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Objectives: This study aimed to evaluate the position of the mandibular lingula (ML) in adult patients (aged between 18 and 35 years old) with different skeletal and growth patterns using cone‐beam computed tomography (CBCT). Design: Cross‐sectional. Setting: Dentistry department of University. Subjects: Subjects comprised CBCT images of 150 adult patients, including 300 rami. Methods and Materials: In total, 150 CBCT aged between 18 and 35 were selected and divided into three main groups of 50 samples based on their skeletal relationships (classes I, II and III). Patients were subdivided based on their growth pattern (vertical vs. horizontal), resulting in 25 samples per subgroup. Distances between the mandibular lingula and occlusal plane (ML‐OP), sigmoid notch (ML‐SN), external oblique ridge (ML‐EOR), internal oblique ridge (ML‐IOR), posterior border of the ramus (ML‐PBR), inferior border of the ramus (ML‐IBR), and horizontal and vertical distances to the mandibular foramen (ML‐hMF and ML‐vMF). One‐way ANOVA variance analysis was employed to compare different angle classifications, and Bonferroni analysis was used for multiple comparisons. The Student's t‐test was also used to compare growth patterns within each main group and genders within the subgroup. Results: The study revealed statistically significant differences in the position of the mandibular lingula between different angle classifications, growth patterns, and genders. Class II samples showed a more anterior position of the ML, whereas Class III samples displayed a more posterior position of the ML. Patients with horizontal growth patterns and Angle Class III had a more posteriorly positioned ML. Gender differences were observed, particularly in Class I and Class III classifications, suggesting that gender may influence the variability of ML position in these specific classifications. Conclusion: The position of the mandibular lingula showed high variability among individuals with different angle classifications, growth patterns and genders. [ABSTRACT FROM AUTHOR]

The integration of 3D printing technology in maxillofacial surgery in Iran represents a significant advancement in medical practice, offering unprecedented precision and efficiency in surgical procedures. Employing the Non-Adoption, Abandonment, Scale-Up, Spread, and Sustainability (NASSS) framework and the WHO Health Systems Framework, this study analyzes the complex impact and challenges of 3D printing adoption within the Iranian healthcare sector. Maxillofacial surgery has seen transformative progress with 3D printing's ability to produce accurate surgical models and customized implants. The results indicate a notable improvement in surgical precision and patient recovery times, alongside combatting identified barriers including technological access, cost, and skill acquisition. This conclusion underscores the critical need for targeted educational programs, policy support, and infrastructure development to overcome these obstacles. This paper highlights 3D printing's potential to revolutionize maxillofacial surgery in Iran, provided that comprehensive strategies are implemented to address the current limitations and fully leverage this innovative technology's benefits. [ABSTRACT FROM AUTHOR]

Objectives: Several meta-analyses have suggested the beneficial effect of vitamin D on patients infected with severe acute respiratory syndrome coronavirus-2. This umbrella meta-analysis aims to evaluate influence of vitamin D supplementation on clinical outcomes and the mortality rate of COVID-19 patients. Design: Present study was designed as an umbrella meta-analysis. The following international databases were systematically searched till March 2023: Web of Science, PubMed, Scopus, and Embase. Settings: Random-effects model was employed to perform meta-analysis. Using AMSTAR critical evaluation tools, the methodological quality of the included meta-analyses was evaluated. Participants: Adult patients suffering from COVID-19 were studied. Results: Overall, 13 meta-analyses summarising data from 4 randomised controlled trial and 9 observational studies were identified in this umbrella review. Our findings revealed that vitamin D supplementation and status significantly reduced mortality of COVID-19 [Interventional studies: (ES = 0·42; 95 % CI: 0·10, 0·75, P < 0·001; I 2 = 20·4 %, P = 0·285) and observational studies (ES = 1·99; 95 % CI: 1·37, 2·62, P < 0·001; I 2 = 00·0 %, P = 0·944). Also, vitamin D deficiency increased the risk of infection and disease severity among patients. Conclusion: Overall, vitamin D status is a critical factor influencing the mortality rate, disease severity, admission to intensive care unit and being detached from mechanical ventilation. It is vital to monitor the vitamin D status in all patients with critical conditions including COVID patients. [ABSTRACT FROM AUTHOR]

Background and Aim: The accuracy of the virtually-designed 3D-printed surgical splints requires investigation for the practical use of surgical plan in the operating room. This study aimed to compare the validity of the 3D-printed and the conventional intermediate splints and evaluate the outcomes after the surgical application of the 3D-printed splint compared with the predicted values. Methods: In this study, ten patients with dentofacial deformity were recruited. Participants were analyzed by the conventional surgical planning and virtual surgical planning. The intermediate surgical splints were created by the conventional and 3D-printing methods. Maxillary movements in 3 spatial directions were measured in an articulator after the application of both splints. Correlation and agreement between the two methods were tested by intraclass correlation coefficient (ICC). After the confirmation of 3D printed splint validity for each patient, the surgery was performed using 3D printed splints. It is assumed that ideally cephalometric prediction values are going to be obtained using conventional acrylic splints (gold standard). So, as a second objective, the outcome of the surgically-applied 3D-printed splint was evaluated and compared with the predicted values and finally analyzed by the paired t-test. Results: Based on the observations, there was an excellent agreement between the virtually-designed 3D-printed and conventional intermediate surgical splints (ICC ranged between 0.83 and 0.99 for linear values). There was a good cumulative agreement of ICC greater than 0.80. Overall, the mean linear measurements were not different between conventional and 3D-printed splint on the articulator. Also, there were no significant differences between the linear and angular measurements of 2D-cephalometric prediction and postoperation values. Conclusion: The results showed cautiously the acceptable accuracy of the 3D-printed splints for several parameters in three spatial dimensions within the laboratory and clinical settings. [ABSTRACT FROM AUTHOR]

Background: Rheumatoid Arthritis (RA) is a systemic and chronic autoimmune disease with inflammation at the synovial joints. The purposes of this study were to evaluate the correlation between serological variables and temporomandibular disorders (TMDs) in patients diagnosed with RA, evaluated through diagnostic criteria for temporomandibular disorders (DC/TMD), and to check the influence of comorbidities on the different TMD signs and symptoms, or any serological variables. Methods: This observational cohort research study included seventeen patients affected by RA. The comorbidities and some variables from the initial serological analyses were collected from the clinical rheumatological charts. Then, the presence of any of the following TMD signs/symptoms, temporal myalgia, temporomandibular joint arthralgia, click or crepitus, was evaluated through the symptom questionnaire of the DC/TMD during clinical evaluation following the DC/TMD examination form. Results: Rheumatoid factor (RF), anticitrullinated protein antibodies (ACPA), and anti-nuclear antibody (ANA) positivity were present in 82.4%, 52.9%, and 41.2% of patients, respectively. Indicators of tissue inflammation were evaluated with median values of 21 mm/h for erythrocyte sedimentation rate (ESR) and 0.50 mg/dL for C-reactive protein (CRP). The RA patients presented comorbidities such as hypertension in 70.6% and diabetes in 23.5%. Negative ACPA had a significant association with myalgia (p = 0.03), and positive ANA was significantly associated with crepitus (p = 0.05). Conclusion: ANA and ACPA evaluation can be considered predictive serological tests associated with specific TMDs. Conversely, no influence of any comorbidities was found between different TMD signs and symptoms, or any serological variables. [ABSTRACT FROM AUTHOR]

Introduction To assess the effects of cleft lip and palate (CLP) on the temporomandibular joint (TMJ) components using cone-beam computed tomography (CBCT). Methodology This historical cohort study evaluated 20 CBCT scans of the TMJ area of patients with unilateral CLP as the test group and 20 CBCT scans of the TMJ area of non-CLP controls with class I occlusion. The morphological properties and dimensions of the condyle, the thickness of the glenoid fossa and articular eminence, and the articular eminence angle were measured and recorded. The two groups were compared regarding the above-mentioned variables by the Chi-square or t test (alpha=0.05). Results The left and right axial condylar angles in CLP patients were significantly lower than the corresponding values in the control group by 1.8 degrees in the left and 2 degrees in the right side (p=0.005). The mediolateral condylar dimension at both sides was significantly lower in CLP patients than in the controls (p=0.001). The differences between the two groups were not significant in the anteroposterior condylar dimension, glenoid fossa thickness, and articular eminence thickness (p>0.05). The CLP patients had significantly lower articular eminence angle in the right side (p=0.016) but not in the left side (p>0.05), compared with the controls. Conclusion Unilateral CLP patients have lower axial condylar angle and mediolateral condylar dimension at both sides, and lower articular eminence angle in the right side than the controls. [ABSTRACT FROM AUTHOR]

Introduction Failure in the fusion of medial nasal processes and maxillary prominences would result in the development of a cleft lip while failure in merging the palatal shelves would result in the development of a cleft palate (CP). At present, patients with a cleft palate (CP) have often undergone corrective surgery before 1 year of age. However, an oronasal fistula (ONF) often remains in the palate after surgery. Methodology In this historical cohort, 40 patients with CP, 6-10 years old, who had undergone corrective surgery at 1 year of age were selected by targeted sampling and assigned to two groups with ONF (N=20) and without ONF (n=20). The two groups were matched in terms of age and gender. All patients had an intraoral photograph of the maxilla and a lateral cephalogram. Twenty-three cephalometric parameters were measured prior to the orthodontic treatment and compared between the two groups using a t-test. Results CP patients with ONF had significantly higher Y-axis, gonial angle, Go1, Go2, GoGn-SN, U1-SN, and lower lip to E line compared with those without ONF (P<0.05). The Jarabak index was significantly lower in the CP patients with ONF compared with those without it (P<0.05). The difference in other cephalometric parameters was not significant between the two groups (P>0.05). Conclusion Patients with ONF had significantly greater growth in the vertical dimension compared with those without ONF. Yet, the difference in the anteroposterior dimension was not significant between the two groups. [ABSTRACT FROM AUTHOR]

Background: Considering the adverse consequences of respiratory insufficiency in cleft lip and palate (CLP) patients, this study aimed to assess the pharyngeal airway dimensions in 9–12-year-old patients with unilateral CLP. This historical cohort evaluated the cone-beam computed tomography (CBCT) scans of 30 patients with non-syndromic unilateral CLP between 9 and 12 years and 30 age- and sex-matched non-cleft controls. Three-dimensional (3D) images were reconstructed by the Mimics software, and the nasopharyngeal, oropharyngeal, and total airway volumes, as well as the minimal cross-sectional area of the airway (minAx), and posterior airway length (PAL) were all measured in the sagittal plane. Data were analyzed by the Student's t test. Results: The oropharyngeal and the total airway volumes, as well as the minAx and PAL in CLP patients, were significantly smaller than the corresponding values in the control group (P < 0.05). Despite smaller nasopharyngeal airway volume in CLP patients than controls, this difference was not statistically significant (P > 0.05). Conclusions: Nine- to twelve-year-old non-syndromic unilateral CLP patients have smaller pharyngeal airway dimensions than non-cleft controls, and are therefore at higher risk of respiratory insufficiency. [ABSTRACT FROM AUTHOR]

Introduction Formation of oronasal fistula is a common complication after surgical closure of cleft lip and palate (CLP). This study aimed to compare the maxillary sinus volume in 9-12-year-old CLP patients with and without an oronasal fistula who had undergone surgical closure of the cleft at 1 year of age, using cone- beam computed tomography (CBCT). Methodology This descriptive, cross-sectional, analytical study was conducted on CBCT scans of 50 patients with unilateral CLP who were between 9-12 years and had undergone surgical closure of the cleft at 1 year of age in two groups with and without an oronasal fistula (n=50). The patients were selected among those presenting to a private orthodontic office between 2001-2009 and already had CBCT scans taken for orthodontic treatment. The 3D CBCT scans were reconstructed with Mimics software, and the volume of the maxillary sinuses was measured on the images. Data were compared using t-test. Results The maxillary sinus volume was significantly smaller in patients with oronasal fistula compared with those without it (9510.7±492 mm² vs. 10278.2±512 mm², P<0.000). The maxillary sinus of the affected side was smaller than that of the unaffected side in both groups of patients with and without an oronasal fistula (P<0.05). Conclusion IImmature patients with unilateral CLP and oronasal fistula have a smaller maxillary sinus than unilateral CLP patients without an oronasal fistula, and may be at higher risk of respiratory infections. [ABSTRACT FROM AUTHOR]

Objectives The purpose of this randomized trial study was to compare the effects of tongue plate and tongue appliance in the treatment of Class III malocclusion with maxillary deficiency in growing patients. Material and Methods 40 patients (19 males, 21 females) with maxillary deficiency were selected. 20 patients (9 boys, 11 girls) with the mean age of 9.3±1.2 were treated with tongue plate. 20 patients (10 boys, 10 girls) with the mean age of 10.1±0.7 were treated by tongue appliance. Lateral cephalograms obtained at the beginning and end of the study were analyzed. Results Paired t-tests and Wilcoxon test showed that SNA and ANB significantly increased in both groups. The Mann-Whitney test showed that there were no statistically significant differences between the two groups except for Jarabak ratio. Jarabak increased by 0.6±3.2° in the tongue appliance group and it decreased 0.4±1.6° in the tongue plate group (p<0.03). Conclusion Both treatment modalities were successful in moving the maxilla forward. The crib of the tongue appliance might bother the tongue and consequently parents are complaining about minor inflammation of the tongue. The smooth surface of the tongue plate might therefore confer some advantages to this system as compared to the tongue plate. [ABSTRACT FROM AUTHOR]

Objective To compare the upper arch dimensions of young patients with unilateral cleft lip and palate (UCLP) before and after treatment with bonded maxillary expander and hybrid activation protocol using digital dental casts. Methods Sixteen subjects with UCLP, aged between 7 and 14 years (mean age 10.9 ± 2.7 years) consecutively treated with bonded maxillary expander and hybrid activation were included. The dental casts before and after treatment were digitalized using a 3Shape scanner. Intercanine, interpremolar and intermolar widths (at cusp and gingival levels) and arch perimeters were measured. The significance level for statistical analyses was set as p < 0.05. Results The total treatment time using the hybrid expansion protocol lasted 12 ± 1.9 months while the active expansion time lasted 4 ± 0.2 months. Patients with UCLP showed significant differences in all transverse upper arch dimensions both at cusp and gingival level. Conclusion The use of a bonded maxillary expander with a hybrid activation protocol during growth may be efficient to improve all transverse upper arch widths in patients affected by UCLP. [ABSTRACT FROM AUTHOR]

Objectives: The aims of this study were to compare the effect of 4 bracket systems including Alexander, Roth, MBT, and Gianelly on upper anterior retraction and to quantify the amount of torque loss ratio in sliding mechanics by help of a 3-dimensional (3D) finite element method. Method and materials: 3D FEM models were constructed in order to simulate anterior incisor retraction in first premolar extraction case. Displacement, stress, and strain on the incisal edge and apex of maxillary central incisor were calculated when 1-, 2-, and 3-N retraction forces were applied. Torque loss ratio was calculated by measuring the displacement of the teeth at crown tip and root apex in all 4 bracket systems on upper central incisor. Results: Uncontrolled lingual crown tipping of the incisor was observed in all bracket systems. The crown moved lingually by 9.5 μm and the root labially by 4.5 μm in MBT system with 3-N retraction force. The amount of crown movement was 8 μm and the root displacement was 4 μm in Gianelly system with the same retraction force. Torque loss ratio was 1.46 in Alexander and Gianelly with 3-N retraction force. However, the amount of torque loss ratio was 1.47 in MBT and Roth with the same retraction force. Conclusions and clinical Relevance: Uncontrolled tipping was the least in Gianelly and was the highest in MBT. The amount of torque loss ratio was the lowest in Gianelly and Alexander systems and the amount of torque loss ratio was the highest in MBT system. [ABSTRACT FROM AUTHOR]

Background: Relapse is one of the major concerns in the correction of skeletal class III malocclusion. Objective: The purpose of this systemic review was to evaluate the degree of relapse on skeletal class III patients who received bimaxillary surgery or mandibular setback with orthodontic treatment. Data Sources: A search of the literature was performed in the databases of PubMed, Google Scholar Beta, Scopus, Web of Science, and the Cochrane Library. Study Selection: Out of the 165 articles identified, 73 studies were obtained, once duplicated articles were excluded. Then, 40 other records were excluded due to titles and abstracts, and 20 were removed for not fulfilling exclusion/ inclusion criteria. 11 studies met the final inclusion criteria. Some cephalometric data during T1-T2-T3 were measured. Data Extraction: SNA did not have any significant changes within less than 2 years but it increased significantly after 2 years. SNB did not have any significant changes in more than 2 years' follow-up, while it rose significantly in less than 2 years. Overjet decreased significantly after 2 years but not earlier than this duration. Overbite intensified significantly in more than 2 years and not earlier. Data Synthesis: SNA and overbite increased significantly after 2 years. SNB increased significantly before 2 years and did not have any changes after it. Overjet was significantly reduced after 2 years. [ABSTRACT FROM AUTHOR]

After orthodontic treatment with fixed appliances, bonded brackets and residual adhesive must be removed. This procedure should lead to restitutio ad integrum of the enamel or, at least, restore the enamel surface as closely as possible to its pre-treatment conditions. The purpose of this study is the in vivo assessment at a microscopic resolution of enamel surfaces after bracket debonding while avoiding the tooth extraction. Nine orthodontic patients who had brackets removed at the conclusion of orthodontic treatment were enrolled. In vivo reflectance confocal microscopy imaging of dental enamel surface after debonding was performed for each patient. Eighteen upper incisors were analyzed, 10 in which the enamel demineralization appeared after the treatment and 8 in which the demineralization was present before the treatment. RCM analyses showed some speckled or roundish dark areas within the enamel. Moreover enamel alterations were detected at different levels of depth. The present in vivo microscopic study allowed for highlighting structural features in dental enamel, after debonding, at a microscopic resolution in real-time and in a non-invasive way, without the need for extraction or processing of the samples. [ABSTRACT FROM PUBLISHER]

Objectives:The aim of this overview of systematic reviews was to investigate methodological quality and outcome of current systematic reviews (SRs) reporting on orthopaedic treatment for class III malocclusion. Materials and methods:Computerized and manual searches were performed in Medline, Google Scholar, Cochrane Library, Embase, LILACS, SciELO, American Journal of Orthodontics and Dentofacial Orthopaedics, Angle Orthodontist, European Journal of Orthodontics, Journal of Orthodontics, Conference abstracts and Grey literature. No restrictions were set on language or date of publication. The search covered the starting date of the relevant databases until 30 April 2015. MeSH terms and free-text terms included ‘malocclusion’, ‘Angle class III’, ‘orthodontic appliances’, ‘functional’, facemask, review and meta-analysis. Screening of eligible studies, assessment of the methodological quality of the SRs and data extraction were conducted in duplicate and independently by two reviewers. Methodological quality was assessed using AMSTAR (assessment of multiple systematic reviews). Results:A total of 222 studies were retrieved and after removal of duplicates, irrelevant studies, literature reviews and surgical approach treatments, 14 SRs and/or meta-analyses were included for qualitative synthesis. Mean AMSTAR score was 7.7/11 with a range of 3–10. There was evidence to demonstrate that face mask therapy can move the maxilla forward whilst causing a backward rotation of the mandible and increased facial height. There was also some evidence of mandibular growth retardation with chin cup therapy. Conclusions:Orthopaedic appliances can improve a class III malocclusion in growing patients over the short-term; however, each appliance has a characteristic effect on the underlying skeletal pattern. [ABSTRACT FROM PUBLISHER]

Background: The aim of this study was to investigate the prevalence of cleft sidedness, and the number of congenitally missing teeth in regard to cleft type and gender. Methods: The charts, models, radiographs, and intraoral photographs of 201 cleft patients including 131 males with the mean age of 12.3 ± 4 years and 70 females with the mean age of 12.6 ± 3.9 years were used for the study. T test, Chi-square, and binomial tests were used for assessment of the data. Results and conclusions: One hundred forty-eight of the subjects suffered from cleft lip and palate followed by 41 subjects who suffered from cleft lip and alveolus. Chi-square test did not show any significant difference between the genders. Binomial test showed that left-sided cleft was more predominant in unilateral cleft lip and palate patients ( P < 0.001). This study also showed that the upper lateral incisors were the most commonly missing teeth in the cleft area. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to evaluate the amount of nickel and titanium ions released from two wires with different shapes and a similar surface area. Methods: Forty round nickel-titanium (NiTi) arch wires with the diameter of 0.020 in. and 40 rectangular NiTi arch wires with the diameter of 0.016 × 0.016 in. were immersed in artificial saliva during a 21-day period. The surface area of both wires was 0.44 in.. Wires were separately dipped into polypropylene tubes containing 50 ml of buffer solution and were incubated and maintained at 37 °C. Inductively coupled plasma atomic emission spectrometry (ICP-AES) was used to measure the amount of ions released after exposure lengths of 1 h, 24 h, 1 week, and 3 weeks. Repeated measures ANOVA and Tukey tests were used to evaluate the data. Results: The results indicated that the amount of nickel and titanium concentrations was significantly higher in the rectangular wire group. The most significant release of all metals was measured after the first hour of immersion. In the rectangular wire group, 243 ± 4.2 ng/ml of nickel was released after 1 h, while 221.4 ± 1.7 ng/ml of nickel was released in the round wire group. Similarly, 243.3 ± 2.8 ng/ml of titanium was released in the rectangular wire group and a significantly lower amount of 211.9 ± 2.3 ng/ml of titanium was released in the round wire group. Conclusions: Release of metal ions was influenced by the shape of the wire and increase of time. [ABSTRACT FROM AUTHOR]

Background: Titanium miniscrews are increasingly used as orthodontic anchorage. Various factors are known to affect the stability of miniscrew. Placement angle is one of the most controversial issues in this area. Thus, the aim of this finite element study was to evaluate the influence of placement angle and direction of force on the stability of miniscrews. Materials and methods: Finite element analysis was performed using miniscrews inserted into 1 mm of cortical bone and 10 mm of trabecular bone at angles of 30, 60, 90, 120, and 150 degrees to the alveolar bone. Force of 2 Newton (N) was applied to the heads of the miniscrews in two directions of 0 and 30 degrees. Results: The finite element analysis showed that inserting miniscrews at 90 degree angle would provide better anchorage than 30, 60, 120, and 150 degree angles at either direction of force. The least trabecular bone von Mises stress was 5.6 MPa at 90 degrees at both directions of force and the least cortical bone stress was 31.2 MPa at 90 degrees at both directions of force. Conclusions: Insertion of miniscrews at angles less than or greater than 90 degrees to the alveolar process bone might decrease the anchorage stability of the miniscrew. [ABSTRACT FROM AUTHOR]

Distraction osteogenesis (DO) has become a mainstream surgical technique for patients with jaw deformities. The aim of this study was to report the effect of DO done by a hyrax screw incorporated in an acrylic plate in the treatment of two maxillary deficient cases with cleft lip and palate.Two patients, a 24-year-old female and a 29-year-old male who suffered from maxillary deficiency and cleft lip and palate, were treated by DO. After making vertical cuts between the premolars on both sides and horizontal cuts similar to Le Fort 1, a hyrax screw was mounted on an acrylic plate for the slow anteroposterior expansion of maxillary arch. The expansion was achieved by turning the hyrax screw 0.8 mm per day after the latency period. Treatment was discontinued after achieving satisfactory over jet and occlusion. This study showed that anterior maxillary distraction is a reliable technique for correction of midfacial deformity arising out of cleft lip and palate. Incidences of complications are negligible compared to total maxillary distraction. [ABSTRACT FROM AUTHOR]

Aims: The aim of this study was to evaluate hard and soft tissue change after bimaxillary surgery in class III patients by focusing on sella, nasion, A point (SNA) and sella, nasion, B point (SNB) angle and aesthetic outcome. Materials and Methods: The sample consisted of 96 skeletal Class III patients (42 women, 54 men) with a mean age of 25 years with standard deviation (SD) of 8.4. The youngest patient was 16-years-old and the oldest 51-years-old at the time of surgery. In total, seven skeletal parameters, eight soft tissue parameters, and two dental parameters were evaluated on the cephalograms. Result: At the beginning of the treatment 49 Patients had SNA between 80° and 84°, 34 had SNA of less than 80° and 13 had SNA of more than 84°. Post surgically, 25 patients had SNA of 78°–84°, 19 had SNA less than 78° and 52 patients had SNA of more than 84°. Out of 96 patients 22 had SNB of 78°–82° before surgery, 16 had less than 78° and 58 had SNA of more than 84°. Postoperatively, we measured SNB of 78°–80° in 42, less than 78° in 18 and of more than 82° in 36 patients. The inclination of the maxilla relative to the cranial base changed from 7.2° (SD = 4)–8° (SD = 5.1) and the mandible changed from 35.7° (SD = 6.6) to 36° (SD = 6.3) postoperatively which was not significant. The distance from upper lip to E-line increased by 2.6 mm (SD = 3.9) after surgery (P < 0.001), while, the lower lip distance to E-line decreased slightly by 0.9 mm (SD = 3.2) (P < 0.01). Nasolabial angle was decreased by 9.5° (SD = 9.4) after surgery (P < 0.001). The nose prominence also decreased from 18.2 mm (SD = 3.5) –16.5 mm (SD = 3.3). Conclusion: Although in many cases we did not have a SNA angle or SNB angle in normal range but a good aesthetic outcome have been observed. Consequently our study showed that soft tissue change and aesthetic aspects should be considered in surgical planning and achieving SNA angle or SNB angle of norm range should not be the only goal. As we could show the advancement of maxilla will result in a better lip and nose profile and this should be considered in treatment planning. [ABSTRACT FROM AUTHOR]

Background. Widespread use of the IOTN along with detailed study of occlusal traits is suitable for planning community dental health resources. Objectives. The aim of current study was to assess the need for orthodontic treatment among school children of Tehran by means of the Dental Health Component (DHC) of the Index of Orthodontic Treatment Need (IOTN) and also to evaluate the occlusal traits of the subjects. Methods. 684 (343 boys and 341 girls) school children, 15 to 17 years of age, were selected at random from 12 schools to represent the four main areas of Tehran. The final sample who met the inclusion criteria comprised 643 subjects (322males and 321 females).Malocclusion was determined with the Index of Orthodontic Treatment Need. The IOTN grades were statistically compared in the two genders using chi-square test. Results. Orthodontic treatment need, using the DHC, was found in only 9.0 per cent of the children. The prevalence of Angle Class I malocclusion in this study was higher than other malocclusions (65.2 per cent), followed by crowding in 62.7 per cent of the subjects. Conclusion. Orthodontic treatment need for Tehran high school students was relatively lower than that reported in most recent studies in Europe [ABSTRACT FROM AUTHOR]

Objective: The purpose of this randomized clinical trial was to compare the effects of facemask and tongue plate therapy in the treatment of class III malocclusion associated with maxillary deficiency in growing patients. Design: Prospective, randomized clinical trial. Setting: Department of Orthodontics, SB University of Medical Sciences Dental School, Tehran, Iran. Methods: Fifty patients with maxillary deficiency were randomly allocated to two groups. One group was treated with a removable facemask and the other with a tongue plate. Three patients dropped out of the study leaving a final number of 47 that were analysed. The face mask group included 24 patients (12 males, 12 females) with a mean age of 9 (SD 1.2) years; while the tongue plate group included 23 patients (10 males, 13 females) with a mean age of 9.1 (SD 0.9) years. The patients lateral cephalograms obtained at the beginning and end of the study were analysed. Results: Paired /-tests showed that SNA increased by Io (SD 1.5°) in the facemask group (/><0.001) and by 2.2° (SD 1.5°) in the tongue plate group (PcO.OOl). With the exception of SNA and GoGn, Mann-Whitney testing showed that there were no statistically significant differences between the two groups. IMPA was found to decrease significantly in both groups. Conclusion: Both treatment modalities were successful in moving the maxilla forward, proclining the maxillary incisors and retroclining the mandibular incisors. The more simple design of the tongue plate might therefore confer some advantages to this system in comparison with a facemask. [ABSTRACT FROM AUTHOR]

Background and Aims: Various methods are used for treatment of open bite. The objective of this study was to investigate the effects of Lower Anterior High Pull Headgear (LAHPH) appliance in Class I subjects with moderate open bite and high lower lip line. Materials and Methods: The study group was composed of 10 subjects with a mean age of 15.8±2.5 years and 3.05 ± 0.07 mm moderate open bite. All the patients rejected orthognathic surgery. The treatment included extraction of upper and lower second premolars followed by leveling, banding, bonding, posterior space closure, and anterior retraction. After these procedures, the open bite was reduced to 2.04±1.17 mm. Afterwards, LAHPH was applied for 18 hours per day for 8±2 months. LAHPH appliance was composed of High Pull Headgear and two hooks mounted on its inner bow. Two elastics (1.8, light, Dentaurum) connected the upper hooks on the inner bow to the lower hooks on the mandibular canines vertically. The forces produced by the prescribed elastics were 10 and 60 g during mouth closing and opening, respectively. Paired T-test was used to evaluate pre-and post-treatment outcomes. Results: The pre-and post-treatment cephalometric evaluations showed that the LAHPH reduced effectively the open bite of the patients to 0.15±1.7 mm (P<0.001). Conclusion: This appliance can be used as an acceptable method for closing the open bite in Class I subjects. [ABSTRACT FROM AUTHOR]

This case report presents a 22-year-old girl with class III malocclusion due to maxillary deficiency. The patient was referred for presurgical orthodontics; however, she rejected the surgery. This case was treated by means of Tongue appliance and slow palatal expansion, followed by lower fixed appliance, reverse chin cup, and upper fixed appliance. Tongue appliance and slow palatal expansion were used at the beginning of the treatment. After 6 months, reverse chin cup and lower fixed appliance were added. Six months later reverse chin cup was removed and upper fixed appliance was mounted. Positive overbite and over jet were achieved after 24 months of active treatment. Nasolabial angle also showed improvement. Nonsurgical treatment of adult class III patients is a difficult procedure; however, this patient was treated nonsurgically. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this randomized clinical trial was to assess differences in the effects of face mask and reverse chin cup therapy on maxillary deficient growing patients. Methods: The sample consisted of 42 class III patients with maxillary deficiency randomly divided into two equal groups. Twenty-one patients (10 males and 11 females) with a mean age of 8.9 (SD: 1.4) years were treated with a face mask for 18 (SD: 2) months. Twenty-one patients (9 males and 12 females) with the mean age of 9.2 (SD: 1.1) years were treated with a reverse chin cup for 19 (SD: 4) months. Cephalometric radiographs were taken at the beginning and end of treatment and the cephalometric measurements were analysed. Paired r-tests and a Wilcoxon test were used for intra-group evaluations. Mann-Whitney test was used for inter-group evaluations. Results: Sella-Nasion-A point (SNA) was increased by Io (SD: 1.7°) (P<0.003) and 1.8° (SD: 1.7°) (P<0.001) in the face mask and reverse chin cup groups, respectively. The IMPA decreased by 4.1° (SD: 6.5") in face mask group (P<0.009) and 3.1° (SD: 4.7°) in the reverse chin cup group (P<0.008). However, no statistically significant differences were seen in changes between the two groups. Conclusion: Both face mask and reverse chin cup appliances are successful at moving the maxilla forward. [ABSTRACT FROM AUTHOR]

Aim: To compare the effects of two different types of face masks in the treatment of Class III malocclusions with maxillary deficiency in growing patients. Methods: Forty-three patients (21 boys and 22 girls) with maxillary deficiencies were selected. Twenty-one patients (10 boys and 11 girls) with a mean age of 8.9 ± 1.4 years were treated with maxillary removable appliances and face masks. Twenty-two patients (10 boys and 12 girls) with a mean age of 9.3 ± 1.2 years were treated with maxillary fixed appliances and face masks. Lateral cephalograms obtained at the beginning and end of the study were analyzed. Results: Paired t tests and Wilcoxon tests showed that SNA and ANB significantly increased in both groups. The Mann- Whitney test showed that there were no statistically significant differences between the two groups except for U1-SN, which increased by 6.2 ± 7.1 degrees in the removable face mask group and 11.1 ± 6.9 degrees in the fixed face mask group (P < .02). Conclusion: Both treatment modalities were successful in moving the maxilla forward. However, the maxillary incisors had more labial inclination in the fixed appliance group. [ABSTRACT FROM AUTHOR]

The purpose of this study was to compare the effects of a differently designed functional appliance (the R-appliance) with a twin-block (TB)-treated group.Thirty patients (18 girls and 12 boys) with a mean age of 10.5 ± 0.7 years were treated with the R-appliance for 16.2 ± 0.3 months and 25 (11 boys and 14 girls) with a mean age of 11.2 ± 1.3 years with a TB for 16.1 ± 1.4 months (control). All had a Class II division 1 malocclusion due to mandibular deficiency. Lateral cephalograms obtained at the beginning (T1) and end (T2) of the study were analysed.Paired t-tests showed that SNB significantly increased in both groups. The incisor mandibular plane angle (IMPA) was reduced in the R-appliance group by 1.9 ± 4.9 degrees (P < 0.04) but increased by 0.5 ± 5.1 degrees (P < 0.6) in the TB group. SNA in the R-appliance group showed an increase of 0.2 ± 1.8 degrees (P < 0.5), while it was decreased by 0.2 ± 1.3 degrees (P < 0.3) in the TB group.Both treatment modalities were successful in moving the mandible forward. However, with the R-appliance, this was achieved without retroclination of the lower incisors. [ABSTRACT FROM PUBLISHER]

Introduction. Numerous devices have been introduced for correction of Class III malocclusion and maxillary deficiency. Aim. To assess the dentoskeletal effects of miniplates combined with Class III traction in treating Cl III malocclusion and maxillary deficiency in growing patients. Methods. This case describes the treatment of a maxillary-deficient 11-year-old boy by using miniplates. The patient's parents rejected the use of extraoral appliances and major surgical correction; therefore the treatment was done by using Class III elastics connected from two mandibular miniplates to an upper removable appliance. Two miniplates were inserted in the anterior part of the mandible in the canine areas under local anaesthesia. The treatment lasted for 10 months after which favourable correction of the malocclusion was observed. Results. The SNA and ANB angles increased by 5.1° and 4.4°, respectively. Lower 1 to mandibular plane decreased by 3.4°. Conclusions. This case demonstrates that miniplates can be a suitable method to extraoral appliances and major surgery in maxillary deficiency cases. [ABSTRACT FROM AUTHOR]

This case report illustrates the treatment of a 12-year-old boy with maxillary deficiency using miniscrew implants. The patient rejected the use of extraoral appliances and future surgical correction; therefore the patient was treated using Class III elastics connected from two mandibular miniscrew implants to an upper removable appliance. The miniscrews were inserted between the permanent canines and first premolars under local anaesthesia. The treatment lasted for 8 months after which favourable correction of the malocclusion was observed. The SNA and ANB angles increased by 30 and the IMPA increased by 4° This case demonstrates that miniscrews can be a suitable alternative method to extraoral appliances and possibly surgery in mild Class III cases. [ABSTRACT FROM AUTHOR]

Background: One of the most controversial issues in treatment planning of class III malocclusion patients is the choice between orthodontic camouflage and orthognathic surgery. Our aim was to delineate diagnostic measures in borderline class III cases for choosing proper treatment.Methods: The pretreatment lateral cephalograms of 65 patients exhibiting moderate skeletal class III were analyzed. The camouflage group comprised of 36 patients with the mean age of 23.5 (SD 4.8), and the surgery group comprised of 29 patients with the mean age of 24.8 years (SD 3.1). The camouflage treatment consisted of flaring of the upper incisors and retraction of the lower incisors, and the surgical group was corrected by setback of the mandible, maxillary advancement, or bimaxillary surgery. Mann-Whitney U test was used to compare the variables between the two groups. Stepwise discriminant analysis was applied to identify the dentoskeletal variables that best separate the groups.Results: Holdaway H angle and Wits appraisal were able to differentiate between the patients suitable for orthodontic camouflage or surgical treatment. Cases with a Holdaway angle greater than 10.3° and Wits appraisal greater than − 5.8 mm would be treated successfully by camouflage, while those with a Holdaway angle of less than 10.3° and with Wits appraisal less than − 5.8 mm can be treated surgically. Based on this model, 81.5% of our patients were properly classified.Conclusions: Holdaway H angle and Wits appraisal can be used as a critical diagnostic parameter for determining the treatment modality in class III borderline cases. [ABSTRACT FROM AUTHOR]