Orthodontics & Craniofacial Research最新文献

The present study aimed to assess the sagittal cephalometric characteristics in females with Turner syndrome (TS) as compared with nonsyndromic females. A literature search was carried out using six electronic databases to identify studies that compared the sagittal lateral cephalometric measurements in females with TS, with the last search performed in February 2024. Studies were selected according to the following inclusion criteria: an experimental group of individuals with TS compared to a control group of females without TS; with sagittal cephalometric characteristics evaluated on lateral cephalometric radiographs. Sagittal cephalometric variables measured in three or more studies were put to meta-analysis, using the random-effects model. Subgroup meta-analyses were also carried out based on karyotype. A modified version of the AXIS tool was used to assess the risk of bias in the included studies. From the initial 199 records identified, 17 studies and 11 sagittal cephalometric variablesere analysed. Four hundred and seventeen unique patients with TS, coming from 10 different European countries, were included. All of the sagittal linear variables compared, namely S-N, N-Ba, Go-Gn, Go-Pg and ANS-PNS, were significantly reduced in those with TS. Concerning the six angular variables compared, the A-N-B angle showed no difference between the groups, whereas the S-N-A, S-N-B and S-N-Pg angles were significantly reduced, and the N-S-Ba and the N-S-Ar angles significantly increased in those with TS. The subgroup meta-analyses for karyotype consistently revealed mean differences much greater than the norm for the 45,X karyotype group than those of the mosaic and isochromosome karyotypes. The sagittal lateral cephalometric characteristics of females with TS differ significantly from those of nonsyndromic females, with the greatest deviation from the norm displayed in the 45,X karyotype. Bimaxillary retrognathia and reduced anterior cranial base and maxillary and mandibular lengths were observed, without this resulting, however, in any difference with regard to the sagittal intermaxillary relationships for the females with TS. While informative, the results of this meta-analysis should be considered in conjunction with the respective risk of bias of each study, as most studies rated towards the moderate to high end of the spectrum. Trial Registration: This study was registered in PROSPERO on September 22, 2022, with the ID CRD42022356773.

Objective: To evaluate the efficacy of a plaque-identifying toothpaste in assisting with plaque removal in adolescents undergoing orthodontic treatment with fixed appliances.

Methods: A randomised, double-blind, active-comparator trial was conducted at the Orthodontic Department, University Medical Center Department, University Medical Center Groningen, the Netherlands, from October 2021 to January 2022. Seventy seven healthy adolescents aged 12-16 years, undergoing buccal fixed appliance treatment for at least 3 months, were enrolled. Participants were stratified based on manual or electric brushing habits and randomised to receive either plaque-identifying toothpaste or a non-colouring control toothpaste. The primary outcome measured reduction in dental plaque using Quantitative Light-Induced Fluorescence ∆R30 (QLF) images at baseline (T0) and after 4-7 weeks (T1). Secondary outcomes included self-reported participant experiences.

Results: No statistically significant difference in plaque reduction was found between the two groups (F = 0.211, p = 0.647). Subgroup analyses showed that participant-related factors did not significantly influence plaque reduction. Participants using plaque-identifying toothpaste reported a slightly stronger perception of plaque removal (p = 0.018) but encountered slightly more difficulty with the toothpaste colour (p = 0.028). Compliance was high, and no adverse effects were reported.

Conclusion: Plaque-identifying toothpaste did not lead to significant plaque reduction among adolescents with fixed orthodontic appliances.

YouTube is among the most popular social media platforms globally. The aim of this scoping review was to collate and synthesise the evidence related to the quality of information (QOI) about orthodontic-related videos uploaded to YouTube. The preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews guidelines were employed by two independent researchers to search and screen the literature over four electronic databases. The study topics were assigned into one of five general categories: 'Appliances', 'Orthodontic conditions', 'Orthodontics', 'Quality of life' and 'Treatment techniques and auxiliaries'. The searches initially returned 82 unique records. A total of 35 cross-sectional studies, evaluating 3129 videos with more than 181,563,304 views, were identified for systematic appraisal after the application of selection criteria. The findings indicated that YouTube plays a prominent role in the provision and sharing of orthodontic-related information. Although the information provided by orthodontic treatment providers was of slightly higher quality, the overall quality of all orthodontic information was generally poor. The studies covered a wide range of orthodontic-related subjects, with those related to appliances, especially clear aligners, being commonplace. Evaluation of the QOI frequently involved the use of the modified DISCERN, video information quality index (VIQI) and global quality score (GQS) tools. Content analysis was employed in most studies, but there was considerable heterogeneity in the use and reporting of this approach. Improvement of the quality of videos, either with or without the involvement of professional bodies, was frequently recommended by the studies.

Background: Orofacial myofunctional therapy (OMT) has emerged as an alternative and adjunct for the treatment of sleep-disordered breathing (SDB) in adults and children. While OMT efficacy has been demonstrated, the morphofunctional mechanisms triggered by each exercise remain poorly elucidated. This study aimed to characterise morphofunctional upper airway (UA) changes associated with established oropharyngeal exercises utilised to treat SDB by nasofibrolaryngoscopy (NFL).

Methods: Thirteen OMT exercises were selected and analysed based on the relevant literature. Respecting inclusion and exclusion criteria, 15 healthy adult subjects of both sexes performed all the exercises, resulting in 390 video recordings of changes in UA dynamics through NFL, from the nasopharyngeal and oropharyngeal view. The video analyses were performed by three blinded ENT doctors using a specific instrument that included structural verification, movement type and intensity classification. Statistical analyses included the Fleiss Kappa Agreement Coefficient and the Friedman Test for comparison between exercises.

Results: This original study used a methodology that allowed for the description and identification of which exercises produce greater mobility, stiffness and modification in the regions of the soft palate, pharyngeal/hypopharyngeal wall, retrolingual region and epiglottis. The 13 exercises analysed provided insights into their action mechanisms in the UA. The exercises that induce the most significant changes, for each pharyngeal region, were identified.

Conclusion: The analyses of the morphofunctional changes described in this study contribute to the understanding of how exercises used in OMT act, aiding in the selection of the most effective clinical approaches.

Recent developments in aligner materials have enabled them to be a feasible choice for children and adolescents. Aligners offer a treatment modality for Class II correction in growing patients claiming to address a mandibular deficiency. This study aimed to assess the effectiveness of functional aligners in skeletal Class II treatment through a systematic review and meta-analysis of the existing literature. A comprehensive search was conducted in MEDLINE, Web of Science, EMBASE, Scopus and Cochrane's CENTRAL up to April 2024, with no language or date restrictions. Clinical studies that complied with the PICO question model were included, and the ROBINS-I tool was used to assess their risk of bias. We extracted relevant data from the included studies using customised data forms and pooled the results via a random-effects inverse variance meta-analysis. Different treatment approaches for growth modification, including Twin-Block, were compared to clear aligners. The primary outcomes measured were ANB, SNB and overjet. Additionally, secondary outcomes included SNA, wits appraisal, mandibular total length, ramal length, angle of convexity, overbite, molar relationship, vertical positions of incisors and molars, incisor angular shifts, interincisal angle, gonial angle, mandibular plane angle, lower anterior facial height, as well as soft tissue changes, such as the distance of the lips from the E-line. In our analysis of 21 studies evaluating the treatment outcomes of functional aligners for growing skeletal Class II patients, we observed significant reductions (p < 0.05) in ANB, Wits appraisal, angle of convexity, overbite, overjet, molar relationship, maxillary incisor angle. In addition, we found that SNB, mandibular incisor angle (IMPA), mandibular incisor horizontal position, mandibular molar vertical position, interincisal angle (L1-U1), mandibular total length, mandibular base length, ramal length and lower anterior facial height all exhibited a significant increase (p < 0.05). Thirteen of the included studies indicated no significant treatment difference between functional aligners and other functional appliances except for mandibular plane angle, lower incisor horizontal position, interincisal angle and ramal length. The findings show that aligners might be a viable option in addressing mild to moderate skeletal Class II malocclusions of growing patients. Compared to other functional appliances, there were no treatment differences in most parameters studied. Based on limited evidence, our results should be interpreted with caution and evaluated with further high-quality studies with long-term observation. Trial Registration: PROSPERO (#CRD42023478039).

Study objectives: To comprehensively evaluate the correlations between the severity of oral clefts at birth and the treatment outcomes during pre-adolescence in patients with complete unilateral cleft lip and palate (CUCLP).

Material and methods: Records of 21 consecutive patients with CUCLP from a cleft/craniofacial centre were obtained. All subjects were treated with nasoalveolar moulding, followed by cheiloplasty and palatoplasty. The severity was measured by anterior cleft width, anterior and posterior arch width, arch circumference and arch length on scanned plaster models taken after birth. Craniofacial morphology, dental arch relationship and nasolabial aesthetics were assessed with cephalometric measurements, GOSLON score and Asher-McDade rating (AMR), respectively. Pearson and Spearman's rank correlation tests were performed to determine correlations between initial severity parameters and the treatment outcomes.

Results: Pearson correlation showed negative correlations between posterior arch width at birth and maxillary position (SNA; r = -0.573, p < 0.01), mandibular position (SNB; r = -0.452, p < 0.05) and nasal prominence (N'-UNT/SN; r = -0.478, p < 0.05). A positive correlation was also found between posterior arch width at birth and maxillary inclination (SN/ANS-PNS; r = 0.454, p < 0.05). The ratio between anterior cleft width to arch length (G-L/Arch Length) demonstrated negative correlations with soft tissue facial height ratio (N'-Sn/Sn-Me'; r = -0.470, p < 0.05) and soft tissue vertical proportions (N'-Sn/N'-Gn'; r = -0.495, p < 0.05). Spearman's rank tests revealed no significant correlation between the initial severity parameters and GOSLON score and AMR.

Conclusions: The initial severity parameters were correlated with some craniofacial characteristics but not with dental arch relationships and nasolabial aesthetics during pre-adolescence.

Objectives: Treatment efficiency is considered an important clinical variable in orthodontic practice; therefore, the aim of this study was to compare the efficiency between different Class II compensatory treatment approaches. The extraction of 2 maxillary premolars was compared to molar distalization with the First Class distaliser indirectly anchored to mini-implants.

Materials and methods: A retrospective sample of 31 patients was divided into two groups. Group 1: Class II treatment with two premolar extractions; 18 patients with a mean initial age of 14.3 ± 1.3 years. Group 2: Distalization with the First Class appliance indirectly anchored to mini-implants; 13 patients with a mean initial age of 13.3 ± 1.3 years. The Peer Assessment Rating (PAR) and the Objective Grading System (OGS) were used to calculate the percentage of occlusal improvement (PcPAR), treatment time (TT) and treatment efficiency index (TEI). The occlusal indexes, TT and TEI between both groups were compared using t tests (p < 0.05).

Results: Similar occlusal outcomes were observed between the groups, with no statistically significant differences (F-PAR and OGS). The TT in Group 1 was significantly shorter compared to Group 2. As a result, treatment with extractions was significantly more efficient (TEI: 3.23) than the treatment with maxillary molar distalization anchored indirectly to mini-implants (TEI: 1.95).

Conclusions: Both treatment protocols showed similar occlusal results; however, Class II correction with two premolar extractions is significantly more efficient than molar distalization with indirect skeletal anchorage.

Objective: To compare head posture and upper spine morphology in hypermobile Ehlers-Danlos syndrome (hEDS) patients with healthy controls with neutral occlusion.

Materials and methods: The study consisted of 27 hEDS patients (23 females, 4 males, mean age 36.41 ± 11.35) and 39 healthy controls (28 females, 11 males, mean age 31.85 ± 11.35) with neutral occlusion and no previous orthodontic treatment. Head posture was analysed by angular measurements on lateral cephalograms taken in natural head position and upper spine morphology was assessed on Cone Beam Computed Tomography (CBCT) by visual analysis of fusion and partial cleft of the upper spine and compared by general linear and logistic analyses adjusted for age and gender.

Results: In total, upper spine morphological deviations occurred significantly more often in hEDS patients (51.9%) compared to controls (15.4%) (p = 0.007). Out of the two categories of upper spine morphological deviations (fusion anomalies and posterior arch deficiencies (PAD)), PAD occurred significantly more often in hEDS patients (48.1%) compared to controls (12.8%) (p = 0.007). The differences remained significant when p-values were corrected for multiple testing comparing groups. Head posture was almost significantly more extended in hEDS patients compared to controls when the p-values were corrected for multiple testing comparing groups (NSL/VER, p = 0.089; NSL/OPT, p = 0.080).

Conclusions: The results of the present study indicate that upper spine morphology is affected in hEDS patients. The results may contribute to a further understanding of the spinal phenotypic spectrum in hEDS patients and thus prove valuable in the diagnostics and treatment of hEDS patients.

Aim: To translate the malocclusion impact questionnaire (MIQ) into Polish, adapt it for Polish cultural conditions, and validate its usage.

Subjects and methods: The original MIQ was translated into Polish following a seven-stage cross-cultural adaptation protocol. A total of 121 orthodontic patients participated in the study: 21 in the translation and cultural adaptation phase (5 males, 13.4 ± 1.5 years; 16 females, 13.6 ± 1.9 years) and 100 in the validation phase (53 males, 13.1 ± 1.6 years; 47 females, 12.9 ± 1.7 years). Confirmatory factor analysis (CFA) was conducted to confirm the one-dimensional structure of the MIQ_PL. Reliability was assessed using Cronbach's alpha for internal consistency and intraclass correlation coefficients (ICCs) for test-retest reliability, whereas construct validity was evaluated by comparing MIQ_PL scores with responses to global questions 1 and 2 from the MIQ_PL questionnaire and the aesthetic component of the index of orthodontic treatment need (IOTN-AC).

Results: The MIQ_PL was generally well understood by the test group and required only minor adjustments, indicating it is well adapted to the Polish cultural context. The internal consistency, measured by Cronbach's alpha, was 0.68, and the intraclass correlation coefficient for test-retest reliability was 0.75, indicating adequate reliability. Many questionnaire items had a high floor effect. The correlation coefficients between global questions 1 and 2 and the MIQ_PL scores were 0.269 and 0.407, respectively, whereas the correlation between the IOTN-AC and MIQ_PL was 0.235.

Conclusions: The MIQ_PL is culturally adapted for Polish conditions but demonstrates lower than expected reliability and internal consistency. Further validation in non-clinical settings with a more diverse sample is recommended.

The objective of the presented study was to evaluate the biomechanics of aligners utilising attachments and the effect of their placement for extrusion. An in vitro Orthodontic SIMulator (OSIM) was used to measure forces and moments produced through aligners incorporating attachments. The maxillary teeth on OSIM were digitally scanned to generate an STL model that was modified by placing a rectangular shaped attachment. Four models were designed with variation in attachment placement: Model NA-no attachment; model BA-buccal attachment; model LA-lingual attachment; model BL-both buccal and lingual attachments. Aligners (n = 30/model) were fabricated using a 0.75 mm thick polyethylene terephthalate material using a Biostar machine following the manufacturer's recommendations. A one-way MANOVA, followed by one-way ANOVA was used to test the effect of models on occlusogingival force (Fz) and mesiodistal moment (Mx) at 0.20 mm of gingival displacement of the left lateral incisor. The BL model exerted maximum Fz (1.22 ± 0.20 N), followed by models BA (1.18 ± 0.25 N) and LA (1.07 ± 0.19 N). The model NA exerted a negligible Fz (0.14 ± 0.08 N) that was statistically different from all other models. The models BA and LA generated Mx that has the tendency to tip the crown of tooth lingually (10.00 ± 3.12 Nmm) and buccally (-1.29 ± 2.26 Nmm), respectively. The models show statistically significant differences between models BL, BA and LA. There was no statistically significant difference between models BL and NA. The experimental evidence suggest that attachments on the lateral incisor could improve the predictability of extrusion forces applied with aligners. The models BL and LA provided favourable biomechanics by generating clinically significant extrusion forces without significant tipping of the lateral incisor tooth.