Evaluating the Amount of Tooth Movement and Root Resorption during Canine Retraction with Friction versus Frictionless Mechanics Using Cone Beam Computed Tomography

BACKGROUND: The current study was carried out to compare the amount of tooth movement during canine retraction comparing two different retraction mechanics; friction mechanics represented by a NiTi closed coil spring versus frictionless mechanics represented by T - loop, and their effect on root resorption using Cone Beam Computed Tomography (CBCT).METHOD: Ten patients were selected in a split-mouth study design that had a malocclusion that necessitates the extraction of maxillary first premolars and retraction of maxillary canines. The right maxillary canines were retracted using T - loops fabricated from 0.017 X 0.025 TMA wires. The left maxillary canines received NiTi coil spring with 150 gm of retraction force. Pre retraction and post retraction Cone Beam Computed Tomography were taken to evaluate the amount of tooth movement and root resorption using three-dimensional planes.RESULTS: T - loop side showed statistically significant higher mean anteroposterior measurement than NiTi coil spring side, indicating a lower amount of canine movement pre and post a canine retraction. Concerning the root resorption, there was no statistically significant change in the mean measurements of canine root length post retraction.CONCLUSION: The NiTi coil spring side showed more distal movement more than the T-loop side. Both retraction mechanics with controlled retraction force, do not cause root resorption

Parents’ Acceptance to Alveolar and Nasoalveolar Molding Appliances during Early Cleft Lip and Palate Care: A Call for High-Quality Research

AIM: Acceptance and compliance of the parents are an essential pillar in the success of pre-surgical infant orthopedic (PSIO) treatment. The aim of this systematic review is to evaluate the burden of care associated with the alveolar molding (AM) and nasoalveolar molding (NAM) appliances as experienced by the parents with unilateral complete cleft lip and palate (UCLP) infants. METHODS: An electronic search was carried on by two reviewers in eight search engines, as well as a manual search till July 2019. Randomized controlled trials (RCTs) comparing AM/NAM appliances to controls in infants with UCLP were selected. Risk of bias was evaluated using Cochrane risk of bias assessment tool for RCTs. RESULTS: One RCT was included in the qualitative analysis. Non-significant differences were found in the amount of mothers’ satisfaction between the intervention and control groups. CONCLUSIONS: Insufficient low-quality evidence is available regarding the effects of AM and NAM on parents’ satisfaction and burden of care. No conclusions can be withdrawn from the existing studies. High-quality research is needed to elucidate the degree of parents’ acceptance to the molding appliances. PROSPERO registration number: CRD42016043174

Transverse Skeletal Effects of Rapid Maxillary Expansion in Pre and Post Pubertal Subjects: A Systematic Review: A Systematic Review.

OBJECTIVE: The aim of this systematic review was to assess the transverse skeletal effects of rapid maxillary expansion (RME) in pre and post-pubertal subjects. MATERIAL AND METHODS: Five databases were searched till May 2018; Pubmed, Cochrane, Scopus, Lilacs and Web of science in addition to the manual search of other sources. There were no language restrictions. Methodological Index for Non-Randomized Studies MINORS was used to assess the quality and risk of bias of the trials included. RESULTS: Six studies were finally included in the qualitative analysis. A meta-analysis wasn’t performed due to the heterogeneity of methodologies and outcomes. All of the included studies showed drawbacks in their structure yielding weak evidence. On the short term, RME caused an increase in the maxillary and lateral-nasal widths in pre-pubertal subjects by 3.4 mm and 3.3 mm, and by 2.8 and 2.2 mm respectively in post-pubertal subjects. Although statistically insignificant, the maxillary width increase was more than that of the post-pubertal subjects by 0.6 mm. Over the long term, expansion produced permanent increases in the transverse dimensions of both the dento-alveolar and skeletal components of the maxilla and circum-maxillary structures in pre-pubertal subjects. The post-pubertal subjects presented with a statistically significant increase only in the later-nasal width by 1.3 mm than the untreated controls with no permanent increase in the skeletal maxillary width. CONCLUSION: The literature is very deficient regarding the use of skeletal age as a reference in the treatment of skeletal crossbites using RME. Only weak evidence exists supporting the increased maxillary and lateral-nasal widths after tooth-tissue borne RME in pre-pubertal subjects, with these effects being less in the post-pubertal ones

Effects of Different Parameters of Diode Laser on Acceleration of Orthodontic Tooth Movement and Its Effect on Relapse: An Experimental Animal Study

AIM: Recent studies have demonstrated that low-level laser therapy (LLLT) can accelerate orthodontic tooth movement. However, there is still controversy about the optimum parameters that can cause acceleration. The present study was designed to examine two different doses of LLLT in the acceleration of orthodontic tooth movement and their effect on relapse. METHODS: An orthodontic appliance was designed to induce tooth movement on lower incisors of rabbits. The in-al-as diode laser was used to radiate different groups of rabbits according to a specific protocol. The amount of tooth movement was measured for 21 days, and then the orthodontic appliance was removed, and the relapse was measured till day 28. RESULTS: The amount of tooth movement was significantly greater in the group with irradiation of low dose in comparison with the high dose group and the control group. The relapse was greatest in the group of low dose irradiation and least in the control group. CONCLUSION: The findings suggest that LLLT with a low dose accelerate the orthodontic tooth movement while LLLT with a high dose was not able to have the same effect. LLLT had a reverse effect on relapse tendency; an increase in the relapse tendency was seen with low dose irradiation

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

Pages: 352-361 of the Temporomandibular Joint

Background: Temporomandibular joint (TMJ) is an integral part of the masticatory apparatus that is in direct coordination with the teeth and the masticatory muscles. Many connections have been proposed regarding the correlation between malocclusion and temporomandibular disorders (TMD), as well as the effect of orthodontic treatment and orthognathic surgery on the temporomandibular joints. With the advent of new advances in three dimensional imaging modalities as that provided by cone beam computed tomography (CBCT), an accurate method for analyzing this region is now possible. Objective: To present a standardized stepwise comprehensive CBCT analysis of the temporomandibular joints including new descriptive measurements in the three orthogonal planes. Results: The multiplanar view was selected as the measuring view in this analysis, because in the TMJ view, the area of interest is too small rendering measurements on this view difficult and inaccurate. Conclusion: A stepwise standardized CBCT analysis of the TMJ is presented. Through using this detailed analysis, orthodontists can three dimensionally evaluate morphological and positional changes in the TMJ

Global distribution of malocclusion traits: A systematic review

Abstract Objective: Considering that the available studies on prevalence of malocclusions are local or national-based, this study aimed to pool data to determine the distribution of malocclusion traits worldwide in mixed and permanent dentitions. Methods: An electronic search was conducted using PubMed, Embase and Google Scholar search engines, to retrieve data on malocclusion prevalence for both mixed and permanent dentitions, up to December 2016. Results: Out of 2,977 retrieved studies, 53 were included. In permanent dentition, the global distributions of Class I, Class II, and Class III malocclusion were 74.7% [31 - 97%], 19.56% [2 - 63%] and 5.93% [1 - 20%], respectively. In mixed dentition, the distributions of these malocclusions were 73% [40 - 96%], 23% [2 - 58%] and 4% [0.7 - 13%]. Regarding vertical malocclusions, the observed deep overbite and open bite were 21.98% and 4.93%, respectively. Posterior crossbite affected 9.39% of the sample. Africans showed the highest prevalence of Class I and open bite in permanent dentition (89% and 8%, respectively), and in mixed dentition (93% and 10%, respectively), while Caucasians showed the highest prevalence of Class II in permanent dentition (23%) and mixed dentition (26%). Class III malocclusion in mixed dentition was highly prevalent among Mongoloids. Conclusion: Worldwide, in mixed and permanent dentitions, Angle Class I malocclusion is more prevalent than Class II, specifically among Africans; the least prevalent was Class III, although higher among Mongoloids in mixed dentition. In vertical dimension, open bite was highest among Mongoloids in mixed dentition. Posterior crossbite was more prevalent in permanent dentition in Europe

Dimensional and positional temporomandibular joint osseous characteristics in normodivergent facial patterns with and without temporomandibular disorders

Objective: This study evaluated the dimensional and positional osseous temporomandibular joint features in normodivergent facial patterns with and without temporomandibular disorders. Methods: A total of 165 adult patients were divided into two groups: group 1 (n = 79 patients; 158 joints): temporomandibular disorders patients and group 2 (n = 86 patients; 172 joints): non-temporomandibular disorders patients. Three-dimensional positional and dimensional temporomandibular joint characteristics, including glenoid fossa, mandibular condyles, and joint spaces, were assessed by cone beam computed tomography. Results: The glenoid fossa positions in the three orthogonal planes and height showed statistical significance between the two studied groups. The temporomandibular disorders patients showed higher horizontal and vertical condyle inclinations while anteroposterior inclination was less, and the condyle was positioned more superior, anterior, and lateral in the glenoid fossa. The condyle width and length showed no significance between the two groups, while condyle height was smaller in temporomandibular disorders patients. Anterior and medial joint spaces increased while the superior and posterior joint spaces reduced in temporomandibular disorders patients. Conclusion: There were significant differences between the patients with and without temporomandibular joint disorders in terms of mandibular fossa positions and height as well as condylar positions and inclinations in horizontal and vertical planes together with reduced condylar height and reduced posterior and superior joint spaces in the temporomandibular disorders patients. Clinical relevance: The temporomandibular disorder is a multifactorial disorder in which one of these factors is the dimensional and positional characteristics of the temporomandibular joints; including or excluding this factor requires a comprehensive three-dimensional investigation of patients with TMD compared to the normal group under the condition that the facial pattern is average as a confounding factor.Scopu

Supplemental Material, DS2_CPCJ_10.1177_1055665618788421 - Effectiveness of Gingivoperiosteoplasty on Alveolar Bone Reconstruction and Facial Growth in Patients With Cleft Lip and Palate: A Systematic Review and Meta-Analysis

<p>Supplemental Material, DS2_CPCJ_10.1177_1055665618788421 for Effectiveness of Gingivoperiosteoplasty on Alveolar Bone Reconstruction and Facial Growth in Patients With Cleft Lip and Palate: A Systematic Review and Meta-Analysis by Noha A. El-Ashmawi, Sherif A. ElKordy, Mona M. Salah Fayed, Amr El-Beialy, and Khaled H. Attia in The Cleft Palate-Craniofacial Journal</p

Supplemental Material, DS1_CPCJ_10.1177_1055665618788421 - Effectiveness of Gingivoperiosteoplasty on Alveolar Bone Reconstruction and Facial Growth in Patients With Cleft Lip and Palate: A Systematic Review and Meta-Analysis

<p>Supplemental Material, DS1_CPCJ_10.1177_1055665618788421 for Effectiveness of Gingivoperiosteoplasty on Alveolar Bone Reconstruction and Facial Growth in Patients With Cleft Lip and Palate: A Systematic Review and Meta-Analysis by Noha A. El-Ashmawi, Sherif A. ElKordy, Mona M. Salah Fayed, Amr El-Beialy, and Khaled H. Attia in The Cleft Palate-Craniofacial Journal</p