Deep learning for temporomandibular joint arthropathies: A systematic review and meta-analysis.

BACKGROUND AND OBJECTIVE: The accurate diagnosis of temporomandibular disorders continues to be a challenge, despite the existence of internationally agreed-upon diagnostic criteria. The purpose of this study is to review applications of deep learning models in the diagnosis of temporomandibular joint arthropathies. MATERIALS AND METHODS: An electronic search was conducted on PubMed, Scopus, Embase, Google Scholar, IEEE, arXiv, and medRxiv up to June 2023. Studies that reported the efficacy (outcome) of prediction, object detection or classification of TMJ arthropathies by deep learning models (intervention) of human joint-based or arthrogenous TMDs (population) in comparison to reference standard (comparison) were included. To evaluate the risk of bias, included studies were critically analysed using the quality assessment of diagnostic accuracy studies (QUADAS-2). Diagnostic odds ratios (DOR) were calculated. Forrest plot and funnel plot were created using STATA 17 and MetaDiSc. RESULTS: Full text review was performed on 46 out of the 1056 identified studies and 21 studies met the eligibility criteria and were included in the systematic review. Four studies were graded as having a low risk of bias for all domains of QUADAS-2. The accuracy of all included studies ranged from 74% to 100%. Sensitivity ranged from 54% to 100%, specificity: 85%-100%, Dice coefficient: 85%-98%, and AUC: 77%-99%. The datasets were then pooled based on the sensitivity, specificity, and dataset size of seven studies that qualified for meta-analysis. The pooled sensitivity was 95% (85%-99%), specificity: 92% (86%-96%), and AUC: 97% (96%-98%). DORs were 232 (74-729). According to Deek's funnel plot and statistical evaluation (p =.49), publication bias was not present. CONCLUSION: Deep learning models can detect TMJ arthropathies high sensitivity and specificity. Clinicians, and especially those not specialized in orofacial pain, may benefit from this methodology for assessing TMD as it facilitates a rigorous and evidence-based framework, objective measurements, and advanced analysis techniques, ultimately enhancing diagnostic accuracy.

The Caribbean and Mesoamerica Biogeochemical Isotope Overview (CAMBIO).

The Caribbean & Mesoamerica Biogeochemical Isotope Overview (CAMBIO) is an archaeological data community designed to integrate published biogeochemical data from the Caribbean, Mesoamerica, and southern Central America to address questions about dynamic interactions among humans, animals, and the environment in the region over the past 10,000 years. Here we present the CAMBIO human dataset, which consists of more than 16,000 isotopic measurements from human skeletal tissue samples (δ13C, δ15N, δ34S, δ18O, 87Sr/86Sr, 206/204Pb, 207/204Pb, 208/204Pb, 207/206Pb) from 290 archaeological sites dating between 7000 BC to modern times. The open-access dataset also includes detailed chronological, contextual, and laboratory/sample preparation information for each measurement. The collated data are deposited on the open-access CAMBIO data community via the Pandora Initiative data platform ( https://pandoradata.earth/organization/cambio ).

Effect of printing technology, layer height, and orientation on assessment of 3D-printed models.

BACKGROUND: Three-dimensional (3D) printing technologies have become popular in orthodontics. The aim of this study is to determine the effect of printing technology, orientation, and layer height on the accuracy of 3D-printed dental models. METHODS: The maxillary arch of a post-treatment patient was scanned and printed at different orientations (0°, 90°) and layer thicknesses (25 µm, 50 µm, 100 µm, and 175 µm) using two different printing technologies (digital light processing and stereolithography). The 120 models were digitally scanned, and their average deviation from the initial model was analyzed using 3D algorithm. A multivariable linear regression analysis was used to estimate the effect of all variables on the average deviation from the initial model for the common layer thicknesses (50/100 µm). Finally, one-way ANOVA and Tukey posthoc test was used to compare the stereolithography (SLA) 25 µm and digital light processing (DLP) 175 µm groups with the groups that showed the least average deviation in the former analysis. RESULTS: The multivariable linear regression analysis showed that the DLP 50 µm (mean ± SD: -0.022 ± 0.012 mm) and 100 µm (mean ± SD: -0.02 ± 0.009 mm) horizontally printed models showed the least average deviation from the initial model. Finally, the DLP 175 µm horizontally printed models (mean ± SD: 0.015 ± 0.005 mm) and the SLA 25 µm horizontally (mean ± SD: 0.011 ± 0.005 mm) printed models were more accurate. CONCLUSIONS: All the models showed dimensional accuracy within the reported clinically acceptable limits. The highest accuracy was observed with DLP printer, 175 µm layer thickness, and horizontal orientation followed by SLA printer, 25 µm layer thickness, and horizontal orientation.

[Translated article] Current situation and evolution of the availability of drugs in the pediatric population in Spain.

OBJECTIVE: To analyze the characteristics of the new medicines approved in the pediatric population in the last 3 years, both those with studies only in the pediatric population and those that extend their indication in this population group, as well as the current situation in relation to their marketing and financing. METHODS: Descriptive observational study of all drugs that include an indication in the pediatric population in Spain (by extension of the indications of drugs already authorized or because they are new drugs that already include an indication in this population group), from January 2019 to March 2022. RESULTS: During the study period, 129 drugs included their indication in the pediatric population. 13.9% of them are not marketed, 46.5% are in a situation of non-financing, under study or without a request for financing, and 4.6% are financed for a specific pediatric subpopulation. 52.7% are original drugs, 4.7% are generic, 38.8% are biological, 3.8% are biosimilar, and 17.8% are orphan drugs. 57.36% of these medicines obtain the pediatric indication due to extension of the indication and 42.64% obtain it because they are new medicines that already include their studies in the pediatric population. CONCLUSIONS: Drugs with authorized indications are increasingly available in the pediatric population and the trend is to extend the indication of authorized drugs to the adult population. However, barriers in terms of financing and marketing need to be expedite and overcome to facilitate access to them.

The uses of 3-dimensional printing technology in orthodontic offices in North America.

INTRODUCTION: The purpose of this study was to examine the use of orthodontic 3-dimensional (3D) printing technology in North America and to understand why orthodontists are, or are not, incorporating 3D printing technology in their practices. METHODS: A survey questionnaire was delivered on a secure online platform, RedCap (Case Western Reserve University Clinical and Translational Science Award; no. UL1TR002548). The survey consisted of 14-34 items with branching logic. The association between participant demographics and in-house 3D printing was assessed using a chi-square test of independence. RESULTS: A total of 518 responses were recorded. The highest number of responses came from respondents in the 36-45-year age group. Most of the respondents were practice owners; 46.9% had 3D printers in their office. Chi-square tests of independence were performed on the data to see which associations existed. The strongest statistical associations with using an in-house 3D printer are seen with patient load, practice type, years since residency, and orthodontist's position. CONCLUSIONS: Approximately 75% of orthodontists use 3D printing technology in some capacity in North America. Major factors that influenced orthodontists to incorporate 3D printing technology into their office were self-interest and research. Major factors that have prevented orthodontists from not incorporating 3D printing technology into their office were space for equipment/ventilation and digital workflow training deficit. Orthodontists use their 3D printers mostly to make plastic retainers from printed models. The strongest associations with using in-house 3D printers are seen in patient load, practice type, years since residency, and orthodontist position. Increasing patient load and being in private practice increases the likelihood of having a 3D printer.

The effect of micro-osteoperforations on the rate of maxillary incisors' retraction in orthodontic space closure: a randomized controlled clinical trial.

BACKGROUND: This single-centered randomized controlled clinical trial aimed to evaluate the effectiveness of micro-osteoperforations (MOPs) in accelerating the orthodontic retraction of maxillary incisors. METHODS: Forty-two patients aged 16-40 were recruited and randomly assigned into two groups, one which underwent MOPs (MOPG) in the buccal and palatal region of all maxillary incisors immediately before the start of retraction and one which did not (CG). Eligibility criteria included the orthodontic need for maxillary first premolars extraction and space closure in two phases. The primary outcome of the study consisted of measuring the rate of space closure and, consequently, the rate of incisors' retraction using digital model superimposition 14 days later and monthly thereafter for the next 4 months. The secondary outcomes included measuring anchorage loss, central incisors' inclination, and root length shortening, analyzed using cone beam computed tomography scans acquired before retraction and 4 months after retraction. Randomization was performed using QuickCalcs software. While clinical blinding was not possible, the image's examinator was blinded. RESULTS: Twenty-one patients were randomly assigned to each group. However, due to various reasons, a total of 37 patients (17 male and 20 female) were analyzed (mean age: 24.3 ± 8.1 years in the MOPG; 22.2 ± 4.2 years in the CG) during the trial. No statistically significant difference was found between the MOPG and the CG regarding the incisors' retraction measured at different time points at the incisal border (14 days, 0.4 mm vs. 0.5 mm; 1 month, 0.79 mm vs. 0.77 mm; 2 months, 1.47 mm vs. 1.41 mm; 3 months, 2.09 mm vs. 1.88 mm; 4 months, 2.62 mm vs. 2.29 mm) and at the cervical level (14 days, 0.28 mm vs. 0.30 mm; 1 month, 0.41 mm vs. 0.32 mm; 2 months, 0.89 mm vs. 0.61 mm; 3 months, 1.36 mm vs. 1.10 mm; 4 months, 1.73 mm vs. 1.39 mm). Similarly, no statistically significant differences were detected in the space closure, anchorage loss, central incisors' inclination, and radicular length between groups. No adverse effect was observed during the trial. CONCLUSIONS: MOPs did not accelerate the retraction of the maxillary incisors, nor were they associated with greater incisor inclination or root resorption. Trial registration ClinicalTrials.gov NCT03089996. Registered 24 March 2017- https://clinicaltrials.gov/ct2/show/NCT03089996 .

Implant-supported canine retraction using different reactivation intervals of elastomeric chains: A CBCT-based split-mouth randomized controlled trial.

INTRODUCTION: Orthodontists attempt to maximize treatment efficiency regarding time, tooth position and adverse effects. A new approach, not yet explored, is the activation frequency. OBJECTIVE: The aim of this split-mouth randomized controlled trial was to evaluate the effect of reactivation intervals on the efficiency of tooth movement. METHODS: Thirty eight patients having a Class I malocclusion with bimaxillary dentoalveolar protrusion or severe crowding, Class II with mandibular deficiency or Class III, requiring first premolar extraction and canine retraction were recruited. Elastomeric chains producing 150g were replaced every two, four, six or eight weeks. There were 36, 37, 36, and 36 quadrants randomly allocated to these groups, respectively. The canine retraction rate was the primary outcome. Canine tipping, rotation, and root resorption and pain were the secondary outcomes. Only the outcome assessors were blinded to group assignment. RESULTS: The average total movement for the 6 months was 5.14, 5.31, 2.79 and 3.85 mm for the two-week, four-week, six-week and eight-week reactivation intervals, respectively. Root resorption was significantly higher in the two-week and four-week groups. No adverse events were observed. CONCLUSION: The canine retraction rate, tipping, rotation and pain were similar in 2, 4, 6 and 8-week activation intervals groups. Longer reactivation intervals show less root resorption. The trial protocol was not pre-registered. The study was self-funded.

Orthodontic Wires: A 12-Year Bibliometric Study.

Aims and Objectives: To perform a bibliometric study to identify and evaluate articles associated with "orthodontic wires" indexed in six databases (PubMed, Embase, Cochrane, Scopus, Lilacs, and Google Scholar) from 2010 to 2022. Materials and Methods: The search strategy in PubMed combined different medical subject heading terms with free-text words and was adjusted for each selected database. The retrieved documents were original English articles containing the keywords used in the search strategies related to orthodontic wires. Collected data consisted of journal name, nationality, field, JIF-2 and JIF-5, SJR, CiteScore, Q and H-index, and categorization of the study. Results: In total, 417 articles were retrieved from the initial search. After the exclusion criteria, 257 articles remained. The most common theme was mechanical properties, with basic studies as the main categorization. Conclusions: This bibliometric survey provides an overview of orthodontic wires publications that might help orthodontists to understand the tendency of the studies on this subject. The retrieved papers were published in 100 journals, including 15 orthodontic journals, mainly in the first and second quartiles. Europe and America were the continents with the highest number of papers. The United States was the country with the highest number of journals on the topic. AJODO presented the highest h-index among the retrieved orthodontic journals. Brazil represented the principal institutions of origin of the listed articles. There was a tendency to increase the number of publications on orthodontic wires over the years. These findings indicate that research on orthodontic wires is still contemporary and relevant.

Current situation and evolution of the availability of drugs in the paediatric population in Spain. / Situación actual y evolución de la disponibilidad de medicamentos en la población pediátrica en España.

OBJECTIVE: To analyze the characteristics of the new medicines approved in the pediatric population in the last three years, both those with studies only in the pediatric population and those that extend their indication in this population group, as well as the current situation in relation to their marketing and financing. METHODS: Descriptive observational study of all drugs that include an indication in the pediatric population in Spain (by extension of the indications of drugs already authorised or because they are new drugs that already include an indication in this population group), from January 2019 to March 2022. RESULTS: During the study period, 129 drugs included their indication in the pediatric population. 13,9% of them are not marketed, 46,5% are in a situation of non-financing, under study, or without a request for financing, and 4,6% are financed for a specific pediatric subpopulation. 52,7% are original drugs, 4,7% are generic, 38,8% are biological, 3,8% are biosimilar and 17,8% are orphan drugs. 57,36% of these medicines obtain the pediatric indication due to extension of the indication and 42,64% obtain it because they are new medicines that already include their studies in the pediatric population. CONCLUSIONS: Drugs with authorised indications are increasingly available in the paediatric population and the trend is to extend the indication of authorised drugs to the adult population. However, barriers in terms of financing and marketing need to be expedited and overcome to facilitate access to them.

Cephalometric evaluation of deep overbite correction using anterior bite turbos.

OBJECTIVES: To evaluate the outcome of treating deep overbite (OB) using anterior bite elevators concurrently with a pre-adjusted edgewise appliance. MATERIALS AND METHODS: The Case Western Reserve University (CWRU) cephalometric analysis was used to isolate tipping movement of upper (TUI) and lower incisors (TLI), bodily tooth movement of upper (BUI), and lower incisors (BLI), as well as vertical skeletal changes in the anterior region of the maxilla (MXSK) and mandible (MNSK). Thirty treated subjects were examined at pretreatment (T1) and posttreatment (T2) and compared to an untreated control group matched on age, sex, and Angle malocclusion from the Bolton Brush Growth Study Collection (CWRU, Cleveland, Ohio). RESULTS: Overbite (OB) in the treated group was decreased significantly (P < .001) (-5.6 mm) compared to controls. Statistically significant (P < .001) changes were found for BUI (-0.7 mm), TUI (0.9 mm), TLI (-1.4 mm), BLI (-1.1 mm), and MNSK (-1.6 mm). Most of the overbite correction was in the lower arch and included tipping and intrusion of the lower incisors along with an increase in lower vertical facial height. CONCLUSIONS: Deep OB correction was achieved efficiently using anterior bite elevators with pre-adjusted edgewise appliance. Correction using bite turbos would be a treatment option for individuals presenting with decreased lower facial height and deep bite.

Obstructive sleep apnea: a review for the orthodontist.

INTRODUCTION: Obstructive sleep apnea (OSA) affects an important part of the population and is characterized by recurrent total or partial obstruction of the upper airway (UA) during sleep, negatively affecting the quality of life of patients in the short and long terms, and constituting an important public health problem for the society. The field of expertise of orthodontists is closely related to the UA, placing them in a strategic position to diagnose air passage failures and intervene when necessary. Orthodontists, as health professionals, must know how to recognize respiratory problems and manage them appropriately, when indicated. OBJECTIVE: Thus, this paper aims to review and critically evaluate the related literature, to provide orthodontists with updated knowledge on the diagnosis and therapy related to OSA. Science and technology are constantly evolving; thus, the literature was also reviewed considering new technologies available in consumer-targeted applications and devices for the diagnosis, monitoring, and treatment of sleep-disordered breathing.

Comparing virtual setup software programs for clear aligner treatment.

BACKGROUND: The aim of this study was to compare the outcomes of the same amount of tooth movement among four different virtual setup software programs. METHODS: This retrospective study included 32 patients who underwent Invisalign treatment. Patients' initial stereolithography (STL) files were imported to three different software programs (SureSmile Aligner [Dentsply Sirona, Charlotte, NC], Ortho Insight 3D [Motion View software, Chattanooga, TN], and Ortho Analyzer [3Shape, Copenhagen, Denmark]). After virtually moving teeth based on the numbers from ClinCheck Pro (Align Technology, Inc., Santa Clara, CA) tooth movement tables, final STL files were exported from all four software programs. ClinCheck Pro final STL files were used as references, while final STL files from the other software programs were used as targets. Superimpositions were performed between references and target STL files using Geomagic Control X software (3D Systems, Rock Hill, SC), and color-coded maps were obtained to illustrate potential differences. RESULTS: Intraclass correlation coefficient showed a high degree of reliability for repeated methodology (0.995-0.997). The differences among absolute averages (Abs Avg.), averages of positive values (+Avg.), and negative values (-Avg.) for both upper and lower models were significant among all software programs (ClinCheck Pro, SureSmile Aligner, Ortho Insight 3D, and Ortho Analyzer), for both upper and lower STL files, the smallest difference was found between ClinCheck Pro and SureSmile Aligner with a median of (0.03, 0.31, -0.19) mm for upper and (0.02, 0.29, -0.17) mm for lower STL files (Abs Avg., +Avg. and -Avg.), respectively. The biggest difference was found to be between ClinCheck Pro and Ortho Analyzer with a median of (0.05, 0.46, -0.45) mm for upper and (0.06, 0.48, -0.40) mm for lower STL files. There were no significant differences in the number of aligners per patient. CONCLUSIONS: Final outcomes of the same amount of tooth movement in four different software programs differed significantly. The number of aligners per patient remained unchanged.

Factores de riesgo asociados a luxación en el paciente con fractura del cuello femoral: estudio de casos y controles / Risk factors associated to prosthetic hip dislocation in patients with femur neck fracture: a case-control study

Introducción La luxación tras una cirugía de artroplastia de cadera es una temible complicación que se ha presentado desde el desarrollo de la técnica. Se han realizado múltiples estudios comparativos que intentan aclarar cuáles son los factores que influyen en este suceso adverso. Métodos En nuestro caso hemos llevado a cabo un estudio retrospectivo analizando 476 pacientes, que han sido divididos en función de si habían sufrido un episodio de luxación o no y llevando a cabo un análisis estadístico de las posibles variables que podrían haber afectado en ello; diseñándose así un estudio de casos y controles. Resultados y conclusiones En nuestro estudio hemos obtenido que la enfermedad mental aumenta hasta 6 veces más el riesgo de sufrir un episodio de luxación tras someterse al paciente a una artroplastia de cadera por fractura (OR 6,429; IC 95% 1,568 - 26,361), al igual que el hecho de padecer una infección post-quirúrgica (OR 11,667; IC 95% 2,147 - 63,394). No obstante, sería adecuado realizar más estudios para su confirmación, al igual que el hecho de realizar estudios con un mayor tamaño muestral podrían apoyar o rebatir nuestros hallazgos. (AU)

Introduction Dislocation after a hip arthroplasty is a terrible complication that has been present since the technique was developed. Many studies have been developed in order to see which risk factors affect on this adverse effect. Methods We have made a retrospective study, analysing 476 patients. They have been divided in two groups, one if they have suffered from prosthetic hip dislocation and the other if they have not. After that, we did a stadistical analysys of posible risk factors, designing a case-control study. Results and conclusión In our study, we have found that mental illness increseases up to 6 times the risk of suffering a hip dislocation (OR 6,429; IC 95% 1,568 - 26,361). We also found relation with suffering from an acu-te infection (OR 11,667; IC 95% 2,147 - 63,394). However, more studies, or with a bigger popula-tion should be performed in order to make a statement. (AU)

Factores de riesgo asociados a luxación en el paciente con fractura del cuello femoral: estudio de casos y controles / Risk factors associated to prosthetic hip dislocation in patients with femur neck fracture: a case-control study

Introducción La luxación tras una cirugía de artroplastia de cadera es una temible complicación que se ha presentado desde el desarrollo de la técnica. Se han realizado múltiples estudios comparativos que intentan aclarar cuáles son los factores que influyen en este suceso adverso. Métodos En nuestro caso hemos llevado a cabo un estudio retrospectivo analizando 476 pacientes, que han sido divididos en función de si habían sufrido un episodio de luxación o no y llevando a cabo un análisis estadístico de las posibles variables que podrían haber afectado en ello; diseñándose así un estudio de casos y controles. Resultados y conclusiones En nuestro estudio hemos obtenido que la enfermedad mental aumenta hasta 6 veces más el riesgo de sufrir un episodio de luxación tras someterse al paciente a una artroplastia de cadera por fractura (OR 6,429; IC 95% 1,568 - 26,361), al igual que el hecho de padecer una infección post-quirúrgica (OR 11,667; IC 95% 2,147 - 63,394). No obstante, sería adecuado realizar más estudios para su confirmación, al igual que el hecho de realizar estudios con un mayor tamaño muestral podrían apoyar o rebatir nuestros hallazgos. (AU)

Introduction Dislocation after a hip arthroplasty is a terrible complication that has been present since the technique was developed. Many studies have been developed in order to see which risk factors affect on this adverse effect. Methods We have made a retrospective study, analysing 476 patients. They have been divided in two groups, one if they have suffered from prosthetic hip dislocation and the other if they have not. After that, we did a stadistical analysys of posible risk factors, designing a case-control study. Results and conclusión In our study, we have found that mental illness increseases up to 6 times the risk of suffering a hip dislocation (OR 6,429; IC 95% 1,568 - 26,361). We also found relation with suffering from an acu-te infection (OR 11,667; IC 95% 2,147 - 63,394). However, more studies, or with a bigger popula-tion should be performed in order to make a statement. (AU)

Skeletal maturation in different anteroposterior and vertical skeletal growth patterns in female subjects.

PURPOSE: The aim of the present work was to study the sequence of skeletal maturation in the various anteroposterior and vertical skeletal growth patterns and to detect whether differences existed between them. METHODS: Cephalograms of 861 growing and adolescent female patients were traced to categorize the subjects into 9 skeletal patterns. Each subject was assigned a skeletal maturational stage. Analysis of variance (ANOVA) followed by Bonferroni test were used to detect differences in the onset of the three growth stages (prepubertal, pubertal and postpubertal) between the 9 groups. The same statistical methods were used to detect differences between the mean ages at the three growth stages within each group. RESULTS: No statistically significant differences were found between the mean ages of pubertal and postpubertal growth stages between the 9 skeletal patterns. However, class III growers had a significantly earlier onset of prepubertal growth (10.25 ± 1.56 years) when compared to that of class II high angle cases (11.11 ± 1.67 years; P < 0.01). Also, significant differences were found between the mean ages at the three growth stages within the groups. CONCLUSION: A map was created defining the sequence of skeletal maturation for each skeletal growth pattern. This map defines clinically relevant differences in the starting time points and the optimum intervals of growth modification for each skeletal growth pattern.

Cone-beam computed tomography assessment of maxillary anterior alveolar bone remodelling in extraction and non-extraction orthodontic cases using stable extra-alveolar reference.

OBJECTIVE: To explore alveolar cortical positional change in response to tooth movement in extraction and non-extraction orthodontic cases, using cone-beam computed tomography (CBCT) and stable extra-alveolar references. MATERIALS AND METHODS: The pre-treatment (T1) and post-treatment (T2) CBCT scans of 25 extraction (EXT) and matched 25 non-extraction (Non-EXT) orthodontic cases were imported into Dolphin Imaging 3D, and oriented uniformly. Sagittal and axial CBCT cross-sections were traced using customized software-generated guides. The displacement of teeth and alveolar bone cortices were automatically measured using the palatal plane (PP) and the line perpendicular to PP and passing Sella as reference. Intra- and inter-group differences between T1 and T2 were analysed. Subjects were also superimposed three-dimensionally using Geomagic Control X for qualitative analysis of cortical remodelling. RESULTS: The EXT group showed incisor retraction, while the Non-EXT group exhibited statistically significant incisor anterior tipping (P < .05). In EXT, both the labial and palatal cortices are resorbed. Non-EXT showed labial cortex anterior modelling, and statistically significant palatal cortex resorption (P < .05). In both groups, statistically significant decrease in total and palatal alveolar widths, increase in labial widths, and palatal dehiscence were observed. Comparatively, EXT showed significantly more incisal total and palatal width decrease and palatal vertical bone loss. CONCLUSION: Labial cortical remodelling was shown to follow anterior tooth movement, but the palatal cortical response to incisor retraction and labial cortical remodelling in general remained inconclusive. Narrowing of the alveolar housing and palatal dehiscence were observed regardless of extraction following orthodontic treatment.

Obstructive sleep apnea: a review for the orthodontist

ABSTRACT Introduction: Obstructive sleep apnea (OSA) affects an important part of the population and is characterized by recurrent total or partial obstruction of the upper airway (UA) during sleep, negatively affecting the quality of life of patients in the short and long terms, and constituting an important public health problem for the society. The field of expertise of orthodontists is closely related to the UA, placing them in a strategic position to diagnose air passage failures and intervene when necessary. Orthodontists, as health professionals, must know how to recognize respiratory problems and manage them appropriately, when indicated. Objective: Thus, this paper aims to review and critically evaluate the related literature, to provide orthodontists with updated knowledge on the diagnosis and therapy related to OSA. Science and technology are constantly evolving; thus, the literature was also reviewed considering new technologies available in consumer-targeted applications and devices for the diagnosis, monitoring, and treatment of sleep-disordered breathing.

RESUMO Introdução: A apneia obstrutiva do sono (AOS) afeta uma importante parcela da população e caracteriza-se pela obstrução total ou parcial recorrente da via aérea superior (VAS) durante o sono, o que afeta negativamente a qualidade de vida dos pacientes no curto prazo e no longo prazo, e constitui importante problema de saúde pública para a sociedade. A área de atuação do ortodontista está em íntima relação com a VAS, o que o coloca em uma posição estratégica para diagnosticar falhas na passagem de ar e intervir quando necessário. É imperativo que o ortodontista, como profissional da saúde, saiba reconhecer problemas respiratórios e manejá-los de maneira apropriada, quando indicado. Objetivo: O objetivo desse artigo é revisar e avaliar criticamente a literatura pertinente, para proporcionar ao ortodontista conhecimento atualizado sobre o diagnóstico e terapêutica relacionados à AOS. Ciência e tecnologia estão em constante evolução; portanto, a literatura também foi revisada considerando as novas tecnologias disponíveis em aplicativos e dispositivos direcionados aos consumidores para o diagnóstico, monitoramento e tratamento dos distúrbios respiratórios do sono.

Implant-supported canine retraction using different reactivation intervals of elastomeric chains: A CBCT-based split-mouth randomized controlled trial

ABSTRACT Introduction: Orthodontists attempt to maximize treatment efficiency regarding time, tooth position and adverse effects. A new approach, not yet explored, is the activation frequency. Objective: The aim of this split-mouth randomized controlled trial was to evaluate the effect of reactivation intervals on the efficiency of tooth movement. Methods: Thirty eight patients having a Class I malocclusion with bimaxillary dentoalveolar protrusion or severe crowding, Class II with mandibular deficiency or Class III, requiring first premolar extraction and canine retraction were recruited. Elastomeric chains producing 150g were replaced every two, four, six or eight weeks. There were 36, 37, 36, and 36 quadrants randomly allocated to these groups, respectively. The canine retraction rate was the primary outcome. Canine tipping, rotation, and root resorption and pain were the secondary outcomes. Only the outcome assessors were blinded to group assignment. Results: The average total movement for the 6 months was 5.14, 5.31, 2.79 and 3.85 mm for the two-week, four-week, six-week and eight-week reactivation intervals, respectively. Root resorption was significantly higher in the two-week and four-week groups. No adverse events were observed. Conclusion: The canine retraction rate, tipping, rotation and pain were similar in 2, 4, 6 and 8-week activation intervals groups. Longer reactivation intervals show less root resorption. The trial protocol was not pre-registered. The study was self-funded.

RESUMO Introdução: Os ortodontistas buscam otimizar a eficiência do tratamento quanto ao tempo de duração, à posição dos dentes e aos efeitos adversos. Um aspecto ainda não avaliado são os diferentes intervalos entre as ativações. Objetivo: O objetivo desse estudo controlado e randomizado de boca dividida foi avaliar a influência de diferentes intervalos de reativação na eficiência da movimentação dentária. Métodos: Foram recrutados 38 pacientes com má oclusão de Classe I com biprotrusão dentoalveolar ou apinhamento severo, Classe II com deficiência mandibular ou Classe III, que necessitavam de extração do primeiro pré-molar e retração do canino. As cadeias elastoméricas gerando 150 g foram substituídas a cada duas, quatro, seis ou oito semanas, constando 36, 37, 36 e 36 quadrantes alocados aleatoriamente nesses grupos, respectivamente. O desfecho primário foi a taxa de retração do canino. Os desfechos secundários foram a inclinação, a rotação e a reabsorção radicular do canino, e a dor. Somente os avaliadores dos resultados não tinham conhecimento da alocação nos grupos. Resultados: O movimento total médio para os seis meses foi de 5,14; 5,31; 2,79 e 3,85 mm para os intervalos de reativação de duas semanas, quatro semanas, seis semanas e oito semanas, respectivamente. A reabsorção radicular foi significativamente maior nos grupos de duas e quatro semanas. Não foram observados eventos adversos. Conclusão: A taxa de retração, a inclinação e a rotação do canino e a dor foram semelhantes nos grupos com intervalos de ativação de duas, quatro, seis e oito semanas. Intervalos de reativação mais longos mostram menos reabsorção radicular. O protocolo do estudo não foi pré-registrado. O estudo foi autofinanciado.

Comparing 3D Tooth Movement When Implementing the Same Virtual Setup on Different Software Packages.

BACKGROUND/OBJECTIVES: The purpose of this study was to compare the differences in tooth movements when implementing the same virtual setup on the following four different software packages: ClinCheck® Pro, Ortho Analyzer®, SureSmile®, and Ortho Insight 3D®. MATERIALS/METHODS: Twenty-five adult patients treated with Invisalign® at the Case School of Dental Medicine (CWRU)'s department of orthodontics were retrospectively collected. Initial stereolithography (STL) files were obtained and imported into three software packages. The teeth were moved in order to replicate the virtual setup from ClinCheck® Pro. The final outcomes were exported from each software package. ClinCheck® Pro STL files were used as the reference while STL files produced by the other software packages were used as the targets. Best fit superimpositions were performed using Geomagic® Control X. Based on the results, tooth position was adjusted in the three software packages until the virtual setups from ClinCheck® Pro were replicated. Once confirmed, the tables containing the tooth movements were compared. The number of aligners and number of attachments automatically generated from each of the software packages were also evaluated. RESULTS: Extrusion/intrusion (p ≤ 0.0001) and translation buccal/lingual (p ≤ 0.0004) were significantly different among the software packages. ClinCheck® Pro and SureSmile® (p ≤ 0.000), SureSmile® and Ortho Insight 3D® (p ≤ 0.014), SureSmile® and Ortho Analyzer® (p ≤ 0.009), and Ortho Insight 3D® and Ortho Analyzer® (p ≤ 0.000) generated a significantly different number of maxillary aligners. The results varied slightly for mandibular aligners, with only ClinCheck® Pro and Ortho Insight 3D® (p ≤ 0.000), SureSmile® and Ortho Insight 3D® (p ≤ 0.000), and Ortho Insight 3D® and Ortho Analyzer® (p ≤ 0.000) exhibiting a significant difference. ClinCheck® Pro and SureSmile® (p ≤ 0.000) differed significantly in the number of attachments produced. CONCLUSIONS: There are statistically significant differences in extrusion/intrusion, translation buccal/lingual, the number of aligners, and the number of attachments when implementing the same virtual setup on different software packages. Clinicians may need to consider this when utilizing software programs for digital diagnosis and treatment planning.