Nahoum index in brachyfacial patients: a pilot study

Objective: Our aim is to test the Nahoum Index as a support in the cephalometric study of vertical dimension and therapeutic orientation in adult patients suffering from Class II malocclusion, deep bite, or short face syndrome. Methods: Twenty-three patients with molar Class II and an overbite >4 mm were stratified into two groups: orthodontic (G2) and surgical orthodontic (G1). The ANB angle and Nahoum Index were calculated for cephalometric tracing pre- and post-treatment. The difference between the ANB and Nahoum Index values were analyzed using the Statistical Package for the Social Sciences software. Results: In G1, the Nahoum Index decreased from 0.954 to 0.797, and the ANB angle decreased from 5.2° to 3.2°. In G2, the Nahoum Index decreased from 0.825 to 0.817, and the ANB angle decreased from 4.4° to 4°. Conclusion: In G1, the difference between before and after treatment was significant for the Nahoum Index only. The difference between before and after values was not significant in the G2 group. It is possible to indicate the Nahoum Index of 0.934 as the limit value in case of which a patient may be treated with orthodontics only. This limit is the opposite of the limit proposed by Nahoum for vertical excess cases and respect the same interval. Therefore, we can consider the range 0.81-0.934 to indicate borderline patients, and >0.934 to indicate surgical patients. If the ratio is close to the normal value as 0.81, the treatment will be orthodontic; if it is further increased, the treatment will be surgical

Study of the maxillary yaw on cone beam computed tomography: a preliminary report and comparison between two different dento‐skeletal malocclusions

Objectives: To assess the skeletal and dental maxillary transverse compensation (yaw) on the cone beam computed tomography (CBCT) three-dimensional reconstructed image of the skull in two groups of patients, both clinically affected by a class III malocclusion with deviation of the lower midline.Materials and Methods: An observational retrospective study was designed to analyse differences in two groups of patients, the first one was composed by patients affected by horizontal condylar hyperplasia, the second one by patients affected by dento-skeletal asymmetric class III malocclusion. Each group was composed by 15 patients. Transverse analysis was performed by measuring five landmarks (three bilateral and two uneven) with respect to a mid-sagittal plane; sagittal analysis was performed by measuring the sagittal distance on the mid-sagittal plane between bilateral points. Means were compared through inferential analysis.Results: In the condylar hyperplasia group, all differences between the two sides were not statistically significant, nor for canines' difference (P = .0817), for molars (P = .1105) or for jugular points (.05871). In the class III group, the differences between the two sides were statistically significant for molars (P = .0019) and jugular points (P = .0031) but not for canines (P = .1158). Comparing the two groups, significant differences were found only for incisors' midline deviation (P = .0343) and canine (P = .0177).Conclusion: The study of the yaw on CBCT should be integrated into three-dimensional cephalometry and could help in differentiating the various malocclusion patterns

Use of an anatomical mid-sagittal plane for 3-dimensional cephalometry: a preliminary study

Purpose: Cone-beam computed tomography (CBCT) is widely used for 3-dimensional assessments of cranio-maxillo-facial relationships, especially in patients undergoing orthognathic surgery. We have introduced, for reference in CBCT cephalometry, an anatomical mid-sagittal plane (MSP) identified by the nasion, the midpoint between the posterior clinoid processes of the sella turcica, and the basion. The MSP is an updated version of the median plane previously used at our institution for 2D posterior-anterior cephalometry. This study was conducted to test the accuracy of the CBCT measures compared to those obtained using standard posterior-anterior cephalometry.Materials and Methods: Two operators measured the inter-zygomatic distance on 15 CBCT scans using the MSP as a reference plane, and the CBCT measurements were compared with measurements made on patients' posterior-anterior cephalograms. The statistical analysis evaluated the absolute and percentage differences between the 3D and 2D measurements.Results: As demonstrated by the absolute mean difference (roughly 1 mm) and the percentage difference (less than 3%), the MSP showed good accuracy on CBCT compared to the 2D plane, especially for measurements of the left side. However, the CBCT measurements showed a high standard deviation, indicating major variability and low precision.Conclusion: The anatomical MSP can be used as a reliable reference plane for transverse measurements in 3D cephalometry in cases of symmetrical or asymmetrical malocclusion. In patients who suffer from distortions of the skull base, the identification of landmarks might be difficult and the MSP could be unreliable. Becoming familiar with the relevant software could reduce errors and improve reliability

SIRT1-NOX4 Signaling Axis Regulates Cancer Cachexia

Approximately one third of cancer patients die due to complexities related to cachexia. However, the mechanisms of cachexia and the potential therapeutic interventions remain poorly studied. We observed a significant positive correlation between SIRT1 expression and muscle fiber cross-sectional area in pancreatic cancer patients. Rescuing Sirt1 expression by exogenous expression or pharmacological agents reverted cancer cell-induced myotube wasting in culture conditions and mouse models. RNA-seq and follow-up analyses showed cancer cell-mediated SIRT1 loss induced NF-κB signaling in cachectic muscles that enhanced the expression of FOXO transcription factors and NADPH oxidase 4 (Nox4), a key regulator of reactive oxygen species production. Additionally, we observed a negative correlation between NOX4 expression and skeletal muscle fiber cross-sectional area in pancreatic cancer patients. Knocking out Nox4 in skeletal muscles or pharmacological blockade of Nox4 activity abrogated tumor-induced cachexia in mice. Thus, we conclude that targeting the Sirt1-Nox4 axis in muscles is an effective therapeutic intervention for mitigating pancreatic cancer-induced cachexia

Characteristics of the bone components of the temporomandibular joint and its relationship with the vertical skeletal pattern in adolescents. A computed tomography study

Aim: The temporomandibular joint (TMJ) is a joint formed by the mandibular condyle and the glenoid cavity of the temporal bone. Several factors affect the morphology of the TMJ components. A relationship between the characteristics of the bone components of the temporomandibular joint and the craniofacial skeletal characteristics has been reported. Objective: The aim of the present study was to verify the relationship between the characteristics of the bone components of the TMJ and the vertical skeletal pattern in adolescent patients. Method: A total of 45 adolescent patients (16.20 ± 1.91 years of age), 13 males and 32 females, were divided into 3 groups according to their vertical skeletal pattern: 15 normodivergent, 15 hyperdivergent and 15 hypodivergent. The TMJ was evaluated in computed tomography (CT) images, the anteroposterior and lateromedial dimensions of the condyle and the anteroposterior dimension and high of the glenoid cavity were measured. The t-Student test was used to compare the measurements of the right and left sides and between the genders, and the ANOVA test was used to evaluate the correlation between condylar and glenoid cavity measurements with the vertical skeletal pattern and the post-hoc Turkey’s test was used to identify the correlation between groups. Results: No statistical difference was found in the measurements of the condyle and glenoid cavity on the right and left sides, so a mean between both sides was used. A statistically signifcant relationship was observed between the medial-lateral dimension of the condyle and the skeletal pattern (P = 0.000), in the paired comparisons a statistical difference of this dimension was observed between hypodivergent and hyperdivergent. The rest of the variables studied did not present a statistically signifcant difference. Conclusion:The lateromedial dimension of the mandibular condyle is greater in hypodivergent patients and lower hyperdivergent patients. The anteroposterior dimension of the condyle and the measurements of the glenoid cavity did not present a correlation with the vertical skeletal pattern in the adolescent

Simplified protocol for tomographic evaluation of mandibular asymmetry

Aim: Facial asymmetries occur near and even above 20% of the patients who attend consultation of Orthodontics. They are the result of the interaction of multiple factors that influence the growth and development, causing discrepancies in size and position between various structures that make up the complex facial skull that depending on the severity and the potential for adaptation of the individual may compromise your facial balance and function. The etiology is believed to be related to congenital, developmental, or acquired factors. Genetic and trauma-related asymmetries may involve muscles, produce excessive unilateral growth, or adversely affect mandible development. Genetic and trauma-related asymmetries may involve muscles, produce excessive unilateral growth, or adversely affect mandible development. The growth of the skull, maxilla, and mandible are closely related. If growth is altered in one of these areas, the asymmetric growth and development of part of the craniofacial skeleton may result in a chin deviated from the mandibular midline. The advent of computed tomography has greatly reduced magnifcation errors from geometric distortions that are common in conventional radiographs. The three-dimensional software (3D) recently introduced allows 3D reconstruction and the multiplanar images obtained from the tomography allow the quantitative measurement of the maxillofacial complex, useful to understand the asymmetric structures involved. The aim of the present work was developing a simplifed protocol on Cone Beam tomography (CBCT) or computed tomography (CT) images, for evaluation of the morphology and dimensions of bone structures involved in the etiology of mandibular asymmetry, for better diagnosis and treatment planning. Methods: Based on the review of the literature is349 Abstracts of poster presentations © ARIESDUE June 2019; 11(2) elaborated a descriptive protocol for evaluation of facial asymmetry on CBCT or CT. Different softwares are applied: volumetric reconstructions in 3D, multiplanar and 2D radiological images. Three reference lines were defned to asses facial asymmetry (vertical, horizontal and axial), from which the structures will be studied; anatomical landmarks are located, and linear and angular measurements are obtained. The asymmetry indices of the bilateral landmarks were calculated. Results: The measurements were recorded in columns showing the right and the left values, respectively and the difference for each pair was recorded in a third column. All measured values were recorded on a chart, and the differences between the right and left side were analyzed. The asymmetry index of each landmark is summarized. Conclusion: The morphological study of the mandibles structures on CBCT or CT and their interpretation is very important for the orthodontic and surgical diagnostic and treatment planning phases as well as in the postoperative follow-up. The protocol proposed in this work simplifes the identifcation of structures involved in the facial asymmetry, as well as its severity, facilitates the diagnosis and the multidisciplinary managemen

Dimensions of the mandibular condyle and the glenoid cavity in the different sagittal skeletal patterns in adolescents. A computed tomography study

Aim: The characteristics of the temporomandibular joint (TMJ) are modifed as a consequence of different factors. The sagittal skeletal pattern has been related to the dimensions of the osseous components of the TMJ. Objective: The aim of this study was to evaluate the relationship between the dimension of the mandibular condyle and the glenoid cavity and the sagittal skeletal pattern in adolescents. Methods: 40 adolescent patients, between 11 and 19 years old, 12 males and 28 females, were evaluated. They were divided into three groups according to the ANB angle: 15 Class I (ANB 0 ° - 4 °), 15 Class II (> 4°) and 10 Class III (<0 °). The width and length of the condyle and the width and depth of the glenoid cavity were measured using computed tomography images. By the t-Student test, the means of the measures of the right and left side were compared. Through the ANOVA test, the means of the measurements of the condyle and the glenoid cavity were analyzed according to the vertical skeletal pattern and the post-hoc Bonferroni test was used to identify the group correlations. Results: No signifcant difference was found between the right and left side averages, so the mean between sides was used for the analysis. A correlation was obtained between the depth of the glenoid cavity and the sagittal skeletal pattern (P = 0.009), was deeper in Class III and less in Class II. The rest of the variables studied did not present a statistically signifcant correlation with the sagittal skeletal pattern. Conclusions: The depth of the glenoid cavity is greater in Class III subjects and less deep in those Class II. The dimensions of the condyle and the width of the glenoid cavity did not show a statistically signifcant relationship with the sagittal skeletal pattern in the adolescents studie