Relationship between obstructive sleep apnea and orthodontic malocclusion in non-obese adults: Review

Introduction: Obstructive Sleep Apnea (OSA) represents the complete or partial obstruction of the airway. Clinically OSA manifests as sleepiness during the day, heavy snoring, and waking up during the night due to lack of air. Obesity, gender and orthodontic anomalies are listed in the literature as the etiologic factor of OSA. Aim: This study aimed to find the correlation in the analyzed studies between OSA and orthodontic anomalies in non-obese adults. Material and methods: The electronic search of the database was performed (PubMed and Google Scholar) to find relevant articles that correlate orthodontic anomalies with OSA. Keywords included: obstructive sleep apnea, orthodontic anomalies, cephalometric analysis, impact, association, body mass index, obesity, adults, non-obesity. Included criteria: non-obesity, a study published from 1999-2019, a study in English, full text. Results: Two hundred papers included keywords. The number of papers that included the full set criteria was nine. These nine papers were analyzed in detail. Conclusion: Analyzed articles showed that there is a correlation between Obstructive sleep apnea (OSA) and orthodontics malocclusion in non-obese adults

Evaluation and comparison of tooth size discrepancies among different malocclusion groups

Introduction: The compliance of proportions between the mesiodistal dimensions of the upper and the lower teeth is necessary for good intercuspidation. Given that a significant discrepancy in tooth size can prevent ideal occlusion at the end of orthodontic treatment, the absence of tooth size discrepancy is a significant factor for the realization of the ideal occlusion. Aim: Aim of this study was to determine whether there is a difference in the incidence of tooth size discrepancies among different skeletal malocclusion groups in the orthodontic patients. Material and methods: The sample comprised 300 pretreatment study casts (118 males and 182 females) with fully erupted and complete permanent dentition except third molars, which were selected randomly from records of orthodontic patients. All subjects were divided in three groups, according to the Angle classification of malocclusion. The measurements were made on study models with digital calipers accurately to 0.01 mm. The Class was defined by using the Steiner analysis on lateral cephalograms. The subjects were divided into three groups depending on the value of the ANB angle. For every subject, the value of the angles SNA, SNB and ANB was measured. The reliability of measurements was examined by the Pearson’s correlation coefficient. To determine whether there were gender differences an independent sample t-test was performed. Results: There is no statistically significant differences in Bolton’s discrepancy by different gender, or at different classes. The average value of the anterior Bolton ratio was 78.16 and of the overall were 90.87. Values of the anterior and overall Bolton ratios are highest in patients with Class III. The highest average value of anterior discrepancy was in male subjects with III Class (-0.72), while the highest average value of overall discrepancy was in male subjects with II Class (0.65). Conclusion: The results of the study show that there are no statistically significant differences in Bolton’s discrepancy by different gender, or at different classes

Choice of the Retention Method After an Orthodontic Treatment-Narative review

Retention is a phase of orthodontic treatment devised to keep the teeth in a correct position once the orthodontic treatment has been completed. There are three main characteristics that each ideal retainer is required to have: to keep the teeth in the correct position after orthodontic therapy, to be long lasting and resistant to mechanical damage, and to have no adverse long-term effects on periodontal tissue. Through a computer-based browsing through a number of databases (such as, e.g. PubMed and Google Scholar) we have found and analysed various articles used in this research. The inclusion criteria to be met were: an overall availability of a research paper, the requirement that these research papers are published in English, that these research papers were published in the period 2007-2019, the requirement that the research papers should involve clinically randomized studies and that their titles contain one of the predefined keywords. The database browsing that is based on the said keywords and carried out within the above time frame has resulted in finding 165 relevant articles. A complete set of the inclusion criteria were met by 8 published research papers, but 7 articles were analysed in the end. The selected articles have compared different types of fixed and mobile retainers, different times of wearing the retainers, the impact that the retainers had on the periodontium, and the acceptability of different retention protocols for patients. The conclusion of this research paper is that bonded retainers prove to be most effective in stabilising the position of the incisors, particularly the lower ones, but that their disadvantages include the reopening of the extraction space and the retention of plaque due to difficulties in maintaining oral hygiene. Vacuum-formed retainers appear to be more effective than Hawley retainers in retaining the position of the incisors, and patients have indicated that they are more acceptable to wear. Hawley retainers prove to be most effective in preserving a closed extraction space, but they do now show solid results with regard to other segments. Changes in the overbite, overjet, arch length, and anterior and posterior widths did not show any significant statistical differences in the different types of retainers

Semi-automatic Assessment of Cervical Vertebral Maturation Stages using Cephalograph Images and Centroid-based Clustering

Korištenjem radiograma istraživala se učinkovitost različitih numeričkih tehnika za poluautomatske procjene stupnja sazrijevanja vratnih kralježaka (CVM). Metode: Kefalogrami 211 pacijenata snimljeni su i spremljeni u digitalnom obliku. Nakon toga su, s pomoću posebno razvijenog softvera i tih pohranjenih radiograma, specijalisti ortodoncije označili i mjerili za svakog pacijenta nekoliko karakterističnih kefalometrijskih obilježja. Rezultati su bili potrebni za automatsko određivanje stupnja sazrijevanja vratnih kralježaka s nekoliko numeričkih tehnika, među kojima K znači klasteriranje (grupiranje), a Fuzzy C – dusteriranje (rasipanje). Rezultati su uspoređeni s podacima koje su dobili specijalisti. Rezultati: Najbolji rezultati dobiveni su korištenjem Fuzzy C rasipanja. Točna ocjena stupnja CVM-a iznosila je oko 70 posto, a procjena klase bila je viša od 99 posto. Zaključak: Eksperimentalni rezultati pokazuju da se može razviti potpuno automatizirani sustav za procjenu i predviđanje stupnjeva CVM-a, premda još treba riješiti manje teškoće prije primjene u kliničkoj praksi.Introduction: Effectiveness of different numerical techniques for use in semi-automatic assessment of cervical vertebral maturation stages (CVM) using radiograph images was investigated. Methods: Lateral cephalographs of 211 patients were recorded and stored in a digital form. Using the specially developed software application, orthodontic experts marked and measured several characteristic cephalometric parameters for every patient. The results of these measurements were used to automatically determine the cervical vertebral maturation stage using numerical techniques, including the K-means clustering and the Fuzzy C-means clustering. These results were compared with the assessment made manually by the trained orthodontists.Results: The best results were achieved using the modified Fuzzy-C means clustering. Identification of the correct CVM stage was around 70%, while the assessment including the adjacent classes [+/- 1 developmental stage] was over 99%. Conclusions: Experimental results show that it may be possible to develop a fully automated system to assess CVM stages, although there are still minor issues that need to be addressed before the method’s implementation in the clinical practice

A determination of the standards of morphometrics variables of the stomatognathic system of a fetus

Introduction: Many factors affect the growth and development of the mandible. The most common one is micrognathia; this can poseand neonatal emergency. Early recognition of mandibular and other face anomalies could provide immediate care for these infants,and presence of neonatologist or other doctors in the delivery room. The aim: Aim of this study was to develop normal ranges of the facial markers: mandibular length, jaw index and the facial angle inthe fetus using 3D ultrasound. Material and methods: The research was conducted as a cross-sectional study in the second trimester of pregnancy. Fetuses (femalen=23 and male n=27) from singleton pregnancy between 29-37 week of gestation were examined by ultrasound. All images wereacquired transabdominally, using Voluson E16. Ultrasound was performed by an experienced operator (SM) and measured thevalues of head circumference, abdominal circumference, biparietal diameter, femur length, body mass. For mandibular length,inferior facial angle, and the jaw index was calculated (Jaw Index =AP mandibular diameter / BPD * 100), the profile images wereused (only images in the exact midsagittal plane were used). The characteristics of the fetal profiles were determined by the Schwartzand Ricketts profile analysis using soft tissue landmarks and analysis of the profile photographs. Results: The results show that the jaw index ranged from 25.33 and 34.06 with an average of 26.00 for all examined fetuses. Conclusion: The physiological position of the mandible is retrognathic and that the average physiological length of the mandible inthe third trimester is 2.31cm. There is no difference in mandibular length between genders

Antimicrobial activity of chlorhexidine in patients with fixed orthodontic appliances

Aim: Oral environment of orthodontic patients undergoes changes, such as pH reduction, larger number of sites available for Streptococcus mutans collection, and increased accumulation of food particles, which may lead to an increased number of S. mutans colony-forming units (CFU) in saliva. Chlorhexidine gluconate (CHX) is the most potent documented antimicrobial agent against Mutans streptococci and dental caries. The aim of this work was to assess efficiency of CHX-based mouthwashes in patient with fixed orthodontic appliances. Methods: Twenty patients with fixed appliances were selected for this study. They were undergoing full-bonded non extraction treatment with metal brackets (Roth 0.22, Discovery Dentaurum) on their teeth and bands on their molars. Each patient was provided with a toothbrush and toothpaste. The mouthwashes were used by patients according to the manufacturers’ directions 15 min after toothbrushing: 5 mL of 0.2% CHX (Corsodyl, GlaxoSmithKline) was applied for 60 s in the morning and before bedtime for 2 weeks. Results: The data were analyzed according to the nonparametric Wilcoxon signed rank test (SPSS software). Statistical significance level was set at p<0.05. Conclusions: The use of CHX-based mouthwashes in patients with fixed orthodontic appliances led to reduction in the level of S. mutans

Antimicrobial activity of chlorhexidine in patients with fixed orthodontic appliances

al environment of orthodontic patients undergoes changes, such as pH reduction, larger number of sites available for Streptococcus mutans collection, and increased accumulation of food particles, which may lead to an increased number of S. mutans colony-forming units (CFU) in saliva. Chlorhexidine gluconate (CHX) is the most potent documented antimicrobial agent against Mutans streptococci and dental caries. The aim of this work was to assess efficiency of CHX-based mouthwashes in patient with fixed orthodontic appliances. Methods: Twenty patients with fixed appliances were selected for this study. They were undergoing full-bonded non extraction treatment with metal brackets (Roth 0.22, Discovery Dentaurum) on their teeth and bands on their molars. Each patient was provided with a toothbrush and toothpaste. The mouthwashes were used by patients according to the manufacturers directions 15 min after toothbrushing: 5 mL of 0.2% CHX (Corsodyl, GlaxoSmithKline) was applied for 60 s in the morning and before bedtime for 2 weeks. Results: The data were analyzed according to the nonparametric Wilcoxon signed rank test (SPSS software). Statistical significance level was set at p<0.05. Conclusions: The use of CHX-based mouthwashes in patients with fixed orthodontic appliances led to reduction in the level of S. mutans