Clinical Oral Investigations最新文献

Objectives: Smile aesthetics are crucial in orthodontic and orthognathic planning, particularly for patients with dentofacial deformities seeking enhanced facial harmony. This study evaluated changes in smile parameters of patients with class III deformities before and after orthognathic surgery using 3D stereophotogrammetry.

Materials and methods: Conducted at Başkent University Oral and Maxillofacial Surgery Department, this retrospective investigation comprised 21 patients with class III skeletal deformities who underwent bimaxillary orthognathic surgery. Standardized social-smile photographs and 3D facial scans were obtained preoperatively and at an average 8-month follow-up. Smile parameters, including buccal-corridor ratio, upper-lip length, inter-commissural width, lip thickness, lip asymmetry and volumetric measures were reported. Preoperative and postoperative differences were analyzed with paired T-tests or Wilcoxon signed-rank tests (p < 0.05), 95% confidence intervals, and Cohen's d for paired samples.

Results: Mean follow-up was approximately 8 months. False-discovery-rate correction identified one significant change: buccal-corridor ratio decreased by 4.4%, producing a visibly fuller transverse smile (d = 0.66). Upper-lip length and inter-commissural width increased by about 1.0 mm and 1.6 mm, respectively (both d ≈ 0.5). Vertical smile dimensions, incisor display, and global facial height and width remained stable (|d|≤0.18). Measurement reliability ranged from good to excellent (ICC = 0.60-0.93(Intraclass Correlation Coefficient).

Conclusion: Orthognathic surgery improved transverse smile fullness in patients with class III skeletal deformities while preserving vertical dental display, affirming the value of 3D assessment.

Clinical relevance: Three-dimensional stereophotogrammetry offers objective, reproducible documentation of soft-tissue changes and should be integrated into routine orthognathic evaluations. Unlike previous studies relying on cephalometry and photographs, this is the first study to utilize 3D stereophotogrammetry for assessing smile parameters.

Objective: To examine the patterns of lymph node metastasis and associated risk factors in patients with recurrent tumors or ipsilateral second primary tumors (SPT), with the goal of providing insights for clinical diagnosis and management.

Methods: A retrospective analysis was conducted on patients who underwent radical surgery for oral squamous cell carcinoma (OSCC) and experienced tumor recurrence or ipsilateral SPT between January 2017 and March 2023. Comprehensive clinical and pathological data were collected at both the time of initial treatment and recurrent or ipsilateral SPT.

Results: Most common primary OSCC sites were the tongue and buccal mucosa, while recurrent and ipsilateral SPT primarily occurred in the buccal mucosa. The lymph node metastasis rate for primary OSCC was 22.9%, increasing to 42.2% in recurrent and ipsilateral SPT (p < 0.001). Primary OSCC tended to metastasize to levels I-III, while recurrent and ipsilateral SPT more commonly metastasized to ipsilateral level V and contralateral level I. Multivariate logistic regression showed moderately and poorly tumor differentiation and T2 stage were significant risk factors for lymph node metastasis in primary OSCC. In recurrent and ipsilateral SPT, poorly differentiated tumors and T2 stage were similarly associated with increased lymph node metastasis. Both lymph node and distant metastases were significant prognostic risk factors in recurrent or ipsilateral SPT.

Conclusion: Recurrent and ipsilateral SPT exhibit a higher likelihood of lymph node metastasis compared to primary OSCC, particularly to ipsilateral level V and contralateral level I lymph nodes. This pattern of metastasis is strongly associated with a poorer prognosis.

Objective: Periodontitis and type 2 diabetes mellitus (T2DM) are chronic diseases with a well-established bidirectional relationship. Recent studies have focused on salivary biomarkers to better understand their shared inflammatory mechanisms. This study aimed to assess salivary levels of asprosin, interleukin (IL) -39, IL-40, and IL-1β in patients with and without periodontitis and/or diabetes.

Materials and methods: Eighty-eight participants were classified into four groups based on periodontal and diabetic status. Unstimulated saliva samples were collected and analyzed by ELISA. In addition to clinical periodontal parameters, body mass index (BMI) and glycated hemoglobin (HbA1c) levels were recorded.

Results: Salivary asprosin and IL-1β levels were elevated in periodontitis groups regardless of T2DM status and showed positive correlations with BMI. IL-39 showed no significant findings. All biomarkers, with the exception of IL-39, were positively correlated with clinical periodontal parameters. IL-40 was elevated in both diabetic and non-diabetic patients with periodontitis.

Conclusions: Elevated salivary asprosin, IL-40, and IL-1β levels in diabetic individuals with periodontitis may indicate their involvement in the inflammatory interactions linking metabolic dysfunction and periodontal tissue breakdown. IL-39 showed limited utility. These findings enhance understanding of salivary inflammatory patterns in diabetes-associated periodontitis, although the saliva-only, cross-sectional design warrants cautious interpretation.

Clinical relevance: The identification of salivary asprosin, IL-40, and IL-1β as potential indicators of periodontal and metabolic inflammation suggests that saliva-based testing could support non-invasive screening and monitoring in patients with diabetes and periodontitis.

Clinical trial number: NCT06735313.

Objective: The objective of this study is to determine the relationship between location of upper airway respiratory collapse using drug-induced sleep endoscopy (DISE) technique and craniofacial morphology using cone beam computed tomography scans (CBCT) in patients diagnosed with moderate to severe obstructive sleep apnea (OSA).

Methods: In this prospective cross-sectional study, 64 adults with OSA (33 moderate and 31 severe) who were candidates for surgery were included. Before surgery, all patients underwent nocturnal polysomnography, DISE and CBCT scan. Measurements of craniofacial anatomical variables were performed on CBCT images. Associations among age, sex, BMI, neck circumference, CBCT measurements (3D, 2D, linear, and angular), DISE findings at various airway levels, and polysomnography indices (apnea-hypopnea index, average oxygen saturation, and minimum oxygen saturation) were analyzed using regression, ANOVA, Tukey's post-hoc test, t-test, chi-squared test, and correlation coefficients.

Results: At the lateral wall of the velum, (1) obstructions increased AHI; (2) there were significant associations between obstructions and CBCT variables: V-RPA, V-RLA, and L-RPA (P < 0.05). Other DISE findings were mostly not associated with CBCT or polysomnography measurements, except obstructions at oropharynx-lateral which increased AHI. However, DISE-Sum was significantly correlated with AHI and oxygen saturations (P ≤ 0.009). It was also correlated with several CBCT measurements (P < 0.05); Regression analysis showed associations between DISE-Sum and Go-Me, C3H, TGL, and TGH (adjusted R² = 0.44). For AHI, CBCT measurements explained almost all the variance (adjusted R² = 0.97). For minimum oxygen saturation, CBCT variables including C3H, PNS-P, HRGN, SNB, and L-RLA showed predictive capability (adjusted R² = 0.31).

Conclusions: CBCT measurements can predict OSA severity. The newly introduced DISE-Sum is highly correlated with polysomnography and CBCT findings. Individual DISE scores may be associated with AHI and CBCT only at one or two airway levels. BMI is associated with OSA. Age and neck circumference are associated with OSA only before controlling for BMI.

Objectives: To compare skeletodental and soft tissue changes in growing Class II patients treated with Herbst or Pendex appliances, followed by fixed edgewise appliances, using two-dimensional lateral cephalometric radiographs extracted from three-dimensional cone-beam computed tomography scans.

Materials and methods: Forty-six patients were examined: 23 treated with Herbst (12.07 ± 1.49 years, 12 males/11 females) and 23 with Pendex (11.76 ± 1.18 years, 10 males/13 females). CBCT-derived lateral cephalograms were analyzed at T1 (initial), T2 (6 months post-Herbst removal or immediately post-Pendex removal), and T3 (final records after edgewise fixed appliance removal). Cephalometric analysis assessed skeletal, dental, and soft tissue changes. Repeated measures ANOVA analyzed within-group changes across the three time points, and t-tests were used to compare between-group differences at each time point and evaluate changes from T1 to T3.

Results: From T1 to T3, the Herbst group exhibited a significant decrease in the SNA angle, a non-significant increase in SNB, and significant increases in mandibular dimensions, including total length, body length, corpus length, and ramus height. In contrast, the Pendex group demonstrated stable SNA values, a significant increase in SNB, and mandibular dimensional changes comparable to those observed in the Herbst group. Vertically, both groups remained stable with no significant differences in skeletal vertical parameters. Overall, no significant between-group differences were observed in skeletal, dental, or soft tissue parameters between T1 and T3.

Conclusion/clinical relevance: We did not detect statistically significant differences in overall skeletal, dental, and soft tissue changes between the two groups.