Search

Comprehensive health records (CHRs) that encompass patients' medical and dental information is here and now. CHRs enable health care providers to deliver personalized, precision medicine/dentistry effectively and efficiently. The objective of this report is to provide an overview of strengths, weaknesses, and opportunities associated with a comprehensive health care record system that integrates medical and dentalrecords. Strengths and benefits of CHRs (elevated patient safety, collaborative care, holistic patient care, enhanced research capabilities) are explained, and practical challenges associated with operating multiple record systems (specifically in medical and dental imaging), data migration and integration are explored. [ABSTRACT FROM AUTHOR]

We sought the perspectives of fourteen orthodontics educators on emerging trends and themes in the orthodontics educational landscape. The focus of this article was on four overarching areas: technology, workforce, research and clinical practice. Strengths, Weaknesses, Opportunities and Threats (SWOT) analysis showed that infusion of newer technologies is poised to change the way we train the next generation of orthodontists, open up new lines of enquiry, and alter the way we render clinical care. Areas of weakness include lack of adequate numbers of orthodontics faculty and lack of progress in Orthodontics research when compared to medical research. Our educational set up is at crucial juncture. We have to make sure that the pipeline of Orthodontics educators is well developed and our new-gen educators have the tools and skillset to adapt to the rapidly evolving healthcare landscape. Over the past decade, the Orthodontics landscape has changed rapidly to keep pace with infusion of newer technologies, increasing digitization, emphasis on personalized orthodontics care, and evolving practice models. In this narrative review, we sought the perspectives of orthodontics educators on what they thought were emerging issues and trends impacting the field of Orthodontics as related to education. We focused on four overarching areas pertaining to Orthodontics education: Technology, Workforce, Research, and Clinical Practice. We then conducted a Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis of themes that the educators highlighted. We present insights from educators as an anthology. [ABSTRACT FROM AUTHOR]

The advent of Chat Generative Pre-Trained Transformer (ChatGPT), a conversational artificial intelligence application, has sparked considerable interest and debate within the educational sphere. This narrative article explores the potential implications of ChatGPT on dental education, including its applications, challenges, and ethical considerations. In the realm of dental school admissions, the use of ChatGPT raises questions about academic integrity and the equitable access to resources for applicants. While it may offer benefits in aiding students with writer's block, concerns arise regarding plagiarism and the authenticity of personal statements. Furthermore, its impact on the learning experiences of dental students presents both opportunities and challenges. While ChatGPT can serve as a helpful learning tool, its use may also hinder the development of critical thinking skills and lead to issues of academic dishonesty. In the realm of research, ChatGPT holds promise for facilitating literature analysis, question-answering, and information retrieval. However, its limitations, such as the lack of domain-specific knowledge and potential for bias, must be considered. Ethical concerns surrounding AI-generated content, including misinformation and transparency, necessitate careful regulation and oversight. Looking ahead, the integration of generative AI models into dental education requires collaborative efforts to establish best practices and ethical guidelines. Future research should focus on developing tailored AI models specific to dental education and investigating their long-term effects on learning outcomes and patient care. Ultimately, as educators, it is imperative to embrace technological advancements while ensuring responsible and equitable integration into dental education curricula. [ABSTRACT FROM AUTHOR]

Thousands of dental students and prospective applicants participate in dental MATCH each year. This paper aimed to briefly overview the MATCH process and analyze trends in applicants, program and summary statistics from 2012 to 2023 for specialty programs. The aggregated MATCH data from 2012 to 2023 for all residencies were obtained from the Dental MATCH website and by contacting the Dental MATCH organization. The variables used in this study included applicants matched, number of positions offered, number of programs filled and unfilled, same-year graduates and previous-year graduates matched, US and non-US graduates that matched into a program for each year of analysis. The data was analyzed statistically using the Chi-squared test for proportions to estimate if the proportions deviated from expectations across the years using R 4.2.2. The results showed that Orthodontic programs had a distinct dip in ratio of applicants to total positions offered between 2017 and 2020 followed by a rise after 2020. The Orthodontic residency programs had a lower number of unfilled positions relative to total positions offered for 2015–2016 and a higher number of unfilled positions in 2018 and 2023 (p < 0.05). Dental Anesthesiology had a higher number of unfilled positions in 2015 and Pediatric Dentistry programs had a lower number of unfilled positions in 2015 and higher in 2023 while Periodontics had a higher number of unfilled positions in 2018. The Periodontics residency programs had higher non-US graduates matched in 2018 and lower in 2021 (p < 0.05). Orthodontic programs had higher number of same year graduates matched to total graduates among all other residencies. An overview of the dental MATCH process was detailed in the paper. Additionally, important trends observed in the applicant and program statistics outlines the dynamic and changing landscape of advanced dental education. [ABSTRACT FROM AUTHOR]

• Temporomandibular disorders (TMDs) is an umbrella term that refers to group of disorders affecting musculoskeletal and neuromuscular conditions. • Osteoarthritis is most common degenerative joint disorder affecting TMJ. • Treatment approaches for TMJ disorders range from non-invasive to surgical interventions depending on the severity of degeneration. Degenerative Joint Disorders (DJD) of the Temporomandibular Joint (TMJ) represent a challenging and multifaceted group of conditions that severely impact the joint's function and quality of life. This comprehensive review delves into the etiology, pathogenesis, clinical manifestations, and contemporary management strategies of TMJ-OA. While systemic illnesses, aging processes, hormonal factors, and behavioral factors have been implicated in its development, recent evidence highlights the pivotal role of mechanical overloading in initiating a series of degenerative changes within the TMJ. Painful joints, a hallmark of TMJ-OA, result from the soft tissues around the affected joint and reflexive muscle spasm, following Hilton's law, which innervates the joint's muscles and overlying skin. This self-preservation reflex protects against further joint damage. Moreover, painful symptoms may arise from subchondral bone destruction. Recognizing the importance of understanding the biomechanical environment within the TMJ, this review underscores its relevance in identifying the mechanisms behind TMJ pain and disability. Furthermore, it discusses the potential application of tissue engineering in TMJ reconstruction, emphasizing the need to learn from past TMJ implant experiences. In the context of treatment, the review highlights the significance of managing TMJ-OA, focusing on restoring function and reducing pain. Treatment modalities span from non-invasive therapies to surgical options, with the latter reserved for cases unresponsive to conservative approaches and severely affecting an individual's quality of life. This review serves as a vital resource for both clinicians and researchers, offering insights into the multifaceted nature of TMJ-OA and the evolving landscape of its diagnosis and management, incorporating biomechanical considerations and potential advances in tissue engineering. Understanding the complexities of TMJ-OA is instrumental in enhancing the care and well-being of individuals affected by this condition. [ABSTRACT FROM AUTHOR]

• This review article focuses on the biomechanics of conventional rapid palatal expansion (RPE) and miniscrew-assisted rapid palatal expansion appliances (MARPE). • Three main things play an important role in the type of movements that follow rapid maxillary expansion: 1) Center of resistance and anatomy of maxilla, 2) Appliance system, and 3) Forces, Stress, and Strain. • The nature of forces after expansion is cyclical with force activation and decay occurring after each turn/activation of the expansion appliance. • The stress levels expressed by RPE and MARPE are different which is responsible for the difference in the effects because of RPE and MARPE • Even within MARPE, bone-anchored MARPE design and hybrid MARPE design result in different force systems or stress on the oral structures. Posterior Crossbite is a common condition resulting because of transverse maxillary deficiency. The growth of the craniofacial complex finishes first in the transverse dimension, followed by sagittal and vertical dimensions. Conventional rapid palatal expansion (RPE) appliances are commonly used to correct transverse maxillary deficiency. Although RPE is efficient in correcting posterior crossbite, it results in dental side effects such as buccal tipping of maxillary molars, root resorption, bone dehiscence, and relapse. Mini-implant-assisted RPE has been introduced to increase the skeletal effects of expansion especially in patients with increased maturation and greater interdigitation of midpalatal suture. This article will review the biomechanics of RPE and mini-implant-assisted RPE. Additionally, the different designs of MARPE and the long-term clinical effects of expansion appliances will also be discussed in detail. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the soft-tissue changes in the long-term after miniscrew-assisted rapid palatal expansion (MARPE) and conventional rapid palatal expansion (RPE) appliances compared with a matched control group using voxel-based superimposition of cone-beam computed tomography (CBCT) scans. A total of 180 CBCTs for 60 patients at 3-time points were evaluated: pretreatment (T1), postexpansion (T2), and posttreatment (T3) for 3 groups: (1) MARPE, (2) RPE, and (3) controls (time-period T1 to T3: MARPE, 2 years 8 months; RPE, 2 years 9 months; control, 2 years 7 months). The voxel-based superimposition technique was used to superimpose the CBCT scans, after which the soft-tissue surfaces were extracted from the superimposed T1-CBCT, T2-CBCT, and T3-CBCT scans. Nine landmarks were identified on the CBCT scans: nasion, A-point, pogonion, right and left alar base, right and left zygoma, and right and left gonion. The coordinates of the 9 parameters were obtained in the x-axis, y-axis, and z-axis for the CBCT scans and subjected to statistical analyses. The changes in the soft-tissue surfaces were also evaluated by color-coded maps for short-term (T2) and long-term (T3) changes. The mean changes from T1 to T2 and T1 to T3 were tested against no change within the groups by paired t test, and the mean changes among the 3 groups were compared with analysis of variance F test with Tukey's Honest significant difference used for adjusting P values for multiple testing. In the short term, both MARPE and RPE led to a significant downward movement of pogonion, left gonion, and lateral movement of the right and left alar base compared with controls at T2 (P <0.05). In addition, MARPE led to a significant downward movement of right gonion than controls at T2 (P <0.05). Moreover, RPE led to a significant downward and forward movement of A-point and downward movement of the right and left alar base than controls at T2 (P <0.05). However, in the long-term, there were no significant differences in the soft-tissue changes among the MARPE, RPE, and control groups. MARPE and RPE do not lead to significant soft-tissue changes in the long term when compared with controls. • MARPE and RPE caused downward movement of pogonion and left gonion than controls in the short term. • MARPE and RPE caused lateral movement of alar bases than controls in the short term. • There were no differences in the soft-tissue changes among the 3 groups in the long term. [ABSTRACT FROM AUTHOR]

Artificial Intelligence based systems are exerting tremendous influence in the way we practice and render care to our patients. Improvements in computing capacities, decreasing costs of computing, availability of data from a wide range of sources, and societal push towards embracing innovations have changed the fundamental landscape of healthcare. Like in all specialties, Orthodontics has witnessed a burgeoning interest in research in the artificial intelligence realm. We undertook this narrative review to examine some of the contemporaneous issues that our specialty is facing with regards to implementing artificial intelligence based systems in our research and clinical practice. We present a high level overview of some common applications of artificial intelligence based systems in the field of Orthodontics and challenges in interpreting the models and implementing them in everyday clinical practice. [ABSTRACT FROM AUTHOR]

This study compared treatment efficacy for specific tooth movements between 2 clear aligner systems (Clarity [3M Oral Care Solutions, St Paul, Minn] and Invisalign [Align Technology, San Jose, Calif]). The study sample included 47 patients (7 males, 40 females; mean age, 36.57 ± 15.97 years) treated with Invisalign and 37 (4 males, 33 females; mean age, 34.30 ± 16.35 years) treated with Clarity aligners who completed their first set of aligners and had an initial refinement scan. Initial and predicted models were obtained from the initial simulated treatment plan. The first model of the refinement scan was labeled as achieved. SlicerCMF software (version 3.1; http://www.slicer.org) was used to superimpose the achieved and predicted digital models over the initial ones with regional superimposition on the relatively stable first molars. Nine hundred forty teeth in the Invisalign system were measured for horizontal, vertical, and angular movements and transverse width and compared with similar measurements of 740 teeth for the Clarity aligners. The deviation from the predicted was calculated and compared between both systems. The deviation achieved from the predicted was significant between the groups for the mandibular interpremolar and intercanine widths (P <0.05). Clarity aligners significantly undercorrected rotations compared with Invisalign for the mandibular first premolars, mandibular canines, maxillary canines, and maxillary central incisors. There was no statistically significant difference between the groups for the achieved vs predicted movements in the horizontal and vertical planes (P >0.05). The efficacy of clear aligner therapy systems (Clarity and Invisalign) in treating mild and moderate malocclusions was comparable. Deviation of the achieved movements from the predicted was greatest for rotational and vertical movements. • We compared the efficacy of various tooth movements achieved by 2 common aligner systems. • The treatment efficacy of Clarity and Invisalign aligners' systems is comparable. • The achieved rotational and vertical movements showed the greatest deviation from the predicted. • Greater rotational precision was noticed for some teeth with the Invisalign system. [ABSTRACT FROM AUTHOR]

The objective of this study was to analyze the short-term and long-term effects of miniscrew-assisted rapid palatal expansion (MARPE) and conventional rapid palatal expansion (RPE) appliances on cranial and circummaxillary sutures as compared with a matched control group. One hundred and eighty cone-beam computed tomography scans for 60 subjects were evaluated for the 3 groups: (1) MARPE (n = 20; aged 13.7 ± 1.74 years), (2) RPE (n = 21; age 13.9 ± 1.14 years), and (3) control (n = 19; age 13.3 ± 1.49 years) at pretreatment (T1), postexpansion (T2), and posttreatment (T3) (T1 to T3: MARPE, 2 years 8 months; RPE, 2 years 9 months; control, 2 years 7 months). Frontonasal suture, frontomaxillary suture, zygomaticomaxillary suture, zygomaticofrontal suture, intermaxillary suture, pterygomaxillary suture, nasomaxillary suture, and zygomaticotemporal suture were measured on the right and left sides for all 3 time labels. In addition, midpalatal suture was measured at the incisor, canine, and molar levels. Within-group analysis showed that MARPE and RPE led to a significant increase in the widths of frontonasal, frontomaxillary, intermaxillary, nasomaxillary, and midpalatal suture at incisor, canine, and molar levels at T2 compared with T1. Between-group analysis showed that MARPE and RPE significantly increased the width of the intermaxillary and midpalatal suture at the incisor, canine, and molar compared with controls at T2. In the long term, between-group comparisons showed no significant difference among the 3 groups except that MARPE led to a significant increase in the width of midpalatal suture at incisor, canine, and molar levels compared with RPE and controls at T3. MARPE led to a significant increase in the width of the midpalatal suture at incisor, canine, and molar levels compared with RPE and controls in the long term. There was no difference in the width of other cranial and circummaxillary sutures among the 3 groups in the long term. • We analyzed the long-term effects of MARPE and conventional RPE on cranial and circummaxillary sutures compared with controls. • In the short term, the width of the intermaxillary suture and midpalatal suture at the incisor, canine, and molar was significantly greater in both MARPE and RPE groups compared with controls. • Long-term comparison showed that the width of the midpalatal suture at the incisor, canine, and molar levels was significantly increased in the MARPE group than in the RPE and control groups. • There was no significant difference in the width of the other cranial and circummaxillary sutures among the MARPE, RPE, and controls in the long term. [ABSTRACT FROM AUTHOR]

The objective of this study was to evaluate the short-term and long-term hard-tissue changes with miniscrew-assisted rapid palatal expansion (MARPE) and rapid palatal expansion (RPE) compared with a matched control group with voxel-based superimposition using 3-dimensional cone-beam computed tomography (CBCT) scans. A total of 180 CBCT scans were analyzed for 60 patients with a mean age of 13.9 years at 3 time points: pretreatment (T1), postexpansion (T2), and posttreatment (T3). Patients were divided into 3 groups: MARPE, RPE, and controls. Voxel-based superimposition was performed for CBCTs from T1 to T2 and T1 to T3 using the anterior cranial base as a reference. The hard-tissue surfaces were extracted after the superimposition procedure. Nine landmarks were analyzed: nasion, A-point, pogonion, left and right alar bases, zygoma, and gonion. Within-group changes were analyzed using linear mixed-effects models, including a random intercept per subject and the mixed effect of time (T1, T2, or T3) with test P values adjusted for multiple testing using Tukey's method. Between-group changes were analyzed using linear mixed-effects models, including a random intercept per subject and the mixed effects of time, group, and group × time interaction with P values adjusted for multiple testing using the Benjamin-Hochberg false discovery rate method. In the short term, both MARPE and RPE led to a significant downward movement of the right gonion and lateral movement of the right alar base compared with controls at T2 (P <0.05). In addition, MARPE led to a significant downward movement of pogonion and left gonion. RPE led to a significant downward movement of the A-point and lateral movement of the left alar base compared with controls at T2 (P <0.05). However, in the long-term, no changes were observed between the groups at T3. There were significant differences in pogonion, alar base, and gonion between MARPE, RPE, and control groups in the short term. However, all the hard-tissue changes were transient, as there were no differences between the 3 groups in the long term. • MARPE and RPE caused a downward movement of right gonion compared with controls at postexpansion (T2). • Lateral movement of the right alar base was observed with MARPE and RPE compared to controls at T2. • RPE caused lateral movement of the left alar base compared with the controls at T2. • No differences were observed in the hard-tissue changes between the 3 groups at posttreatment. [ABSTRACT FROM AUTHOR]

• Routine alignment with fixed mechanics or aligners is indeterminate mechanics. • Aligned arches can be moved predictably with determinate mechanics. • Temporary skeletal anchorage devices are retromolar implants, inter-radicular miniscrews, and extra-alveolar bone screws in the infrazygomatic crest and mandibular buccal shelf. • Skeletal Class III malocclusion can be corrected with infrazygomatic crest and mandibular buccal shelf retraction of the lower arch, but only mandibular buccal shelf anchorage decreases facial height. • Retraction and posterior rotation of the mandibular arch with mandibular buccal shelf anchorage reverses the etiology of Class III open bite malocclusion. • The axis of rotation for the lower arch, as calculated with finite element analysis, is through the upper root of the canines. • Periodontal ligament stress <5 kPa avoids necrosis and results in tooth movement of about 1 mm per month, which is near the physiologic rate of bone resorption during remodeling. Routine alignment with fixed appliances and aligners is indeterminate mechanics because equilibrium equations are only applicable to two abutments: teeth, segments, or arches. Orthodontists must depend on compliance and resilience of materials (archwires and aligners) for initial alignment. However, stabilized segments and arches are "large multirooted teeth" that can be moved with determinate mechanics using temporary skeletal anchorage devices. Temporary skeletal anchorage devices have advanced from retromolar implants and inter-radicular miniscrews to extra-alveolar bone screws placed in the basilar bone buccal to the first molars: mandibular buccal shelf and infrazygomatic crest. Extra-alveolar anchorage is determinate mechanics to move teeth, segments, and arches. Retraction and rotation of the lower arch reverses the etiology of Class III open bite malocclusion to correct severe skeletal dysplasia with no extractions or orthognathic surgery. [ABSTRACT FROM AUTHOR]

Introduction: The purpose of this study was to evaluate the long-term effects of bone-anchored and tooth-anchored expansion appliances on alveolar bone in vertical and horizontal dimensions, compared with controls, using cone-beam computed tomography.Methods: We evaluated 180 cone-beam computed tomography scans for 60 patients at 3-time points: T1 (pretreatment), T2 (postexpansion), and T3 (posttreatment), for 3 groups: bone-anchored expansion appliance (BA), tooth-anchored expansion appliance (TA), and controls (T1-T3: BA, 2 years 8 months; TA, 2 years 9 months; control: 2 years 7 months). The intermolar width, molar angulation, palatal width, vertical buccal bone height, buccal bone thickness at the alveolar crest, and root apex were measured in the 3 groups at different time points.Results: In the short term, both BA and TA led to a statistically significant increase in the intermolar width and vertical buccal bone loss after expansion compared with controls. Vertical buccal bone loss was significantly greater in TA than in BA. In addition, TA led to significantly increased molar angulation (buccal tipping) compared with controls at T2. There were no significant differences in the 3 groups in the long term except vertical buccal bone loss, which was significantly greater in TA than controls. A substantial correlation was found between molar angulation and vertical buccal bone loss, and a moderate negative correlation was found between intermolar width and buccal bone thickness at the alveolar crest at T3.Conclusions: There was no difference in the treatment outcomes between the 3 groups in the long term except vertical buccal bone loss, which was significantly increased in the TA group compared with controls. [ABSTRACT FROM AUTHOR]

Introduction: The purpose of this study was to use cone-beam computed tomography to compare immediate and long-term effects of conventional and miniscrew-assisted rapid palatal expansion (MARPE) appliances on root resorption in 2 treatment groups and a control group.Methods: One hundred eighty cone-beam computed tomography images of 60 patients at 3 time points were assessed: initial, postexpansion, and debond. The patients were divided into 3 groups: control (n = 19), rapid palatal expansion (RPE) appliance (n = 21), and MARPE (n = 20). The period of initial to debond varied for the 3 groups: 2 years, 7 months for controls; 2 years, 9 months for RPE; and 2 years, 8 months for MARPE. The length of mesiobuccal, distobuccal, and palatal root of the maxillary first molar (1M); the buccal root of maxillary first premolar; and second premolar were measured. The inclination of the 1M, intercuspal width (ICW), interroot width (IRW), ICW/IRW ratio, maxillary skeletal width were measured in all 3 groups at different time points.Results: Immediately after expansion, RPE and MARPE groups showed a significant increase in the molar inclination, ICW, ICW/IRW ratio, and maxillary skeletal width compared with controls at postexpansion. However, the long-term comparison did not show any significant difference for root resorption and expansion parameters between the 3 groups, except the ICW/IRW ratio, which was higher in MARPE than controls at debond. A significant negative association was observed between the length of the mesiobuccal root of 1M and molar inclination (β = -0.025; 95% confidence interval, -0.050 to 0.0008; P <0.05). The expansion of ICW and IRW did not show a significant association with root resorption.Conclusions: The long-term outcomes showed no difference in the amount of root resorption between the RPE, MARPE, and control groups. Molar inclination showed a significant negative association with the length of the mesiobuccal root of the 1M. [ABSTRACT FROM AUTHOR]

Introduction: The purpose of this study was to quantitatively evaluate the ramus bone parameters (ramus thickness and ramus depth) for miniscrew placement. An additional aim was to compare and contrast the ramus bone parameters in growing and nongrowing male and female subjects with hyperdivergent, normodivergent, hypodivergent facial types.Methods: Cone-beam computed tomography scans of 690 subjects were evaluated. They were classified in terms of growth status, gender, and facial type. Ramus thickness was measured as the distance from the outer (buccal) to the inner (lingual) aspects of the mandibular ramus. Ramus depth was measured as the distance from the anterior border of the ramus to the inferior alveolar nerve canal. The measurements for ramus thickness and ramus depth were performed at 3 different levels bilaterally: (1) occlusal plane (OP), (2) 5 mm above the occlusal plane (5OP), and (3) 10 mm above the occlusal plane (10OP).Results: Males showed a significantly higher ramus thickness than females (P <0.05). Ramus thickness decreased significantly (P <0.05) as we moved superior from the level of OP to 5OP and 10OP in all 3 facial types in both females (growing and nongrowing) and males (growing and nongrowing). Growing females and growing males had significantly higher ramus thickness than nongrowing females and nongrowing males, respectively. Ramus depth increased as we moved higher from the OP to 10OP. Hyperdivergent facial type showed a significantly reduced ramus depth compared with hypodivergent and normodivergent facial type in growing and nongrowing males and females at all 3 locations, namely OP, 5OP, and 10OP (P <0.05).Conclusions: Because of adequate ramus depth and ramus thickness, 5OP was considered the optimal insertion site for the placement of miniscrews. Patients with a hyperdivergent facial type showed significantly reduced ramus depth than hypodivergent and normodivergent facial types. Ramus thickness in males was significantly higher than in females in all facial types. [ABSTRACT FROM AUTHOR]

• We analyzed the short-term and long-term effects of bone-anchored and tooth-anchored expansion on the condyle–fossa relationship, compared to those in a matched control group. • Tooth-anchored maxillary expansion led to a significant increase in the posterior joint space, compared to that in a control group at post-expansion. • Tooth-anchored maxillary expansion led to an increase in the distance from the condyle to the mid-sagittal plane on the left side, in the short term—at post-expansion compared to pretreatment. • There was no significant difference in the condyle–fossa relationship among the bone-anchored maxillary expansion, tooth-anchored maxillary expansion, and control groups in the long term. Thus, age and growth may be overriding factors. • The amount of change in molar extrusion showed weak correlation with the amount of change in the posterior joint space, and moderate correlation with the amount of change in the superior joint space at post-expansion and post-treatment. The amount of change in the skeletal maxillary width showed weak correlation with the amount of change in the posterior joint space at post-treatment. The objective of this study was to evaluate the short-term and long-term effects of tooth-anchored and bone-anchored maxillary expansion appliances on the condyle–fossa relationship, compared to those in a matched control group. Another objective of the study was to evaluate whether the amount of dental and skeletal expansion is correlated with the condyle–fossa relationship. A total of 180 cone-beam computed tomography scans (CBCTs) for 60 subjects were analyzed for 3 groups: 1) bone-anchored maxillary expansion (BA; n = 20); 2) tooth-anchored maxillary expansion (TA; n = 21); and 3) controls (n = 19) at pretreatment, post-expansion (T2), and post-treatment (T3). The posterior joint space (PJS), superior joint space (SJS), anterior joint space, angle of mandibular condyle, distance of the condyle to the mid-sagittal plane, the inter-molar cuspal width, and the skeletal maxillary width (SMW) were measured for all 3 groups. Both BA and TA led to a significant increase in inter-molar cuspal width, SMW, and TA led to a significant increase in PJS as compared to controls at T2. However, there was no significant difference in the joint spaces between the BA, TA, and control groups in the long term. Both the BA and TA groups showed a significant increase in SMW at T3 compared to the control group. Molar extrusion showed a weak correlation with PJS at T2 (r = 0.46) and T3 (r = 0.51), and a moderate correlation with SJS at T2 (r = 0.61) and T3 (r = 0.69). TA led to a significant increase in PJS, compared to a control group, at T2, but there was no long-term difference in the condyle–fossa relationship among the BA, TA, and control groups. Molar extrusion showed moderate correlation with SJS and PJS. [ABSTRACT FROM AUTHOR]

Objective: The objective of this report is to identify predictors of systemic infections following orthognathic surgeries. We test the hypothesis Neural Network models are better at predicting infections compared to traditional analytical models while using a large number of predictor variables. Methods: The Nationwide Inpatient Sample for the years 2006 to 2014 was used. All patients who had a jaw anomaly and underwent an orthognathic surgery were selected. Two models: Neural Network model and multivariable logistic regression model fit with the Maximum Likelihood method were used to predict systemic infections. Results: 55,839 orthognathic surgeries for maxillary/mandibular hyperplasia/hypoplasia required hospitalization in the United States. The overall systemic infection rate was 1.1%. The success rate for accurately predicting the occurrence of an infection was 98.7% by the Neural Network model. The top six predictors included: age, co-morbid condition of fluid and electrolyte disorders, year of procedure, race, deficiency anemia, and mandibular osteoplasty/segmental or subapical osteotomy. The multivariable logistic regression model had poor goodness of fit. Conclusions: Neural Network model is better at predicting systemic infections following orthognathic surgeries when compared to a traditional analytical model such as multivariable logistic regression approach while using a large set of predictor variables in a nationwide database. [ABSTRACT FROM AUTHOR]

The guided image filter (GIF) and weighted guided image filter (WGIF) are local linear model-based good edge-preserving filters. However, due to fixed regularization parameter, they suffer from halo artifacts (morphological artifacts) in the sharp regions. To overcome this issue, a robust multi-scale weighting-based edge-smoothing filter (RMWEF) for single image dehazing is proposed in this paper. It removes morphological artifacts and over-smoothness strongly and preserves edge information precisely in both flat and sharp regions. The proposed dehaze method has four-steps. First, initial transmission map and atmospheric map are estimated by using a novel dark channel prior (DCP) method. Then, the morphological artifacts of initial transmission map are reduced by using non-local haze line averaging (NL-HLA) method. In the third step, transmission map is refined by using the proposed RMWEF. Finally, the haze free image is restored. Theoretical and experimental analysis proves that the proposed algorithm produce effective dehaze results quicker than the existing methods. • Robust multi-scale weighting-based edge-smoothing filter (RMWEF) is proposed in this paper. • The value of the cost function (a x ′ , y ′ ) must vary in the range of '0' to '1' depending on the edge- aware smoothing parameter (γ x ′ , y ′ ). The mathematical formulation presented in this paper shows that the proposed filter maintains this relationship, as expected. • This article presents quantitative analysis for three different values of the regularization (ϵ) parameter viz. 0.01 2 , 0.1 2 , 1 2. Thus, it shows the trade-off between regularization parameter (ϵ) and morphological artifacts. • The proposed RMWEF removes morphological artifacts and over-smoothing effects strongly in the fine structures and preserves details in such areas very well by choosing large window radius ζ 1 =60. • The proposed method is tested on 6,618 images from different datasets and the results are compared with 9 existing methods. The experimental results show that it is independent of the nature of images. [ABSTRACT FROM AUTHOR]

Introduction: The primary objective of the study was to quantitatively analyze the width and height of the mandibular buccal shelf area (MBS) at 3 different potential locations for mini-implant placement. In addition, we aimed to compare and contrast the bone parameters of the MBS to study the correlation between different growth status (growing or nongrowing), facial types (hypodivergent, normodivergent, and hyperdivergent), and sex differences (male or female).Methods: In this retrospective cone-beam computed tomography study, 678 subjects were included. They were divided into groups according to growth status, facial type, and sex. Scans were imported into the reconstruction program and were aligned in 3 different steps. Measurements were made at 6 different coronal sections: mandibular first molar distal root, second molar mesial root, and second molar distal root (bilaterally). The roots of mandibular molars were used as a reference to measure the width and the roof of the inferior alveolar canal to measure the height of the buccal shelf area. Intraobserver reliability was assessed by measuring the width and height of MBS in 20 randomly selected subjects.Results: No significant difference (P > 0.05) was found in the width of MBS between males and females. MBS width increased, and height decreased (P < 0.0001) as moved distally from the first molar distal root to the second molar distal root in all 3 facial types irrespective of age or sex. The hypodivergent facial type had significantly greater bone width than the hyperdivergent facial type at all the 3 locations in both males and females. The hypodivergent facial type had significantly less (P < 0.0001) bone height than the hyperdivergent group at all the 3 locations irrespective of age or sex.Conclusions: The optimal site for MBS mini-implant is the buccal region of the distal root of mandibular second molars. Hypodivergent patients have more width and less height of MBS compared with hyperdivergent patients. MBS mini-implants are not advised for growing patients because of proximity to developing roots. [ABSTRACT FROM AUTHOR]

The objective of this study was to evaluate the effects of single plane and multiplane rotational errors in yaw, pitch, and roll of the head while recording the lateral cephalogram on CVM (cervical vertebrae maturity) assessment. A total of 40 cone-beam computed tomography (CBCT) scans and 360 lateral cephalograms were analyzed for patients with different rotations: Controls (no rotation), Y5 (yaw 5° rotation), Y10 (yaw 10° rotation), R5 (roll 5° rotation), R10 (Roll 10° rotation), P5 (pitch 5° rotation), P10 (pitch 10° rotation), YRP5 (yaw, roll, and pitch 5° rotation), and YRP10 (yaw, roll, and pitch 10° rotation). The C2, C3, and C4 concavity and their base-anterior ratio and posterior-anterior ratio were measured. In addition, maxillomandibular linear parameters, such as effective mandibular length and height, mandibular body length, effective midface length, and maxillomandibular differential, were also evaluated. Y5, Y10, R5, and R10 led to overestimation of CVM in comparison with controls. Multiplane rotations (YRP5 and YRP10) led to more inaccuracies in CVM measurements than single plane rotations; 10° of rotation led to more inaccuracies than 5° of rotation while recording the lateral cephalogram, irrespective of the plane. Yaw rotational errors led to an underestimation of maxillomandibular linear measurements, whereas roll rotational errors led to an overestimation of the measurements; however, there were wide individual variations in the measurements between the different rotations and controls. Rotational errors lead to overestimation of CVM assessment. Multiplane rotations cause higher inaccuracies than single plane rotations. Increased degree of rotations while capturing the lateral cephalograms lead to more inaccuracies in CVM assessment. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate whether the effects on the mandibular condylar cartilage (MCC) and subchondral bone are transient of botulinum neurotoxin (Botox) injection into the masseter muscle.Methods: Botox (0.3 U) was injected into the right masseter of 6-week-old female mice (C57BL/6; n = 16). In addition, 16 mice were used as control and received no injections. Experimental and matching control mice were killed 4 or 8 weeks after the single Botox injection. Mandibles and mandibular condyles were analyzed by means of microscopic computed tomography (microCT) and histology. Sagittal sections of condyles were stained for tartrate-resistant acid phosphatase (TRAP), toluidine blue, 5-ethynyl-2'-deoxyuridine (EdU), and terminal deoxynucleotide transferase-mediated dUTP nick-end labeling.Results: Bone volume fraction was significantly decreased on the subchondral bone of the Botox-injected side, compared with the control side and control mice, 4 and 8 weeks after injection. Furthermore, histologic analysis revealed decrease in mineralization, cartilage thickness, TRAP activity, and EdU-positive cells in the MCC of the Botox-injected side 4 and 8 weeks after injection.Conclusions: The effects on the MCC and subchondral bone of Botox injection into the masseter muscle persisted for 8 weeks after injection and were not considered to be transient. [ABSTRACT FROM AUTHOR]

Short root anomaly (SRA) is a rare familial dental condition that is often misdiagnosed. Orthodontic treatment of patients with SRA is challenging because it is difficult to diagnose, it may be accompanied by other dental anomalies, and it has been reported to contribute to additional susceptibility to root resorption during orthodontic treatment. In this article, we describe a methodical and evidence-based means of diagnosing and orthodontically managing a patient with SRA. The patient had additional challenges, including impacted and ectopic teeth. An individualized treatment plan that incorporated efficient and effective mechanics led to a well seated occlusion and an esthetic smile. [ABSTRACT FROM AUTHOR]

Introduction: Clear aligners and to a lesser extent self-ligated brackets are considered to facilitate better oral hygiene than traditional fixed orthodontic appliances. This 3-arm parallel-group prospective randomized clinical trial compared the long-term and short-term effects of clear aligners, self-ligated brackets, and conventional (elastomeric-ligated) brackets on patients' oral hygiene during active orthodontic treatment.Methods: Seventy-one participants (41 boys, 30 girls; mean age, 15.6 years) undergoing orthodontic treatment were randomly allocated through a computer-generated randomization schedule to one of the groups based on the choice of intervention: Clear Aligners (CLA) (Align Technology, San Jose, Calif) (n = 27), preadjusted edgewise fixed appliance with self-ligated brackets (SLB) (Carriere, Carlsbad, Calif (n = 22), or preadjusted edgewise fixed appliance with elastomeric ligated brackets (ELB) (Ortho Organizers Inc., Carlsbad, CA) (n = 22). For each participant, the primary outcome, plaque index (PI), and secondary outcomes, gingival Index (GI) and periodontal bleeding index (PBI), were measured at baseline (T0), after 9 months of treatment (T1), and after 18 months of treatment (T2). Blinding of the clinicians and the patients to the intervention was impossible. It was only done for outcome assessment and for the statistician. Ten participants did not receive the allocated intervention for various reasons.Results: The means and standard deviations of PI at T0 (CLA, 0.50 ± 0.51; SLB, 0.65 ± 0.49; ELB, 0.70 ± 0.73), T1 (CLA, 0.83 ± 0.48; SLB, 1.38 ± 0.72; ELB, 1.32 ± 0.67), and T2 (CLA, 0.92 ± 0.58; SLB, 1.07 ± 0.59; ELB, 1.32 ± 0.67) were similar. The odds ratio (OR) for plaque index (0 or ≥1) comparing SLB or CLA to ELB was not significant. OR for SLB vs ELB = 1.54 at T0 (95% CI, 0.39-6.27), 0.88 at T1 (95% CI, 0.03-24.69), and 0.83 at T2 (95% CI, 0.02-27.70); OR for CLA vs ELB = 1.07 at T0 (95% CI, 0.30-3.88), 0.24 at T1 (95% CI, 0.01-1.98), and 0.17 at T2 (95% CI, 0.01-1.71). However, the odds ratios comparing CLA with ELB for GI (OR = 0.14; P = 0.015) and PBI (OR = 0.10; P = 0.012) were statistically significant at T1.Conclusions: In this prospective randomized clinical trial, we found no evidence of differences in oral hygiene levels among clear aligners, self-ligated brackets, and conventional elastomeric ligated brackets after 18 months of active orthodontic treatment.Registration: The trial is registered at ClinicalTrials.gov (NCT02745626).Protocol: The protocol was not published before trial commencement. [ABSTRACT FROM AUTHOR]