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November, 2024
Vol.54 No.6
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Abstract : Objective: To investigate sex-specific correlations between the dimensions of permanent canines and the anterior Bolton ratio and to construct a statistical model capable of identifying the sex of an unknown subject. Methods: Odontometric data were collected from 121 plaster study models derived from Caucasian orthodontic patients aged 12–17 years at the pretreatment stage by measuring the dimensions of the permanent canines and Bolton's anterior ratio. Sixteen variables were collected for each subject: 12 dimensions of the permanent canines, sex, age, anterior Bolton ratio, and Angle’s classification. Data were analyzed using inferential statistics, principal component analysis, and artificial neural network modeling. Results: Sex-specific differences were identified in all odontometric variables, and an artificial neural network model was prepared that used odontometric variables for predicting the sex of the participants with an accuracy of > 80%. This model can be applied for forensic purposes, and its accuracy can be further improved by adding data collected from new subjects or adding new variables for existing subjects. The improvement in the accuracy of the model was demonstrated by an increase in the percentage of accurate predictions from 72.0–78.1% to 77.8–85.7% after the anterior Bolton ratio and age were added. Conclusions: The described artificial neural network model combines forensic dentistry and orthodontics to improve subject recognition by expanding the initial space of odontometric variables and adding orthodontic parameters.
Abstract : Objective: Surgically assisted maxillary protraction is an alternative protocol in severe Class III cases or after the adolescent growth spurt involving increased maxillary advancement. Correction of the maxillary deficiency has been suggested to improve pharyngeal airway dimensions. Therefore, this retrospective study aimed to analyze the airway changes cephalometrically following surgically assisted maxillary protraction with skeletal anchorage and Class III elastics. Methods: The study population consisted of 15 Class III patients treated with surgically assisted maxillary protraction combined with skeletal anchorage and Class III elastics (mean age: 12.9 ± 1.2 years). Growth changes were initially assessed for a mean of 5.5 ± 1.6 months prior to treatment. Airway and skeletal changes in the control (T0), pre-protraction (T1), post-protraction (T2), and follow-up (T3) periods were monitored and compared using lateral cephalometric radiographs. Statistical significance was set at p < 0.05. Results: The skeletal or airway parameters showed no statistically significant changes during the control period. Sella to nasion angle, N perpendicular to A, Point A to Point B angle, and Frankfort plane to mandibular plane angle increased significantly during the maxillary protraction period (p < 0.05), but no significant changes were observed in airway parameters (p > 0.05). No statistically significant changes were observed in the airway parameters in the follow-up period either. However, Sella to Gonion distance increased significantly (p < 0.05) during the follow-up period. Conclusions: No significant changes in pharyngeal airway parameters were found during the control, maxillary protraction, and follow-up periods. Moreover, the significant increases in the skeletal parameters during maxillary protraction were maintained in the long-term.
Abstract : Objective: This study aimed to investigate the effects of archwire form and power arm positions on maxillary incisors during lingual en masse retraction supported by miniscrew implants, using the finite element analysis method. Methods: Sliding mechanics for lingual en masse retraction were simulated using the finite element method. Power arms were placed mesial and distal to the maxillary canine with straight and mushroom-shaped archwires. Miniscrews provided absolute anchorage for retraction force. Results: When power arms were positioned mesial to the canine teeth, an increase in the intercanine distance was observed, while a decrease was noted when the power arms were distal to the canine tooth. Lateral incisors exhibited a greater torque loss, particularly when the power arm was mesial to the canine tooth. In the central incisors, the mushroom archwire resulted in intrusion, while the straight archwire showed an extrusion tendency. Movements in groups using the straight archwire were less controlled compared to those in groups using the mushroom archwire. Conclusions: The archwire form and the position of the power arm affected the torque loss and vertical position of incisors during lingual en masse retraction supported by miniscrew implants. The most controlled movement was achieved with the combination of a power arm positioned distal to the canine tooth and a mushroom archform.
Abstract : Objective: The study aimed to evaluate the changes in mandibular width after sagittal split ramus osteotomy (SSRO) in patients with mandibular asymmetric prognathism using cone-beam computed tomography (CBCT). Methods: Seventy patients who underwent SSRO for mandibular setback surgery were included in two groups, symmetric (n = 35) and asymmetric (n = 35), which were divided according to the differences in their right and left setback amounts. The mandibular width was evaluated three-dimensionally using CBCT images taken immediately before surgery (T1), 3 days after surgery (T2), and 6 months after surgery (T3). Repeated measures analysis of variance was applied to verify the differences in mandibular width statistically. Results: Both groups showed a significant increase in the mandibular width at T2, followed by a significant decrease at T3. No significant difference was observed between T1 and T3 in any of the measurements. No significant differences were found between the two groups (p > 0.05). Conclusions: After mandibular asymmetric setback surgery using SSRO, the mandibular width increased immediately but returned to its original width 6 months after surgery.
Abstract : Objective: To determine the correlation between dentoskeletal parameters related to craniofacial morphology and the upper airway (UA) volume. Methods: Cone-beam computed tomography images of 106 randomly selected orthodontic patients were analyzed using NemoFab Ortho software. The dentoskeletal variables assessed were anterior facial height (AFH), posterior facial height (PFH), PFH/AFH ratio, hyoid position, maxillary width (MW), and palatal depth. The UA volume (evaluation in anatomical regions and as a whole) was also assessed using the same software. We also evaluated potential differences in UA variables between age and sex groups. The correlation between the dentoskeletal parameters and UA volume was calculated using the Pearson correlation coefficient (R). Analysis of variance and Student’s t test were performed to assess differences between age and sex for UA variables. Statistical analyses were performed using SPSS software (version 26 for Windows). Results: This study found that PFH, AFH, and MW were the dentoskeletal parameters most strongly correlated with UA volume. However, the ANB angle did not show any significant correlation with UA volume. Additionally, differences in UA volumes were observed between age groups. Sex differences were found in both the “8–12” and “≥ 16” age groups for oropharyngeal and pharyngeal volumes. Conclusions: In conclusion, our findings indicate a significant correlation between UA volume and dentoskeletal parameters, particularly those related to facial height and MW.
Abstract : Objective: A three-dimensional-printed individual titanium plate was applied for maxillary protraction to eliminate side effects and obtain the maximum skeletal effect. This study aimed to explore the stress distribution characteristics of sutures during maxillary protraction using individual titanium plates in various directions and locations. Methods: A protraction force of 500 g per side was applied at forward and downward angles between 0° and 60° with respect to the Frankfort horizontal plane, after which the titanium plate was moved 2 and 4 mm upward and downward, respectively. Changes in sutures with multiple protraction directions and various miniplate heights were quantified to analyze their impact on the maxillofacial bone. Results: Protraction angle of 0–30° with respect to the Frankfort horizontal plane exhibited a tendency for counterclockwise rotation in the maxilla. At a 40° protraction angle, translational motion was observed in the maxilla, whereas protraction angles of 50–60° tended to induce clockwise rotation in the maxilla. Enhanced protraction efficiency at the lower edge of the pyriform aperture was associated with increased height of individual titanium plates. Conclusions: Various protraction directions are suitable for patients with different types of vertical bone surfaces. Furthermore, when the titanium plate was positioned lower, the protraction force exhibited an increase.
Abstract : Objective: The number of three-piece maxillary osteotomies has increased over the years; however, the literature remains controversial. The objective of this study was to evaluate the skeletal stability of this surgical modality compared with that of one-piece maxillary osteotomy. Methods: This retrospective cohort study included 39 individuals who underwent Le Fort I maxillary osteotomies and were divided into two groups: group 1 (three pieces, n = 22) and group 2 (one piece, n = 17). Three cone-beam computed tomography scans from each patient (T1, pre-surgical; T2, post-surgical; and T3, follow-up) were used to evaluate the three-dimensional skeletal changes. Results: The differences within groups were statistically significant only for group 1 in terms of surgical changes (T2-T1) with a mean difference in the canine region of 3.09 mm and the posterior region of 3.08 mm. No significant differences in surgical stability were identified between or within the groups. The mean values of the differences between groups were 0.05 mm (posterior region) and –0.39 mm (canine region). Conclusions: Our findings suggest that one- and three-piece maxillary osteotomies result in similar post-surgical skeletal stability.
Abstract : Objective: To evaluate tooth displacement and periodontal stress generated by the dual action vertical intra-arch technique (DAVIT) for open-bite correction using three-dimensional finite element analysis. Methods: A three-dimensional model of the maxilla was created by modeling the cortical bone, cancellous bone, periodontal ligament, and teeth from the second molar to the central incisor of a hemiarch. All orthodontic devices were designed using specific software to reproduce their morpho-dimensional characteristics, and their physical properties were determined using Young’s modulus and Poisson’s coefficient of each material. A linear static simulation was performed to analyze the tooth displacements (mm) and maximum stresses (Mpa) induced in the periodontal ligament by the posterior intrusion and anterior extrusion forces generated by the DAVIT. Results: The first and second molars showed the greatest intrusion, whereas the canines and lateral incisors showed the greatest extrusion displacement. A neutral zone of displacement corresponding to the fulcrum of occlusal plane rotation was observed in the premolar region. Buccal tipping of the molars and lingual tipping of the anterior teeth occurred with intrusion and extrusion, respectively. Posterior intrusion generated compressive stress at the apex of the buccal roots and furcation of the molars, while anterior extrusion generated tensile stress at the apex and apical third of the palatal root surface of the incisors and canines. Conclusions: DAVIT mechanics produced a set of beneficial effects for open-bite correction, including molar intrusion, extrusion and palatal tipping of the anterior teeth, and occlusal plane rotation with posterior teeth uprighting.
Abstract : Objective: To determine whether the gonial angle on digital panoramic radiographs is associated with vitamin D receptor (VDR) Taql polymorphism. Methods: Genomic DNA samples were collected from the buccal mucosa of patients aged 26–43 years. TaqMan assay for single nucleotide polymorphism genotyping was used to detect the genotype of Taql polymorphism. The gonial angle was measured bilaterally on panoramic radiography. The normal gonial angle was fixed as 121.8°, and it represented the cutoff value for the high gonial angle (HGA) and low gonial angle (LGA) groups. Various genetic models were analyzed, namely dominant (homozygous [AA] vs. heterozygous [AG] + polymorphic [GG]), recessive (AA + AG vs. GG), and additive (AA + GG vs. AG), using the chi-squared test. Results: The reliability of the gonial angle measurement was analyzed using a random sample (26%) of the tests, with the intra-examiner correlation showing an intra-class correlation coefficient of 0.99. The frequencies of the AA, AG, and GG genotypes of rs731236 polymorphism were 40.5%, 41.9%, and 17.6% in the HGA group and 21.8%, 51.0%, and 27.2% in the LGA group, respectively (P = 0.042). A statistically significant difference was observed in the allele frequencies between the two groups (P = 0.011). Moreover, a significant correlation was observed in the dominant genetic model. Conclusions: Taql polymorphism in the VDR gene plays a critical role in the vertical growth of the mandible and decreased gonial angle.