- and post-operative lateral cephalograms were analyzed to compare changes in 14 soft tissue parameters between the two surgical approaches. Statistically significant differences were found for cervical length, which increased after maxillary advancement but decreased after mandibular setback. Some other aesthetic parameters were found to be superior after maxillary advancement compared to mandibular setback. The study aims to help determine the best surgical approach for correcting class III deformities while optimizing aesthetic outcomes.
68.Dr. Afreen Kauser; Dr. Rahul VC Tiwari; Dr. Ankita Khandelwal; Dr. Heena Tiwari; Dr. Sourabh Ramesh Joshi; Dr. Fawaz Abdul Hamid Baig; Dr. Anil Managutti. "Preference Of Orthodontic Treatment Versus Orthognathic Surgery In Class Iii Malocclusion Cases: A Research Survey". European Journal of Molecular & Clinical Medicine, 8, 1, 2021, 1271-1276.
1) The document summarizes research on early orthodontic intervention for patients with tooth-size discrepancies. It focuses on using rapid maxillary expansion (RME) in the mixed dentition stage to correct crowding issues.
2) Long-term studies found that RME followed by fixed appliances resulted in clinically significant increases in maxillary and mandibular arch width even 5+ years post-treatment. RME also had benefits like improving nasal breathing.
3) For patients with mild-moderate crowding, RME combined with other approaches like Schwarz appliances in early treatment resulted in increased arch widths that were maintained long-term. RME was found to be an effective option for treating mixed dentition patients
1. The study assessed the effectiveness of an orthodontic tongue crib appliance in treating 18 growing children with Class 3 malocclusion and open bite.
2. Cephalometric analysis found that after 12 months of treatment, patients had significant forward growth of the maxilla and improved maxilla-mandibular relationships.
3. The tongue crib was effective at improving the maxillary complex growth and facial esthetics in growing patients with skeletal Class 3 and open bite malocclusions.
This study evaluated changes in nasal airway function following Le Fort I osteotomy in 25 patients. Patients underwent either maxillary impaction, advancement, or both, with alar base cinch suture. Pre- and post-operative nasal examinations, rhinomanometry, and acoustic rhinometry were performed. The results showed that total nasal airflow increased and resistance decreased significantly following surgery in all groups. Nasal volume decreased but cross-sectional areas at the isthmus nasi increased. The study concluded that maxillary impaction or advancement of up to 5.5 mm combined with alar base cinch suture can improve nasal airflow by reducing resistance.
International Journal of Pharmaceutical Science Invention (IJPSI)inventionjournals
International Journal of Pharmaceutical Science Invention (IJPSI) is an international journal intended for professionals and researchers in all fields of Pahrmaceutical Science. IJPSI publishes research articles and reviews within the whole field Pharmacy and Pharmaceutical Science, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online.
Treatment of class ii non compliant /certified fixed orthodontic courses b...Indian dental academy
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This randomized clinical trial compared the effects of two different force magnitudes (200g vs 400g) for maxillary buccal segment intrusion using mini-screws in patients with skeletal open bites. Twenty-two patients were randomly assigned to receive either 200g or 400g of intrusive force. Both groups experienced statistically significant posterior teeth intrusion and open bite closure, with no significant differences between the groups. The study concluded that 200g and 400g forces produced similar outcomes for maxillary posterior intrusion and open bite correction.
Immediate effects of rapid maxillary expansion with haas-type and hyrax-type ...Dr. Carlos Joel Sequeira.
This randomized clinical trial evaluated and compared the immediate effects of rapid maxillary expansion (RME) using Haas-type and hyrax-type expanders through cone-beam computed tomography (CBCT) scans. 33 subjects were randomly assigned to either the Haas or hyrax group. Both groups underwent RME with 4 quarter turns of initial activation followed by 2 quarter turns per day until 8mm of expansion was reached. CBCT scans were taken before and after expansion. Measurements showed that both appliances significantly increased maxillary transverse dimensions, with greater skeletal than dental expansion. The hyrax group demonstrated greater orthopedic effects and less tipping of maxillary molars compared to the Haas group, but the differences were less
Treatment of gingival recession using coronally advanced flapShruti Maroo
This document describes a case study evaluating the efficacy of the coronally advanced flap technique for treating gingival recession. A 27-year old male patient presented with Miller's Class I gingival recession on teeth 22 and 23, along with sensitivity. The coronally advanced flap procedure was performed, involving incisions and elevation of a partial-thickness flap. One month and three months post-operatively, the patient showed uneventful healing and 100% root coverage, with reduction in sensitivity and no probing defects. The coronally advanced flap technique alone can successfully treat gingival recession when residual gingiva is thick and wide, resulting in good esthetic and functional outcomes.
Mandibular arch form the relationship between dental and basal anatomyEdwardHAngle
We investigated mandibular dental arch form at the levels of both the clinically relevant application points of the orthodontic bracket and the underlying anatomic structure of the apical base. The correlation of both forms was evaluated and examined to determine whether the basal arch could be used to derive a standardized clinical arch form.
This research article compares graft uptake and resorption between chin and ramal bone grafts used to reconstruct atrophic maxillary ridges for dental implant placement. 5 patients received chin grafts and 5 received ramal grafts. Cone beam CT scans after 5 months found mean resorption of 16.8% for ramal grafts and 18% for chin grafts. Ramal grafts had advantages of a minimally invasive approach, more graft volume, and less postoperative morbidity compared to chin grafts. Patient compliance was also better with ramal grafts due to less immediate postoperative pain. The survival of ramal grafts was better than chin grafts due to the higher resorption rate of chin grafts.
The document discusses a study that assessed the effect of surgically removing impacted mandibular third molars (M3) on the adjacent second molars (M2). 78 young patients underwent M3 removal, and probing depths and attachment levels were measured at baseline and 6 months post-op. The results showed a statistically significant decrease in probing depths and improvement in attachment levels over time. Male patients and those with submucosally impacted M3 experienced greater reductions in probing depths. In conclusion, surgical removal of impacted M3 had no negative effects and potentially positive periodontal benefits for the adjacent M2.
Comparison of the effects of face mask treatment started simultaneously
and after the completion of the alternate rapid maxillary expansion and
constriction procedure
This document summarizes research on the stability and predictability of orthognathic surgery procedures. It finds that superior repositioning of the maxilla and mandibular advancement of less than 10mm are the most stable procedures. Mandibular setback, downward movement of the maxilla, and maxillary expansion are the least stable and have a high risk of significant postoperative change. Condylar remodeling often occurs after surgery and can be evaluated using cone-beam computed tomography scans. Long-term stability depends on the specific procedure and factors like rigid internal fixation.
This study compared the outcomes of treating mandibular angle fractures with either a single miniplate placed at the superior border (Group A) or a 3D miniplate (Group B). Group B, treated with 3D plates, had longer surgery times but better fracture stability and fewer cases of postoperative malocclusion requiring maxillomandibular fixation. Both groups experienced similar pain levels. While 3D plating provided improved fracture stability, it also resulted in more initial postoperative discomfort due to increased soft tissue stripping during surgery. Overall, 3D plating appeared to be superior for mandibular angle fracture treatment.
This study compared the anchorage provided by the Nance appliance (NA) and fixed frontal bite plane (FBP) during intra-arch distal molar movement over 6 months in 40 patients. Both groups experienced approximately 1.4-1.9mm of anterior movement of the maxillary central incisors, with no significant difference between groups. Distal molar movement was 1.7-1.8mm in both groups. The overbite decreased more in the FBP group. Neither appliance provided fully stable anchorage. A second treatment phase is recommended to correct anchorage loss after distal molar movement.
The document discusses the stability of open bite treatment. It finds that:
1) Relatively few scientific studies have evaluated the stability of open bite treatment. The studies that do exist show that 35-60% of non-surgically treated patients experience a relapse of their open bite.
2) Various therapies have been proposed to improve stability, such as crib therapy and myofunctional therapy, but no long-term studies conclusively prove their effectiveness.
3) While early treatment is generally indicated for open bites depending on severity, age, etc., stability remains a clinical problem as about 20-40% of patients, both surgically and non-surgically treated, will experience a relapse.
Similar to 2015 ghassemi-maxillary advancment2015 (20)
An 83-year-old female patient was admitted to the hospital with breathing difficulties and weight loss. An autopsy revealed adenocarcinoma of the lung and colon in the late stages. Molecular testing found that both cancers had a BRAF V600E mutation, which is rare for two separate cancers to share. The autopsy also uncovered several other previously unknown medical conditions, demonstrating the importance of autopsies for quality control and teaching.
Kongressplakat pathologie dworak grading system prof. hansen_din a0Klinikum Lippe GmbH
This study evaluated the Dworak tumor regression grading (TRG) system as a prognostic indicator for 159 rectal cancer patients treated with neoadjuvant chemoradiotherapy. Patients were observed for a mean of 42.5 months. A univariate Kaplan-Meier analysis found that patients with Dworak TRG grades 3+4 had a mean progression-free survival of 121 months, significantly higher than the 53.6 months for patients with grades 1+2. A multivariate analysis identified Dworak TRG grade and postoperative nodal stage as independent risk factors. The study concludes that Dworak TRG is an important prognostic indicator of progression-free survival and that subclassifying into grades 1+2 and 3
This study developed and tested a non-language specific speech test using made-up syllables to evaluate speech in cleft patients from different cultural and language backgrounds. The test was administered to 41 cleft patients and 39 non-cleft individuals from Germany, Iran, and India. Two speech pathologists independently rated audio recordings of the tests and found significant differences in hypernasality, nasal emissions, and consonant errors between cleft patients and non-cleft controls from the same language group. While inter-rater agreement was poor, the test was able to distinguish speech characteristics between cleft and non-cleft individuals across different languages and cultures.
This study evaluated the use of vascularised fatty tissue flaps to replace excised parotid tissue and prevent Frey's syndrome in 37 patients who underwent parotidectomy between 2008-2017. The fatty flaps took an average of 17 minutes to dissect and were stable for up to 9 years of follow up. None of the patients reported symptoms of Frey's syndrome such as flushing or sweating when eating. The flaps were an easy technique that avoided donor site morbidity compared to other options and successfully prevented Frey's syndrome in all patients.
1) The study compared the effects of dexamethasone, tranexamic acid, and a combination of both on post-rhinoplasty edema and ecchymosis in 60 patients who underwent primary open rhinoplasty.
2) Patients were divided into 4 groups: dexamethasone only, tranexamic acid only, combination, and placebo. Medications were given intravenously before and after surgery.
3) Edema and ecchymosis were evaluated on a scale of 0-4 on postoperative days 1, 3, and 7. The dexamethasone, tranexamic acid, and combination groups had significantly lower edema and ecchymosis ratings compared to the placebo
This study compared information obtained from standard computed tomographic angiography (s-CTA) scans and modified CTA (m-CTA) scans of the deep circumflex iliac artery (DCIA) flap to cadaver dissections. The m-CTA scans showed longer visible DCIA lengths, better visualization of branching patterns, and more detail on vessel course compared to s-CTA scans. However, s-CTA scans allowed bilateral evaluation while m-CTA only showed the injected side. Both CTA methods provided more information than cadaver dissections for preoperative planning of DCIA flaps.
This document describes a new minimally invasive technique for harvesting a deep circumflex iliac artery (DCIA) flap for jaw reconstruction using virtual surgical planning and 3D printed surgical guides. Virtual planning based on CT scans allows for precise preoperative design of the bone flap and surgical guide. The guide enables a medial approach to the pelvis to harvest the flap, preserving important anatomical structures and muscles to reduce donor site morbidity. Initial results found the new technique allowed for shorter recovery times and less complaints about walking or hip profile changes compared to standard approaches.
This study analyzed the three-dimensional morphology of ears in 240 Caucasian volunteers aged 21-65. 3D scans were taken and distances, angles, and proportions between landmarks on the ears were measured. The results showed that the distance between the subaurale and superaurale, as well as the width of the ear, significantly increased with age. The lower quadrant of the ear extended the most with increasing age. The ear continues changing shape in adulthood even after body growth stops. These measurements can help surgeons plan operations to achieve aesthetic outcomes for patients of different ages.
This study assessed parental risk factors for cleft lip and palate (CL/P) in 187 children with CL/P and 190 non-cleft children. The study found that family history of clefts, lack of folic acid consumption during pregnancy, and consanguineous marriage were strongly associated with increased risk of a child being born with CL/P. Children with CL/P also had significantly higher rates of other congenital abnormalities and physical problems compared to non-cleft children. The findings suggest expecting mothers with a family history of CL/P or who engage in consanguineous marriages should take extra precautions to prevent CL/P in their children.
2016 wahl-immunotherapy with imiquimod and interferon alfa for metastasized m...Klinikum Lippe GmbH
1) The document describes the case of a 90-year-old woman with metastatic Merkel cell carcinoma (MCC) that was treated with a combination of local and systemic immunotherapy.
2) Treatment included weekly intralesional injections of interferon alfa-2a along with topical imiquimod cream 3 times per week, as well as subcutaneous injections of pegylated interferon alfa-2b.
3) This combination led to the regression of all cutaneous metastases and lymph node metastases within 4 months, and the patient remained alive 30 months after starting immunotherapy, suggesting locally metastasized MCC can be controlled with local and systemic immunotherapy.
1) The study examined the effect of using acellular dermal grafts in combination with Z-plasty technique for secondary cleft lip deformities.
2) 18 patients underwent scar revision, submucosal tunneling, Z-plasty, and placement of an acellular dermal graft.
3) Quantitative measurements before and after surgery found significant improvements in symmetry, defect height, and lip thickness, indicating acellular dermal grafts with Z-plasty can effectively treat secondary cleft lip deformities.
This document describes a technique for reconstructing full-thickness defects of the lower third of the nose using a three-layer approach. A reversed nasolabial flap is used to reconstruct the nasal lining, an auricular cartilage graft provides structural support, and a forehead flap provides skin coverage. The technique was used in 21 patients and resulted in satisfactory aesthetic and functional outcomes in most cases. Combined flaps from local and distant sites incorporating cartilage can effectively reconstruct large nasal defects while restoring the three anatomical layers.
2016 heinz-two-step reconstruction of non-marginal auricular defectsKlinikum Lippe GmbH
This document describes a two-step surgical technique for reconstructing non-marginal full-thickness defects of the auricle. In the first step, tissue from the preauricular and retroauricular regions is used to reconstruct the anterior and posterior surfaces of the auricle defect. In the second step, performed two weeks later, the tissue pedicles are separated and adjusted. Thirteen patients underwent this procedure with excellent esthetic outcomes, low morbidity, and patient satisfaction. Vertical and horizontal dimensions of the reconstructed auricles changed minimally. The two-step technique provides an improved method for reconstructing central auricle defects.
This study compared the clinically usable bone regions of the ilium and fibula for mandible reconstruction. Measurements were taken of 241 ilia, 91 mandibles, and 60 fibulas. The ilium offered a similar total usable bone length to the fibula but maintained a more constant bone thickness throughout, whereas the fibula's dimensions varied significantly. In some fibulas, only a small portion of the total bone length could actually be used. The study suggests the ilium may be a better donor site than the fibula, especially for women requiring occlusal rehabilitation after mandible reconstruction.
This study compared outcomes of 86 patients who underwent reconstruction of facial soft tissue defects following tumor excision using various surgical techniques, including non-vascularised skin grafts, local flaps, a modified face-lift technique, and microvascular free flaps. The face-lift technique resulted in shorter hospital stays and lower rates of ectropion than other methods for defects under 60 cm2. It provided the best aesthetic outcomes but was limited to smaller defects. Microvascular free flaps were necessary for the largest defects over 60 cm2 due to the amount of tissue needed.
2015 heinz-repairing a non-marginal full-thickness auricular defect using a r...Klinikum Lippe GmbH
This document describes a surgical technique using an anterior pedicled retroauricular flap (APRF) to reconstruct full-thickness defects of the central non-marginal area of the ear. The APRF is harvested from the postauricular skin in two stages and used to reconstruct both the posterior and anterior surfaces of the defect. The procedure was performed successfully in 11 patients to repair conchal defects, with good aesthetic outcomes, minimal donor site morbidity, and high patient satisfaction. The APRF provides an effective method to reconstruct central ear defects while maintaining ear size and shape with minimal stress on the flap.
This document discusses the use of techniques from aesthetic rhinoplasty in reconstructive nasal surgery after tumor resection. The authors used osteotomy and tip shaping techniques in 17 patients to reshape the nasal framework after removing underlying bone or cartilage. This increased the margin of safety and reduced the size of the defect, allowing tension-free primary closure with local tissue flaps. Patients were satisfied with the aesthetic and functional outcomes. The techniques require knowledge of procedures from aesthetic rhinoplasty but can improve reconstruction results.
“Psychiatry and the Humanities”: An Innovative Course at the University of Mo...Université de Montréal
“Psychiatry and the Humanities”: An Innovative Course at the University of Montreal Expanding the medical model to embrace the humanities. Link: https://www.psychiatrictimes.com/view/-psychiatry-and-the-humanities-an-innovative-course-at-the-university-of-montreal
Osvaldo Bernardo Muchanga-GASTROINTESTINAL INFECTIONS AND GASTRITIS-2024.pdfOsvaldo Bernardo Muchanga
GASTROINTESTINAL INFECTIONS AND GASTRITIS
Osvaldo Bernardo Muchanga
Gastrointestinal Infections
GASTROINTESTINAL INFECTIONS result from the ingestion of pathogens that cause infections at the level of this tract, generally being transmitted by food, water and hands contaminated by microorganisms such as E. coli, Salmonella, Shigella, Vibrio cholerae, Campylobacter, Staphylococcus, Rotavirus among others that are generally contained in feces, thus configuring a FECAL-ORAL type of transmission.
Among the factors that lead to the occurrence of gastrointestinal infections are the hygienic and sanitary deficiencies that characterize our markets and other places where raw or cooked food is sold, poor environmental sanitation in communities, deficiencies in water treatment (or in the process of its plumbing), risky hygienic-sanitary habits (not washing hands after major and/or minor needs), among others.
These are generally consequences (signs and symptoms) resulting from gastrointestinal infections: diarrhea, vomiting, fever and malaise, among others.
The treatment consists of replacing lost liquids and electrolytes (drinking drinking water and other recommended liquids, including consumption of juicy fruits such as papayas, apples, pears, among others that contain water in their composition).
To prevent this, it is necessary to promote health education, improve the hygienic-sanitary conditions of markets and communities in general as a way of promoting, preserving and prolonging PUBLIC HEALTH.
Gastritis and Gastric Health
Gastric Health is one of the most relevant concerns in human health, with gastrointestinal infections being among the main illnesses that affect humans.
Among gastric problems, we have GASTRITIS AND GASTRIC ULCERS as the main public health problems. Gastritis and gastric ulcers normally result from inflammation and corrosion of the walls of the stomach (gastric mucosa) and are generally associated (caused) by the bacterium Helicobacter pylor, which, according to the literature, this bacterium settles on these walls (of the stomach) and starts to release urease that ends up altering the normal pH of the stomach (acid), which leads to inflammation and corrosion of the mucous membranes and consequent gastritis or ulcers, respectively.
In addition to bacterial infections, gastritis and gastric ulcers are associated with several factors, with emphasis on prolonged fasting, chemical substances including drugs, alcohol, foods with strong seasonings including chilli, which ends up causing inflammation of the stomach walls and/or corrosion. of the same, resulting in the appearance of wounds and consequent gastritis or ulcers, respectively.
Among patients with gastritis and/or ulcers, one of the dilemmas is associated with the foods to consume in order to minimize the sensation of pain and discomfort.
Travel vaccination in Manchester offers comprehensive immunization services for individuals planning international trips. Expert healthcare providers administer vaccines tailored to your destination, ensuring you stay protected against various diseases. Conveniently located clinics and flexible appointment options make it easy to get the necessary shots before your journey. Stay healthy and travel with confidence by getting vaccinated in Manchester. Visit us: www.nxhealthcare.co.uk
Test bank for karp s cell and molecular biology 9th edition by gerald karp.pdfrightmanforbloodline
Test bank for karp s cell and molecular biology 9th edition by gerald karp.pdf
Test bank for karp s cell and molecular biology 9th edition by gerald karp.pdf
Test bank for karp s cell and molecular biology 9th edition by gerald karp.pdf
NAVIGATING THE HORIZONS OF TIME LAPSE EMBRYO MONITORING.pdfRahul Sen
Time-lapse embryo monitoring is an advanced imaging technique used in IVF to continuously observe embryo development. It captures high-resolution images at regular intervals, allowing embryologists to select the most viable embryos for transfer based on detailed growth patterns. This technology enhances embryo selection, potentially increasing pregnancy success rates.
Nano-gold for Cancer Therapy chemistry investigatory projectSIVAVINAYAKPK
chemistry investigatory project
The development of nanogold-based cancer therapy could revolutionize oncology by providing a more targeted, less invasive treatment option. This project contributes to the growing body of research aimed at harnessing nanotechnology for medical applications, paving the way for future clinical trials and potential commercial applications.
Cancer remains one of the leading causes of death worldwide, prompting the need for innovative treatment methods. Nanotechnology offers promising new approaches, including the use of gold nanoparticles (nanogold) for targeted cancer therapy. Nanogold particles possess unique physical and chemical properties that make them suitable for drug delivery, imaging, and photothermal therapy.
How to Control Your Asthma Tips by gokuldas hospital.Gokuldas Hospital
Respiratory issues like asthma are the most sensitive issue that is affecting millions worldwide. It hampers the daily activities leaving the body tired and breathless.
The key to a good grip on asthma is proper knowledge and management strategies. Understanding the patient-specific symptoms and carving out an effective treatment likewise is the best way to keep asthma under control.
STUDIES IN SUPPORT OF SPECIAL POPULATIONS: GERIATRICS E7shruti jagirdar
Unit 4: MRA 103T Regulatory affairs
This guideline is directed principally toward new Molecular Entities that are
likely to have significant use in the elderly, either because the disease intended
to be treated is characteristically a disease of aging ( e.g., Alzheimer's disease) or
because the population to be treated is known to include substantial numbers of
geriatric patients (e.g., hypertension).
- Video recording of this lecture in English language: https://youtu.be/Pt1nA32sdHQ
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Computer in pharmaceutical research and development-Mpharm(Pharmaceutics)MuskanShingari
Statistics- Statistics is the science of collecting, organizing, presenting, analyzing and interpreting numerical data to assist in making more effective decisions.
A statistics is a measure which is used to estimate the population parameter
Parameters-It is used to describe the properties of an entire population.
Examples-Measures of central tendency Dispersion, Variance, Standard Deviation (SD), Absolute Error, Mean Absolute Error (MAE), Eigen Value
2. Please cite this article in press as: Ghassemi M, et al. Effect of maxillary advancement on the change in the soft tissues after treatment of
patients with class III malocclusion. Br J Oral Maxillofac Surg (2015), http://dx.doi.org/10.1016/j.bjoms.2015.06.001
ARTICLE IN PRESSYBJOM-4539; No.of Pages6
2 M. Ghassemi et al. / British Journal of Oral and Maxillofacial Surgery xxx (2015) xxx–xxx
ratios are used by prediction software programs to guide sur-
geons, orthodontists, and patients in making their decisions.
Various studies have evaluated the precision of such compu-
terised programs in predicting the postoperative profile with
allpossiblesurgicaloptions.5–7 Chew8 foundthatmovements
of hard and soft tissue after bimaxillary surgery strongly cor-
related horizontally, but not vertically. However, Marsan et
al9 reported that movements of maxillary and mandibular
soft and hard tissue correlated significantly in both horizon-
tal and vertical directions after bimaxillary surgery. The study
by Enacar et al10 suggested that the soft tissue responses to
two-jaw surgery were similar to those of mandibular setback
alone, with the exception of the changes in projection of the
nasal tip, and the upper lip. Louis et al11 found that in patients
who had maxillary advancement with a Le Fort I osteotomy
but without adjunctive nasal procedures, the superior rotation
of the important soft tissue points occurred with horizon-
tal movement of the maxilla, and the correlation coefficients
showed a small relation between the soft:hard tissue ratios.
There are controversial studies about the amount of max-
illary advancement and the resulting stability,12–14 most of
which show that the mean maxillary advancement was 6 mm.
However, none of these studies discussed the effect of maxil-
lary advancement on the submental region and the soft tissue.
Our aim in the present study was to evaluate whether maxil-
lary advancement of more or less than 6 mm would result in
different changes to the soft tissue, which are critical to the
aesthetic outcome. Based on previous studies12–14 we used
the cutoff of 6 mm for maxillary advancement. The aesthetic
outcome was assessed by the nasolabial angle, the aesthet-
ics of the upper and lower lip, and the cervical length. We
hypothesised that there would be no significant changes in
the aesthetic outcome between the 2 groups.
Patients and methods
We retrospectively studied 53 patients with skeletal Class III
malocclusion (29 women and 24 men, mean (SD) age 28
(11) years) who were selected from the patients treated in
our department between 1 January 2002 and 30 December
2012.
All the patients met the inclusion criteria of a Wits
appraisal of < 0◦, 15 and Le Fort I advancement. No addi-
tional operations were done. Patients with cleft lip and palate
and other congenital craniofacial anomalies were excluded.
Standard lateral cephalograms were available for only 48
patients, and we divided these into 2 groups based on the
amount of their maxillary advancement. The first included
28 patients (13 women and 15 men) in whom it was less
than 6 mm, and the second comprised 20 patients (14 women
and 6 men) in whom it was 6 mm or more. Preoperative
cephalograms were taken before the orthodontic treatment,
and the postoperative films 6 months later, to ensure that
postoperative swelling did not mask actual changes in the
soft tissue. All radiographs were taken with the teeth in
centric occlusion and the lips in repose. The cephalograms
were digitised using ONYX software (OnyxCeph Version
2.7.8, Image Instruments, Chemnitz, Germany) by one expe-
rienced examiner.
The landmarks measured included gonion angle, Wits
appraisal, upper 1 inclination, lower lip to E-line, nasolabial
angle, soft tissue facial angle, prominence of the nose, thick-
ness and length of the upper lip, length of the lower lip,
cervical length, lip-chin-throat angle, and upper lip to E-line
(Fig. 1).
The reliability of the measurements was confirmed by
randomly selecting 15 cephalograms before and after oper-
ation. The cephalograms were measured a second time by 2
other investigators unaware of the previous result. The SD of
the error of each measurement was calculated by Dahlberg’s
formula16 (
√
D2 /2N), where D is the difference between
the first and the second measurement and N is the number
of double measurements. The “values of error” study were
within acceptable limits (less than 1 mm) (Table 1).
Because of the limited sample size and the observational
character of our study, we have restricted our statistical
evaluation to an independent samples t test. To assess the
significance of the difference between the two groups (<
6 mm compared with 6 mm or more), an independent sam-
plesttestassuminginhomogeneityofvariancewasused.This
causes adjusted degrees of freedom (df) for the t distribution
according to Satterthwaite (Table 2). To assess the different
distributions of the two groups by sex, we used Fisher’s exact
test (Table 2).
Results
The 48 eligible patients who underwent orthodontic and
orthognathic treatment for Class III malocclusion had a mean
(SD) maxillary advancement of 5.4 (3.1) mm, and the posi-
tion of the maxilla was changed by a maximum of 12.7 mm
and a minimum of 3.8 mm.
The soft tissue balance differed significantly relative to
differences in the change at point A between patients with
<6 mm advancement and those in whom it was 6 mm or
more(p= 0.0001). The Wits appraisal also changed signifi-
cantly in the two groups. The mean (SD) distance of the upper
lip changed by 2.3 (2.2) mm in the less than 6 mm group and
by 5.9 (3.2) mm in the 6 mm or more group.
The distance of the lower lip to the aesthetic line
also changed significantly depending on the advancement
(p=0.0072). In patients in whom it was less than 6 mm, the
mean (SD) difference was -0.88 (9.7) mm, and in patients in
whom it was 6 mm or more it was 9 (15.3) mm. The cervi-
cal length also differed significantly (p=0.001) between the
2 groups (Table 2).
The prominence of the nose changed significantly in the 2
groups (0.005). The mean (SD) change of the lip-chin-throat
angle was 0.9 (9.8)◦ in the less than 6 mm group. When the
movement was 6 mm or more, the change was 3.95 (15.5)◦.
3. Please cite this article in press as: Ghassemi M, et al. Effect of maxillary advancement on the change in the soft tissues after treatment of
patients with class III malocclusion. Br J Oral Maxillofac Surg (2015), http://dx.doi.org/10.1016/j.bjoms.2015.06.001
ARTICLE IN PRESSYBJOM-4539; No.of Pages6
M. Ghassemi et al. / British Journal of Oral and Maxillofacial Surgery xxx (2015) xxx–xxx 3
Fig. 1. Tracing of hard and soft tissue (gonion angle, mandibular inclination, upper 1inclination, lower lip to E-line, nasolabial angle, soft tissue facial angle,
nose prominence, upper lip thickness, upper lip length, lower lip length, cervical length, lip chin throat angle, facial contour, and upper lip to E-line).
These changes were significantly associated with the baseline
measurement and the horizontal skeletal change (p= 0.015).
Changes in the gonion angle are shown in Table 2. There
is no significant difference between the A point changes and
the gonion angle between the 2 groups (p=0.984). The mean
(SD) change in the soft tissue facial angle in patients with
<6 mm was - 0.55 (2.5)◦ and in patients with 6 mm or more
advancement - 0.90 (3.3)◦. There was no significant change
4. Please cite this article in press as: Ghassemi M, et al. Effect of maxillary advancement on the change in the soft tissues after treatment of
patients with class III malocclusion. Br J Oral Maxillofac Surg (2015), http://dx.doi.org/10.1016/j.bjoms.2015.06.001
ARTICLE IN PRESSYBJOM-4539; No.of Pages6
4 M. Ghassemi et al. / British Journal of Oral and Maxillofacial Surgery xxx (2015) xxx–xxx
Table 1
Mean (SD) values of selected cephalometric variables before and after oper-
ation with.
Variables Preoperatively Postoperatively Dahlberg’s
SD of error
SNA (◦) 78(4.9) 83(4.6) 0.8
SNB (◦) 81(4. 49) 80.5 (3.45) 0.79
Wits appraisal (mm) -9.5 (4 .23) -3.0(2.86) 0.75
Gonion angle (◦) 127.5(8.69) 128(8.19) 0.69
Maxillary
inclination (◦)
34.61 (6.8) 34.76(6.44) 0.78
Upper 1 inclination
(◦)
105.61 (7.61) 104.88(5.80) 0.81
Lower lip to E-line
(mm)
-8.3 (3.3) -5.7 (3.7) 0.51
Nasolabial angle -2.5 (3.3) -3.4 (3) 0.78
Soft tissue facial
angle
110(12.5) 100.6 (12.2) 0.8
Upper lip thickness
(mm)
18.2 (3.5) 16.5 (3.3) 0.51
Pg’ (mm) 13(3) 13(4) 0.7
Upper lip length
(mm)
21.9 (4.3) 23.7 (4.4) 0.4
Lower lip length
(mm)
46.5 (7.5) 48.1 (6.1) 0.6
Cervical length
(mm)
50.6 (10) 47.9 (10) 0.72
Lip-chin-throat
angle
50.6 (10) 47.9 (10) 0.77
Upper lip to E-line
(mm)
-8.3 (3.3) -5.7 (3.7) 0.74
Dahlberg’s SD of error for each variable.
of the soft tissue facial angle in the 2 groups (p=0.686)
(Table 2).
The mean (SD) change in the thickness of the upper lip
was an anterior movement of - 0.9 (3.5) in patients with a
<6 mm advancement and -2.6 (3.7) in patients in whom it
was 6 mm or more. This was not significant (p=0.129). The
length of the lower lip did not change significantly in relation
to the degree of advancement (p=0.418), and neither did the
length of the upper lip (p=0.634) (Table 2).
Discussion
The modern treatment of orthognathic deformities requires
planning of treatment by the orthodontist and the orthog-
nathic surgeon together, and should be initiated at the
patient’s first presentation. The aesthetic outcome is impor-
tant, and the possible change in the soft tissues as a result
of changes in the hard tissue should be considered during
planning. How to achieve optimal facial aesthetics has inter-
ested many research workers from different disciplines,17
as it influences the social and psychological development
of patients and can have an important role in their interper-
sonal relationships.18,19 Many factors such as nose, lips, chin,
and cervical length have a fundamental influence on the aes-
thetic outcome. Ho et al.,20 showed that the chin is a key
aesthetic unit that contributes to the balance and harmony of
the lower third of the face. The lip-chin-throat angle and the
cervical length are also important in aesthetics and should
be considered at the same time. However, the change in the
lip-chin-throat angle that depends on the degree of maxil-
lary advancement has not often been taken into account in
previous publications.21
The main purpose of this study was to find out what effect
maxillary advancement had on the nasolabial area, the aes-
thetics of the lip, and the submental region. It should be noted
that various types of bias can affect observational studies. We
had no performance bias because we used the same surgical
methods, whereas attrition bias was present.
In general, it is difficult to assess the degree of bias in the
study results. Of course the randomisation of patients to the
extent of maxillary advancement is not possible. To validate
the measurements (which may show considerable variation)
Table 2
Mean (SD) soft tissue cephalometric index in relation to amount of maxillary advancement (t test for inhomogeneous variances), comparison of groups within
sex (Fisher’s exact test).
Mean (SD) differences:
maxillary advancement
< 6 mm (n=28)
Mean (SD) differences:
maxillary advancement
6 mm or more (n=20)
(t) (df) p Value
Sex (F/M) 13 / 15 14/6 -0.35 0.725
Age (years) 30.42 (11.59) 28.80(8.96) 0.55 (45.65) 0.586
Gonion angle 0.48 (5.33) 0.45 (5.28) 0.02 (41.31) 0.984
Wits appraisal (◦) 4.8 (3.01) 8.5 (4.4) -3.18 (31.51) 0.003
Upper 1 inclination (◦) -2.07(7.2) 0.15 (6.33) -1.12 (43.63) 0.268
Lower lip to E-line (mm) 0.18 (2.6) 2.25 (2.35) -2.82 (43.29) 0.007
Nasolabial angle -5.44 (8.45) -5.6 (10.27) .06 (36.19) 0.954
Soft tissue facial angle -.55 (2.50) -0.90 (3.32) 0.39 (33.92) 0.699
Nose prominence -1.29 (2.30) -3.10 (1.83) 2.99 (44.72) 0.005
Upper lip thickness (mm) -0.88 (3.46) -2.55 (3.74) 1.55 (39.21) 0.129
Upper lip length (mm) 1.22 (2.62) 1.75 (4.86) -0.44 (27.13) 0.634
Lower lip length (mm) -0.62 (4.1) -2.05 (6.87) 0.88 (28.92) 0.418
Cervical length (mm) -1.00 (5.6) 4.10 (4.49) -3.43(44.77) 0.001
Lip chin throat angle 7.00 (2.12) 10.16 (10) -2.55(24.73) 0.015
Upper lip to E-line (mm) 2.29 (2.16) 5.9 (3.17) -4.38(31.56) 0.0001
5. Please cite this article in press as: Ghassemi M, et al. Effect of maxillary advancement on the change in the soft tissues after treatment of
patients with class III malocclusion. Br J Oral Maxillofac Surg (2015), http://dx.doi.org/10.1016/j.bjoms.2015.06.001
ARTICLE IN PRESSYBJOM-4539; No.of Pages6
M. Ghassemi et al. / British Journal of Oral and Maxillofacial Surgery xxx (2015) xxx–xxx 5
Fig. 2. Tracing of hard and soft tissue before and after maxillary advance-
ment of more than 6 mm.
we calculated the SD of error using Dahlberg’s formula.16
Because of the limited size of the sample we were not able
to account for confounding variables by doing a multivariate
analysis. However, compared with other studies20 our well-
defined sample enrolled over such a long period makes it an
important clinical group.
Cervical length is important because of the possibility
of creating a double chin, which is aesthetically unpleas-
ant. In our study the only operation done was maxillary
advancement. As other studies have shown, the mandible
moves forward after the anterior and cranial movement of
the maxilla.22 However, one of our goals was to show
the relation between the change in the cervical length and
the lower lip on the one hand, and the degree of maxil-
lary movement on the other. Fig. 2 shows the influence of
maxillary advancement on the cervical length and the aes-
thetics of the lower lip. The preoperative cervical length
was similar in both groups, whereas postoperatively it
clearly increased in the group with advancement of 6 mm or
more.
There were significant changes in the lip-chin-throat angle
in the 2 groups. The mean (SD) change was 7.0(2.1)◦ if the
maxilla was advanced less than 6 mm, and 10.2 (4.5)◦ if the
advancement was 6 mm or more (Table 2).
Modern treatment of Class III deformity consists of max-
illary advancement and mandibular setback, and the amount
of repositioning of any jaw can influence its functional, aes-
thetic, and long-term stability. Lim et al19 pointed out that
the impact of changes in the soft tissue after mandibular set-
back were more in the lower lip and chin than in the upper
lip and corner of the mouth. The generation of a double chin
should be considered, depending on the amount of movement
of the jaw, and the treatment should not be based purely on
the findings of the cephalogram.
Until 2005, our correction of Class III malocclusion was
focused primarily on mandibular setback (as far as possi-
ble) and advancing the maxilla to compensate for the rest.
The main rationale for planning treatment was the cephalo-
graphic findings. We increasingly adapted the amount of
movement of the jaw to the anatomical findings and the
actual deformity on the one hand, but aimed for optimum
aesthetic and functional outcome on the other. We adapted
the amount of movement of the jaw individually, not only
based on the cephalograms. As suggested by Arnett et al,17
we should consider a combination of clinical, facial, and soft
tissue cephalometry as effective guidance to the treatment
not only of occlusion but also the face in three dimensions,
so improving the aesthetic outcome. We also considered the
shape and the size of the nose, the nasolabial angle, the
chin, and the cervical region. Our study has clearly shown
the improving effect of maxillary advancement on submental
aesthetics. Many recent studies have suggested bimaxillary
surgery as the best option for Class III deformity for different
reasons.21
One reason is an appreciable increase in the width of the
airway postoperatively, which is beneficial to the patient,
whereas the opposite could prove detrimental. We think that
if this fact is ignored in planning treatment, it will also
result in an undesired effect on the submental region, which
may require additional procedures such as liposuction.17
A double-jaw operation increases the amount of maxillary
advancement and will reduce the need for extensive mandibu-
lar setback. Reduced mandibular setback can influence the
aesthetic and functional outcome, as shown in this and other
studies, by respecting anatomical feasibility. This has also
been shown to give better long-term stability. 22–24 However,
we need greater scope to show the long-term stability in these
2 different groups.
Conflict of Interest
We have no conflict of interest.
Ethics statement and confirmation of patients’
permission
Not required.
6. Please cite this article in press as: Ghassemi M, et al. Effect of maxillary advancement on the change in the soft tissues after treatment of
patients with class III malocclusion. Br J Oral Maxillofac Surg (2015), http://dx.doi.org/10.1016/j.bjoms.2015.06.001
ARTICLE IN PRESSYBJOM-4539; No.of Pages6
6 M. Ghassemi et al. / British Journal of Oral and Maxillofacial Surgery xxx (2015) xxx–xxx
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