Stability of the hard and soft tissue profile after mandibular advancement in sagittal split osteotomies: a longitudinal and long-term follow-up study

The aim of the study was to conduct a long-term follow-up investigation of the stability of hard and soft tissues after bilateral sagittal split osteotomy (BSSO) with rigid internal (RIF) fixation to advance the mandible. Sixteen consecutive patients (12 females and 4 males, mean age 21.4 years) were available for re-examination 12.7 years (T5) after surgery. The preceding follow-ups were before (T1), and 5 days (T2), 7.3 months (T3), and 13.9 months (T4) after surgery. Lateral cephalograms were traced by hand, digitized, and evaluated with the Dentofacial Planner® program. The x-axis for the system of co-ordinates ran through sella (point zero) and the line NSL -7 degrees. Thus, the program determined the x- and y-values of each variable and the usual angles and distances. Statistical analysis was carried out using Wilcoxon's matched-pair signed-ranks test with Bonferroni adjustments. The relationships between the examined variables were analysed by Spearman rank correlation coefficients. The backward relapse at point B (T5) was 2.42 mm, or 50 per cent, and at pogonion 3.21 mm, or 60 per cent of the initial advancement. The mean net effect at T5 on the labial fold (soft tissue point B) was 94 per cent of the advancement at point B. For the soft tissue chin (soft tissue pogonion), it was 119 per cent of the advancement at pogonion. The net effect on the lower lip (labrale inferior) was 55 per cent of the advancement at incision inferior. The amount of the surgical advancement of the mandible was correlated with the long-term relapse in point B. Among possible reasons for this relapse are the initial soft tissue profile, the initial growth direction, and the remodelling processes of the hard tissu

Stability of hard tissue profile after mandibular setback in sagittal split osteotomies: a longitudinal and long-term follow-up study

The aim of the study was to conduct a long-term follow-up on the stability of the hard tissues after bilateral sagittal split osteotomy (BSSO) with rigid internal fixation (RIF)to set back the mandible and to compare it with that of mandibular advancement performed by the same team of surgeons and with the same examination protocol. Seventeen consecutive patients (6 females and 11 males) could be re-examined 12.7 years (T5) after surgery. The previous examinations were before surgery (T1), 5 days (T2), and 6.6 (T3) and 14.4 (T4) months after surgery. Lateral cephalograms were traced by hand, digitized, and evaluated with the Dentofacial Planner® software program. The x-axis for the system of co-ordinates ran through sella (point zero) and the line nasion-sella-line minus 7 degrees. The program determined the x- and y-values of each variable and the usual angles and distances. The effects of treatment were determined with Wilcoxon matched pairs, signed ranks test, with Bonferroni adjustment, and the relationship between variables with Spearman rank correlation coefficient. Relapse at point B was 0.94 mm or 15 per cent and at pogonion 1.46 mm or 21 per cent of the initial setback at T5. Relapse was mainly short-term (T4-T2), 13 per cent for point B and 17 per cent for pogonion. Gender correlated significantly with relapse (T5-T2) at point B (P = 0.002) and pogonion (P = 0.021), i.e. females in contrast to males showed further distalization of the mandible instead of relapse. No correlations were seen for age or the amount of surgical setback. The long-term results in mandibular setback patients were more stable when compared with the mandibular advancement patients examined previously. The initial soft tissue profile, the initial growth direction, and the remodelling processes of the hard tissues must be considered as reasons for long-term relapse. Growth direction positively influenced the long-term results in females: further distalization of the mandible occurre

Neurosensory and functional impairment in sagittal split osteotomies: a longitudinal and long-term follow-up study

The aim was to conduct a long-term follow-up study on the function and sensitivity of the mandible in advancement and setback patients after bilateral sagittal split osteotomy (BSSO) with rigid internal fixation. The advancement and setback groups consisted of 16 (12 females and 4 males, mean age: 21.4 and 21.3 years, respectively) and 17 (11 females and 6 males, mean age: 27.1 and 27.7 years, respectively). The final follow-up was a mean of 12.7 years (T4) post-operatively. The other follow-up examinations were before surgery (T1) and 7.3/6.6 (T2) and 13.9/14.4 (T3) months after surgery. To evaluate craniomandibular function, mouth-opening capacity, laterotrusion, protrusion, deviations during opening, pain and clicking of the temporomandibular joint (TMJ), muscular pain, and the retruded contact position-intercuspal position (RC-IP) distance were examined. A questionnaire was used to record subjective reports. The neurosensory status was determined with two-point discrimination (2-pd), the pointed, blunt, and light-touch tests. Statistical analysis included the following tests: Wilcoxon signed ranked matched pairs, Mann-Whitney U, paired t, and Fisher's exact test. Bonferroni's adjustments were made for evaluation of the questionnaire and Spearman's rank correlation coefficients to determine the interdependence of selected variables. Craniomandibular function showed restitution at T4 after 12.7 years. The 2-pd at the lip and chin had largely normalized in the two groups at T3. At T4, there was a significant increase of 2-pd at the lip and chin in both groups. The discrimination between sharp and blunt was limited in both groups in 25 per cent of patients at T4. Dysfunctions such as TMJ clicking, bruxism, and pain in the TMJ and muscles were neither increased nor decreased after BSSO. The initial post-surgical neurosensory impairment was barely detectable 1 year post-surgery. The new neurosensory impairment manifested at T4 was probably due to the normal human process of ageing. Neither age, gender, surgical advancement, nor setback showed any significant correlation

Effect of muscle exercise with an oral screen on lip function

The study aimed at evaluating how training of the lips with an oral screen affects the strength of the lips and the pressure of the lips on the teeth. In addition, the effect of the treatment with an oral screen on the dentition was studied. The treatment and lip training programme was instituted for 9 months in 16 children, 7-11 years old, with protruding maxillary incisors. The effect on the dentition was studied on dental casts made before and at the end of the treatment, and 5 months thereafter, as well as on lateral cephalograms. The lip strength was recorded with a dynamometer. The pressure from the lips on the upper and lower central incisors at rest, and during chewing and swallowing was measured with an extraoral pressure transducer incorporated in a water-filled system with an intra-oral measuring point. Measurements of lip strength and pressure were made regularly before and during the treatment; and continued for up to 10 months thereafter. The treatment resulted in a decrease of the overjet and upper dental arch length, but with some relapse after the treatment. The strength of the lips increased during the treatment, but decreased afterwards. The pressure from the lips on the teeth at rest and during swallowing was unaffected by the lip training. The pressure from the lower lip during chewing increased temporarily during the treatment perio

Lack of correlation between mouth-breathing and bite force

The correlation between mouth-breathing and bite force was studied in 81 children, 7 to 16 years old. Mouth-breathing was diagnosed on the basis of the subject history, the rhinomanometrically determined nasal airflow and the size of the airway measured on the profile cephalogram. The maximum bite force was measured at the first molars. In addition, the facial morphology was analysed on profile cephalograms. Both mouth-breathing and bite force were associated with the facial morphology but there was no association between mouth-breathing and bite force. It was concluded that the longface morphology characteristic of mouth-breathing children is not due to weak masticatory muscle

Further studies of the pressure from the tongue on the teeth in young adults

The pressures from the tongue on the teeth were recorded simultaneously in four locations lingual to the upper and lower central incisors, and left first molars in 20 young adults with largely normal occlusion. Measurements in the rest position, and during chewing and swallowing were made with an extra-oral pressure transducer incorporated in a fluid-filled system with intra-oral mouthpieces. The size of the dental arches was determined from dental casts. The median pressures in the rest position were low and negative at the upper incisors. Negative pressures at rest were recorded in a few subjects at all four points of measurement, most frequently at the upper incisors and least frequently at the lower molar. The pressures during swallowing were 2-4 times greater than those during chewing. There were no significant correlations between the pressures found and those recorded in the same individuals at an examination 2 years earlier. Positive correlations were found between the pressures recorded in the four locations during the various functions. This was interpreted as being an effect of the size of the tongue. The relatively few correlations between the pressures and the parameters describing the dental arch size indicated an adaptive role of the tongue within the confines of the dental arche

A comparison between anamnestic, rhinomanometric and radiological methods of diagnosing mouthbreathing

Three methods of evaluating the mode of breathing were applied in 119 children aged 7-15 years who were to start orthodontic treatment for various malocclusions. The three methods were: the history, rhinomanometric recording of the nasal airflow and determination of the size of the airway on profile and frontal cephalograms. The variables describing the mode of breathing were correlated with the facial morphology and the natural position of the head and the cervical spine as recorded with profile cephalometry. There were no correlations between the results of the evaluation of the mode of breathing obtained with the three methods. Nor were there any correlations between these and the position of the head or the cervical spine. A history of mouth-breathing, the rhinomanometrically determined airflow through the nose and the size of the airway on the profile cephalogram were, however, correlated with the long face morphology characteristic of mouth-breathing. A diagnosis of mouth-breathing should be based on different supplementary methods, the history and the size of the airway on the profile cephalogram being at least as valuable as the rhinomanometric recordin

Natural lip function in wind instrument players

The lip strength, lip muscle activity, pressure from the lips on the teeth and the morphology of the face and the dentition were studied in professional wind instrument players. Twelve trumpeters and twelve clarinetists, aged 19-55 years, were compared with a control group of dental students. The lip strength was measured with a dynamometer. Electromyographic measurements of the lip muscle activity and recordings of the pressure from the lips on the front teeth were made in the rest position, during chewing and speech and during playing of the instrument. The morphology was studied with x-ray cephalometry and on dental casts. There were practically no differences between the two groups of musicians or in relation to the control group. Thus, the musicians had the same lip strength, the same muscle activity of the lips and the same pressure from the lips on the teeth during natural functions as did the control group. The pressure from the soft tissues on the teeth during playing of the instrument was considerably greater than during natural lip function but no effect on bite morphology was discernibl

No posterior mandibular displacement in Angle Class II, division 2 malocclusion as revealed with electromyography and sirognathography

The activity of the anterior and posterior temporal, and of the masseter muscles was studied by electromyography and the position of the mandible by sirognathography. The recordings were made in 22 children, aged 8-13 years, with Angle Class II, division 2 malocclusion before and during treatment of their malocclusion. The treatment comprised two phases: proclination of the upper incisors and bite raising with a removable plate, and the subsequent correction of the distal occlusion with an activator. The aim of the study was to reveal signs of anterior mandibular positioning during the treatment. The electromyographic recordings were made in the rest position of the mandible, and during maximal biting, chewing, and swallowing. The sirognathographic recordings comprised the positions of the mandible at rest, at intercuspation, and during tooth contact during chewing and maximal mandibular movements. The muscle activity at rest was unchanged during the period of observation. The activity during maximal biting, chewing, and swallowing decreased during the phase of proclination, which was interpreted as a result of occlusal instability. The positions of the mandible at rest, at intercuspation, and during chewing were stable during the treatment. Neither the electromyographic recordings nor the recordings of mandibular positions revealed any signs of anterior mandibular positioning during the treatment of the Class II, division 2 malocclusio

Differential cross section measurements for the production of a W boson in association with jets in proton–proton collisions at √s = 7 TeV

Measurements are reported of differential cross sections for the production of a W boson, which decays into a muon and a neutrino, in association with jets, as a function of several variables, including the transverse momenta (pT) and pseudorapidities of the four leading jets, the scalar sum of jet transverse momenta (HT), and the difference in azimuthal angle between the directions of each jet and the muon. The data sample of pp collisions at a centre-of-mass energy of 7 TeV was collected with the CMS detector at the LHC and corresponds to an integrated luminosity of 5.0 fb[superscript −1]. The measured cross sections are compared to predictions from Monte Carlo generators, MadGraph + pythia and sherpa, and to next-to-leading-order calculations from BlackHat + sherpa. The differential cross sections are found to be in agreement with the predictions, apart from the pT distributions of the leading jets at high pT values, the distributions of the HT at high-HT and low jet multiplicity, and the distribution of the difference in azimuthal angle between the leading jet and the muon at low values.United States. Dept. of EnergyNational Science Foundation (U.S.)Alfred P. Sloan Foundatio