Search

Background: This study used cone-beam computed tomography (CBCT) via voxel-based superimposition to evaluate lip and incisor changes after orthodontic treatment with four premolar extractions (Ext) versus nonextraction (Non-Ext) among African American (AA) and White (W) patients., Methods: A total of 240 CBCTs of 120 adolescent orthodontic patients with Class I skeletal/dental relationships were included. Patients were initially divided according to treatment, and then each group was subdivided according to patients' ethnicity (Ext/W = 30, Ext/AA = 30, Non-Ext/W = 30, and Non-Ext/AA = 30). CBCTs were imported into Invivo6 for voxel-based superimposition. Lip and incisor measurements were recorded. Independent t tests and two-way ANOVA were used for statistical assessment., Results: The Non-Ext/W group had a greater increase in all outcome variables compared with the Non-Ext/AA group, with a significant change in volume and position of upper (UL) and lower lips (LL), inclination of upper (U1) and lower incisors (L1), and position of U1. The Ext/AA group had a greater decrease in all measured outcomes compared with the Ext/W group, with significant change in inclination of U1 and L1, and position and volume of LL. W patients had more crowding than AA patients in both treatment approaches. Retraction ratios of 6.5:1 and 2.1:1 were recorded between the U1 and UL positions, and L1 and LL positions, respectively. There were no direct interaction effects between ethnicity and treatment, nor were there any significant effects of ethnicity after controlling for the covariates., Conclusions: Ethnicity alone has no impact on incisor and lip position after treatment. However, ethnicity in the form of initial presentation of malocclusion can have a significant influence., (Copyright © 2024. Published by Elsevier Inc.)

Background/objectives: The prevention of white spot lesions (WSLs) during orthodontic treatment with fixed appliances is of paramount importance to orthodontists. Numerous non-invasive techniques have been extensively researched to effectively manage WSLs. The objective of this study was to investigate the efficacy of MI varnish application, diode laser irradiation and their combination on remineralization of WSLs., Materials and Methods: In this in vitro study, 40 enamel samples were divided randomly into 4 groups based on the applied treatment after demineralization. In Group I, MI varnish was applied to the enamel samples for a period of 7 days. In Group II, samples were irradiated with diode laser. In Group III, MI varnish was applied for 7 days, followed by diode laser irradiation. Whereas Group IV (control group) received no treatment and samples were stored in artificial saliva for 7 days. Microhardness assessments were performed at baseline, after demineralization and following the different treatment protocols. A representative sample from each group was randomly selected for scanning electron microscopy (SEM) analysis. One-way ANOVA, repeated measures ANOVA, and Tukey's Post Hoc tests were used for statistical analysis, with significance set at P≤0.05., Results: All treatment groups demonstrated significantly higher mean microhardness values compared to the control group (P<0.05). Group 1 (MI varnish) had a final microhardness mean value of 193.50 (P<0.001), Group 2 (diode laser) recorded the highest final mean of 214.20 (P=0.018), and Group 3 (MI varnish+diode laser) had a mean of 203.93 (P=0.011). SEM observations supported these findings by showing enhanced surface morphology in the treatment groups., Conclusions: MI varnish application, laser irradiation, and their combination demonstrated enhanced microhardness of artificially demineralized enamel, highlighting their effectiveness in remineralization of WSLs., (Copyright © 2024 CEO. Published by Elsevier Masson SAS. All rights reserved.)

Design: Systematic review and meta-analysis of randomized clinical trials (RCTs), non-randomized studies of intervention (NRSIs), cohort and cross-sectional studies. The systematic review was registered in advance on PROSPERO, and was conducted following the Cochrane Handbook of Systematic Reviews of Interventions and PRISMA checklist., Data Sources: An electronic search in three databases (PubMed, Scopus, and Embase) was conducted by two authors to evaluate studies published from 1990 until May 2023., Study Selection: The review question was defined in PICOS format as follows: Population (P), subjects with permanent dentition who having/had orthodontic therapy; Exposure (E), orthodontic therapy with fixed orthodontic appliance; Comparison/Control (C), no orthodontic treatment or intervention; Outcome (O), assessing incidence and/or prevalence of initial caries lesions (ICLs) at subject and teeth levels was the primary outcome, whereas evaluating the influence of demographics and treatment-related variables were secondary outcomes; studies (S), randomized clinical trials, non-randomized clinical studies, cohort and cross-sectional studies., Data Analysis: Meta-analysis was conducted of three or more included studies had comparable findings. The following factors were calculated for each study; sample size, number of patients with ICLs, number of teeth with ICLs, number of teeth affected per patient, and number of surfaces affected. Statistical heterogeneity of effects among studies was assessed by means of the Cochran's test was used to evaluate the statistical heterogeneity of effects in the included studies. Funnel plot approach was used to assess publication bias, whereas Begg's and Egger's correlation test were used to identify asymmetry. Meta-analysis was conducted using a random effects model owing to high methodological and clinical heterogeneity. A descriptive analysis was presented when the meta-analyses appeared inappropriate. Statistical significance level was set at p < 0.05 for all statistical analyses., Results: 21 studies were included in the qualitative synthesis (systematic review); 11 RCTs; 7 NRSIs, and 3 observation studies. Of the included studies, 19 studies were analyzed in the quantitative synthesis (meta-analysis). In regard to the prevalence rate of ICLs; 57% of patients had ICLs, with a mean of 2.24 lesions per patient and 22% of surfaces were affected. In regard to the incidence rate; 48% of patients developed new ICLs, with a mean of 2.29 new lesions per patient, and 15% of surfaces became affected. Both prevalence and incidence rates were positively associated with the duration of the orthodontic therapy (P = 0.01 and P < 0.01, respectively), illustrating an elevation in the ICLs numbers as the treatment duration (number of months) increases. There was no association between patients' age and ICLs numbers., Conclusions: Orthodontic therapy using fixed appliances can increase the risk of accumulating plaque and developing caries lesion. However, other risk factors may play a role in developing ICLs; thus, controlling for these factors is paramount to better evaluate the true influence of orthodontic therapy on the ICLs development. Implementing caries preventive measures during orthodontic treatment may be needed to minimize the potential risks., (© 2024. The Author(s), under exclusive licence to British Dental Association.)

Article Title and Bibliographic Information: Duarte L, Bezerra AP, Flores-Mir C, De Luca Canto G, Pereira LJ, Vega Gonçalves TMS. Activation and installation of orthodontic appliances temporarily impairs mastication. Angle Orthod. 2022 Mar 1;92(2):275-286. doi: 10.2319/061,221-469.1. PMID: 34,878,525; PMCID: PMC8887415., Source of Funding: Not reported., Type of Study/design: Systematic review with meta-analysis of data., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Design: Systematic review and meta-analysis of randomized controlled trials, non-randomized and observational studies, and previous systematic reviews if matching PECOS strategy. The protocol of the study was registered on PROSPERO., Data Sources: An electronic search was conducted in the following five databases: The Cochrane Library, PubMed, Web of Science, Scopus, and CINAHL. The search was carried out to cover the literature up to June 15, 2022. In addition, ClinicalTrials.gov and PROSPERO were searched for detecting any relevant unpublished data and ongoing studies., Study Selection: The review was defined in PECOS format as follows: population (P), healthy adolescents (ASA Class I or II; age 10-19); Exposure (E), malocclusion and/or need of orthodontic therapy as determined by professionals utilizing validated standardized tools such as Index of Orthodontic Treatment Need, Index of Complexity, Outcome and Need, Peer Assessment Rating, Dental Aesthetic Index, or any well-described tool; comparison (C), no malocclusion and/or need of orthodontic therapy as determined by professionals utilizing validated standardized tools; outcome (O), self-reported oral health-related quality of life (OHRQoL) using validated tools; study design (S), randomized clinical trials, non-randomized/observational studies (prospective and cross-sectional studies with untreated/no-malocclusion controls), and previous systematic reviews if matching PECOS strategy. Studies assessing ASA Class III or higher, craniofacial conditions, previous or ongoing orthodontic or surgical treatment, and case studies were excluded., Data Analysis: Screening and data extraction and management, risk of bias (RoB), and quality assessments were conducted by four independent investigators. RoB was assessed based on the guidelines of the Swedish Agency for Health Technology Assessment and Assessment of Social Services., Results: A total of 13 studies (non-randomized studies of cross-sectional design) were included in the qualitative synthesis, of which, 4 studies were included in the quantitative synthesis. Meta-analysis showed that malocclusions (measured with DAI) in adolescents aged 11-14 years old have a negative impact on OHRQoL (measured with CPQ 11-14 short form) (number of studies = 4, rate ratio/prevalence ratio = 1.15, 95% confidence interval = 1.12-1.18, I 2  = 0.03%, Q3 = 0.09, certainty level = moderate)., Conclusions: Moderate level of evidence suggests that malocclusions in adolescents have a negative impact on the oral health-related quality of life., (© 2023. The Author(s), under exclusive licence to British Dental Association.)

Design: Systematic review and meta-analysis of clinical trials, and prospective or retrospective cohort. The protocol of the study was registered in advance on PROSPERO., Data Sources: An electronic search in MEDLINE (PubMed), Web of Science, Scopus, and The Cochrane Library was conducted by two independent authors up to September 2022. Additionally, OpenGrey and www.greylit.org were searched for gray literature, whereas ClinicalTrials.gov was searched for detecting any relevant unpublished data., Study Selection: The review question was defined in PICOS format as follows: population (P), patients undergoing orthodontic therapy; intervention (I), orthodontic therapy with clear aligner (CA); comparison (C), orthodontic therapy with fixed appliances (FA); outcome (O), periodontal health status and development of gingival recession; studies (S), randomized clinical trials (RCTs), controlled clinical trials, and retrospective or prospective cohort studies. Cross-sectional studies, case series, case reports, studies without a control group, and studies with less than 2 months follow-up were excluded., Data Analysis: Periodontal health status was assessed as a primary outcome and it was measured in terms of pocket probing depth (PPD), gingival index (GI), plaque index (PI) and bleeding on probing (BoP). Gingival recession (GR) was assessed as secondary outcome, and was measured as the development or progression of GR, shown by the apical migration of the gingival margin occurring between pre- and post-orthodontic treatment. Each periodontal index was assessed in three-time points; short-term (2-3 months from baseline), mid-term (6-9 months from baseline), and long-term (12 months or more from baseline). A descriptive analysis of included articles was performed. Pairwise meta-analyses were conducted to compare outcomes assessed in FA and CA groups and were only performed when studies reported similar periodontal indices at similar follow-ups., Results: 12 studies (3 RCTs, 8 prospective cohort studies, 1 retrospective cohort study) were included in the qualitative synthesis, of which, 8 studies were included in the quantitative synthesis (meta-analysis). A total of 612 patients (321 treated with buccal FA and 291 with CA) were assessed. Results from meta-analyses favored CA in regards to PI, demonstrating a significant difference in the mid-term follow-up (number of studies = 4, standardized mean difference [SMD] = -0.99, 95% confidence interval [CI] = -1.94 to -0.03, I 2  = 99%, P = 0.04). There was a tendency to report better GI values with CA, specifically in long-term (number of studies = 2, SMD = -0.46 [95% CI, -1.03 to 0.11], I 2  = 96%, P = 0.11). However, no statistical significance between the two treatment modalities was shown for any follow-up intervals (P > 0.05). As for PPD, the long-term follow-up showed statistical significance favoring CA (SMD = -0.93 [95% CI, -1.06 to 0.7], P < 0.0001), whereas short- and mid-term follow-ups did not show significant differences between FA and CA. Overall, patients treated with CA showed better values of BoP and less GR when compared to patients treated with FA., Conclusions: Available evidence is still not enough to conclude the superiority of clear aligner therapy in terms of periodontal status during orthodontic treatment compared to fixed appliances., (© 2023. The Author(s), under exclusive licence to British Dental Association.)

Article Title and Bibliographic Information: Liu S, Silikas N, Ei-Angbawi A. Analysis of the effectiveness of the fiber-reinforced composite lingual retainer: A systematic review and meta-analysis. Am J Orthod Dentofacial Orthop. 2022 Aug 26:S0889-5406(22)00,432-2. doi: 10.1016/j.ajodo.2022.07.003. Epub ahead of print. PMID: 36,031,511., Source of Funding: Not reported., Type of Study/design: Systematic review with meta-analysis of data., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Design: Single-center randomized clinical trial with two parallel arms. The protocol of the study was approved by the institutional review board (IRB) of the Faculty of Dentistry, Alexandria University (IRB: 00010556-IORG: 0008839) and registered in Clinicaltrials.gov (identifier number: NCT04225637). Before the trial commencement, parents/legal guardians signed informed consents. The study complied with the CONSORT (Consolidated Standards of Reporting Trials)., Case Selection: 30 adolescent patients aged between 12 to 16 years with transversely deficient maxilla requiring skeletal maxillary expansion were recruited to be included in the study. Patients received miniscrew-supported Penn expanders and they were randomly allocated (ratio 1:1) into two groups based on the activation protocol; slow maxillary expansion (SME = turn every other day) or rapid maxillary expansion (RME = 2 turn/day)., Data Analysis: The patient-reported outcome measures were the following: pain, headache, pressure, dizziness, speech, chewing and swallowing difficulties, swallowing difficulty. The participants rated the reported outcomes using numeric rating scale (NRS) at 4 time points: t 1  = before appliance insertion, t 2  = after first activation, t 3  = after 1 week of activation, and t 4  = after last activation. Patients were advised not to use analgesics, and to contact their provider in case of severe pain. Descriptive measures and patient-reported outcomes at various time points were calculated. Comparisons between the two groups at each time point were assessed using Mann-Whitney U-test. Comparisons of time points in each group were assessed using the Friedman test and followed by post-hoc tests with Bonferroni correction., Results: 6 patients were not included in the analysis for different reasons, allowing a total of 24 patients (12 patients in each group) to be analyzed. Mean ages of the patients in the SME and RME group were 14.30 ± 1.37 and 15.07 ± 1.59, respectively. Median scores were in the bottom quartiles of NRS for all reported outcomes. RME group reported significantly higher scores for all measured variables, with exception of headache and dizziness, which showed no statistical difference between the two group., Conclusions: Mild to moderate discomfort and functional limitation is anticipated with the activation of miniscrew-anchored Penn expanders. Slow activation protocol provided a better overall patient experience when compared to a rapid activation protocol., (© 2023. The Author(s), under exclusive licence to British Dental Association.)

Purpose: This cross-sectional study aimed to utilize quantitative polymerase chain reaction (qPCR) to investigate the influence of genetic variance over teeth inclination and angulation in orthodontic patients with Class I occlusion., Materials and Methods: DNA was extracted from adolescent patients seeking orthodontic treatment in a single institution (from July 2018 to April 2020), who had CBCTs taken as part of initial standardized records. Patients had permanent dentition, Class I skeletal and dental classifications, with normal vertical and transverse skeletal dimensions, normal incisors inclination, no to mild crowding or spacing. qPCR was performed using genetic markers for candidate genes EPB41, TGFβ3, GHR and PAX9. Three-dimensional teeth inclinations (TI) and angulations (TA) were evaluated using Invivo6 software and correlated with genotypes. Reliability of TI and TA was assessed using intraclass correlation coefficients (ICC). Mixed models and multiple linear regression analyses were used to assess the association between each single nucleotide polymorphisms (SNP) with tooth inclination (TI) and with tooth angulation (TA). The results were evaluated at the significance level of P<0.05., Results: Twenty four adolescent patients with mean age of 13.4±2.4 years were included in the study. ICC showed adequate intra-examiner reliability for TI and TA (0.806

Design: Systematic review and meta-analysis of randomized controlled trials (RCTs) and controlled clinical trials (CCTs). The protocol of the study was registered on the International Prospective Register of Systematic Reviews (PROSPERO: CRD42019157298)., Data Sources: Seven electronic databases (MEDLINE, Web of Science Core Collection, Unpublished Clinical Trials accessed through clinicaltrials.gov, Embase, LILACS, ProQuest Database, The Cochrane Library) were searched. Additionally, the reference lists of the included studies were hand searched., Study Selection: Clinical trials (RCT and CCT) that assessed the impact of the interventional use of mobile applications and social media among orthodontic patients were included. The review question was defined in PICO format as follows: population (P) = patients (no age restriction) undergoing orthodontic treatment using fixed, removable, or functional appliances, or patients in the retention phase that are wearing fixed or removable retainers; intervention (I) = mobile applications and social media-based interventions; comparison (C) = control group that did not receive any adjunctive intervention; outcome (O) = behavior changes in orthodontic patients after receipt of the intervention. Two authors independently conducted literature search from inception up to March 2021., Data Analysis: Social media-based interventions and mobile applications (or bespoke) were used in the form of reminders (WhatsApp reminders) and provision of information including YouTube videos and Instagram posts. Primary outcomes included adherence to wearing appliances or adjuncts, oral hygiene levels, oral health-related behaviors, periodontal outcomes, appointment attendance, knowledge, and related iatrogenic effects. Treatment-related experiences and patient-reported outcomes were assessed as secondary outcomes., Results: 16 studies (14 RCTs and 2 CCTs) were included in the qualitative synthesis, of which only 7 studies were included in the quantitative synthesis (meta-analysis). Results from meta-analyses showed that the intervention was favored in relation to gingival index (GI) (number of studies = 4, standardized mean difference [SMD] = -0.81, 95% confidence interval [CI] = -1.35 to -0.28, P = 0.00, certainty of evidence = very low), plaque index (PI) (number of studies = 7, SMD = -0.91 [95% CI, -1.64 to -0.19], P = 0.01, certainty of evidence = very low), and bleeding index (BI) (number of studies = 4, SMD = -0.22 [95% CI, -0.50 to 0.05], P = 0.11, certainty of evidence = high). Sensitivity analysis was performed (including additional 3 studies for GI and 5 studies for PI), which also favored the intervention in relation to GI (number of studies = 7, SMD = -0.60 [95% CI, -1.01 to -0.18], P = 0.00, certainty of evidence = very low), and PI (number of studies = 12, SMD = -0.67 [95% CI, -1.14 to -0.19], P = 0.01, certainty of evidence = very low)., Conclusions: Limited evidence supports beneficial behavior change among orthodontic patients when using mobile applications or social media-based interventions., (© 2023. The Author(s), under exclusive licence to British Dental Association.)

Introduction: Presurgical infant orthopedics was introduced as an interceptive approach for treating cleft lip and/or palate (CLP). This study aimed to evaluate the intraoral digital impression technique as a viable alternative to conventional impression in infants with unilateral CLP., Methods: Trios 3-Shape scanner (3Shape, Copenhagen, Denmark) was used for intraoral scanning of the infants' maxillary arches to provide a direct digital scan (DDS). In addition, conventional impressions of the same patients were taken in a hospital setting, and the resultant stone models were digitized using the same scanner to create an indirect digital scan (IDS). Both scans (DDS and IDS) were exported in stereolithography format, and the resultant stereolithography files were imported into computer-assisted-design software (Exocad DentalCAD; exocad GmbH, Darmstadt, Germany) for 3-dimensional surface model superimposition. Differences between the 2 surfaces were quantified in millimeters and visually displayed by a color map., Results: Three-dimensional surface model superimposition of the DDS and IDS scans showed an excellent agreement between both approaches, in which differences ranged from 0.01 mm to 0.1 mm CONCLUSIONS: Intraoral direct digital impression in infants with unilateral CLP is a safe, accurate, and time-efficient technique, which can be a viable alternative to conventional impression. This will aid in overcoming the challenges and complications that are frequently associated with using conventional impressions in infants with unilateral CLP, thus reducing the burden of care not only on the patients' families but also on the care providers., (Copyright © 2022 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.)

Article Title and Bibliographic Information: ElShehaby M, Mofti B, Montasser MA, Bearn D. Powered vs manual tooth brushing in patients with fixed orthodontic appliances: A systematic review and meta-analysis. Am J Orthod Dentofacial Orthop. 2020 Nov;158(5):639-649. doi: 10.1016/j.ajodo.2020.04.018. Epub 2020 Sep 17. PMID: 32951930., Source of Funding: Information not available., Type of Study/design: Systematic review with Meta-analysis., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Purpose: The aim of this study is to evaluate craniofacial characteristics and upper airway morphology in adolescents with Attention Deficit Disorder with Hyperactivity (ADHD) compared to controls (CON)., Materials and Methods: Records from July 2014 to May 2018 of patients who were seeking orthodontic treatment at a single institute and had full pre-treatment orthodontic records including cone-beam computed tomography (CBCT) were reviewed. Comprehensive cephalometric variables were measured to determine craniofacial morphology. Upper airway volume (UAV), minimum cross-sectional area (MCA), and linear measurements were calculated at multiple planes., Results: A total of 87 adolescents (ADHD, 29; CON, 58) were included in the study. Overall, UAV and MCA in ADHA group were smaller than CON. Statistical significance was evident in airway widths at planes A (P=0.002), C (P=0.042), and D (P<0.001), and airway area at plane D (lower hypopharynx) (P<0.001), with the ADHD group showing narrower widths and area compared to CON. The most common skeletal classification in the ADHD group was sequenced as Class II, Class I then Class III, with percentages of (58.6%), (31%) and (10.3%), respectively. No significant differences were found between the groups for any of the skeletal, dental, and soft tissue cephalometric variables., Conclusions: ADHD affected adolescents have similar craniofacial characteristics, but narrower upper airway dimensions compared to controls. Further investigations with larger samples are warranted to further elucidate the relationship between SDB and ADHD., (Copyright © 2021 CEO. Published by Elsevier Masson SAS. All rights reserved.)

Objective: The purpose of this study is to utilize cone-beam computed tomography (CBCT) to compare the bone mineral density (BMD) on the affected versus nonaffected side, among individuals with hemifacial microsomia (HFM)., Methods: This retrospective study included 9 patients with HFM. Pretreatment CBCT volumes were imported into Invivo5 software, which was used to measure BMD through Hounsfield units (HU) in 3 regions of the mandible; inferior to the lower lateral incisors, inferior to the first molar and at the ramus inferior to the sigmoid notch. Each region was measured at the buccal cortical bone, lingual cortical bone, and cancellous bone. The densities on the right and left sides were compared by Wilcoxon signed-rank test., Results: Overall, the BMD on the affected side tended to show slightly lower values when compared with the nonaffected side. Differences ranged from 14 HU at the lingual cortical plate of the first molar region to 234 HU at the buccal cortical plate of the ramus region. Differences were only statistically significant at the ramus region for the buccal ( P = .002) and lingual ( P < .001) cortical plates and at the lower incisor region at the buccal cortical plate ( P = .016) and cancellous bone ( P = .044). The differences, however, did not seem to be clinically significant., Conclusions: The current study shows that the quality of bone on the affected side may be slightly reduced but did not seem to be clinically significant. This should be accounted for during surgical and orthodontic planning for patients with HFM.

Purpose: Ectodermal dysplasias (EDs) are a diverse set of hereditary conditions in which 2 or more ectodermal structures develop abnormally. The purpose of this study was to use cone-beam computed tomography (CBCT) scans to measure the pharyngeal airway volume and minimum cross-sectional area (MC) among patients with ED and compare them with healthy controls., Patients and Methods: The pretreatment CBCT scans of 9 individuals with ED and 61 controls were analyzed. Lateral cephalograms were created from the CBCT volumes and then traced and compared between the 2 groups. Airway volumes were evaluated by Dolphin 3D software (Dolphin Imaging, Chatsworth, CA) to compare the total pharyngeal volume, nasopharyngeal volume, oropharyngeal volume, hypopharyngeal volume, and MC. The mean airway volumes of the 2 groups were compared, and the odds ratio and relative risk of having an MC of less than 100 mm 2 in the ED group were calculated., Results: Intraclass correlation analysis showed excellent inter-rater reliability. All cephalometric features of controls were within the norms of patients with ideal skeletal-dental relationships. Patients with ED displayed significantly lower values for SNA (angle between sella-nasion and nasion-A point) (P = .018), ANB (angle between nasion-A point and nasion-B point) (P = .002), L1-MP (angle between long axis of mandibular incisor and gonion-menton plane) (P = .013), and L1-NB (distance between mandibular incisor and perpendicular line between nasion and B point) (P < .001). Although the ED group exhibited slightly smaller airway volumes for all subregions, the differences were not statistically significant for total pharyngeal volume, nasopharyngeal volume, oropharyngeal volume, hypopharyngeal volume, or MC (P > .05). The odds of having an MC of less than 100 mm 2 were almost 3 times greater among ED patients, and the relative risk of an MC of less than 100 mm 2 among ED patients was double that of controls., Conclusions: Although the craniofacial structures of individuals with ED are characterized by maxillary and midface deficiency, the airway volumes among affected individuals may not be significantly different from those of unaffected controls. However, patients with ED displayed a higher risk of having an MC of less than 100 mm 2 , which may be of clinical significance and warrants further investigations with larger samples., (Copyright © 2020 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.)