Correlation between the three-dimensional hyoid bone parameters and pharyngeal airway dimensions in different sagittal and vertical malocclusions.

OBJECTIVE: This study aimed to explore the relationship between three-dimensional (3D) measurements of the hyoid bone (HB) and pharyngeal airway space (PAS) in relation to sagittal and vertical malocclusion. METHODS: A total of 368 cone-beam computed tomography (CBCT) scans were classified into three skeletal groups (Class I, II, and III) and subdivided by vertical growth patterns (hypodivergent, normodivergent, and hyperdivergent). PAS dimensions, including nasopharyngeal, oropharyngeal, hypopharyngeal, and total airway spaces, were measured in surface area, volume, minimum constricted area (MCA), length, and width, HB position and dimension were analyzed in 3D using InVivo 6.0.3 and Dolphin 11.8 software. Data were analyzed using two-way ANOVA, and Bonferroni post-hoc tests, with P ≤ 0.05 considered significant. RESULTS: The study found that patients with skeletal Class III and hypodivergent growth pattern had the highest sagittal position of the hyoid bone, while those with skeletal Class II and hyperdivergent pattern had the lowest hyoid length. Nasopharyngeal airway space width was significantly lower in skeletal Class III patients, while volume and area were lower in hyperdivergent patients. Oropharyngeal and hypopharyngeal dimensions were also affected by skeletal class and growth pattern, with hyperdivergent patients having the lowest values. Total pharyngeal volume, area, and minimum constricted area were also affected, with hyperdivergent patients having the lowest values and skeletal Class II patients having the lowest minimum constricted area. CONCLUSION: Pharyngeal airway dimensions and hyoid bone parameters vary with malocclusions. The hyoid bone's position influences the airway, identifying patients at risk for airway obstruction and sleep-disordered breathing.

Regenerated silk fibroin based on small aperture scaffolds and marginal sealing hydrogel for osteochondral defect repair.

BACKGROUND: Osteochondral defects pose an enormous challenge without satisfactory repair strategy to date. In particular, the lateral integration of neo-cartilage into the surrounding native cartilage is a difficult and inadequately addressed problem determining tissue repair's success. METHODS: Regenerated silk fibroin (RSF) based on small aperture scaffolds was prepared with n-butanol innovatively. Then, the rabbit knee chondrocytes and bone mesenchymal stem cells (BMSCs) were cultured on RSF scaffolds, and after induction of chondrogenic differentiation, cell-scaffold complexes strengthened by a 14 wt% RSF solution were prepared for in vivo experiments. RESULTS: A porous scaffold and an RSF sealant exhibiting biocompatibility and excellent adhesive properties are developed and confirmed to promote chondrocyte migration and differentiation. Thus, osteochondral repair and superior horizontal integration are achieved in vivo with this composite. CONCLUSIONS: Overall, the new approach of marginal sealing around the RSF scaffolds exhibits preeminent repair results, confirming the ability of this novel graft to facilitate simultaneous regeneration of cartilage-subchondral bone.

A quantitative three-dimensional comparative study of alveolar bone changes and apical root resorption between clear aligners and fixed orthodontic appliances.

BACKGROUND: This study aimed to evaluate and compare the alveolar bone changes and to investigate the prevalence and severity of orthodontically induced inflammatory root resorption (OIIRR) of maxillary incisors in patients who received treatment with clear aligners (CA) versus conventional fixed appliances (FA), using cone-beam computed tomography (CBCT). METHODS: One hundred sixty maxillary incisors from 40 patients with similar baseline characteristics based on the American Board of Orthodontics discrepancy index scores were divided into the CA and FA groups. The dentoalveolar quantitative changes were analyzed using pre- (T0) and post-treatment (T1) CBCT. The measured parameters included alveolar bone thickness (ABT), alveolar bone height (ABH), root length (OIIRR), and maxillary incisor inclinations. RESULTS: Post-treatment, the average palatal and total ABT significantly decreased in central and lateral incisors in the FA group. In contrast, the CA group's average labial ABT of the lateral incisors decreased considerably. Regarding the ABH, both groups showed significant labial and palatal marginal bone resorption. In both groups, root lengths significantly decreased after treatment (p < 0.005). The inter-group comparison revealed that ABT and root length had significantly decreased in the FA group compared to the CA group, while the ABH showed no significant difference between the two groups. The mean absolute reductions of ABT and OIIRR in the CA group were significantly less (- 0.01 ± 0.89 and 0.31 ± 0.42) than those in the FA group (0.20 ± 0.82 and 0.68 ± 0.97), respectively. CONCLUSIONS: CA and FA treatments appear to cause a significant ABT reduction and a statistically significant increased OIIRR in the maxillary incisor region, with a greater extent expected with FA treatment. However, the increased OIIRR values in the majority of both groups' cases were not clinically significant. Both treatment modalities resulted in a significant ABH reduction, with the highest found in the labial side of lateral incisors in the CA group.

Three-dimensional assessment of temporomandibular joint in skeletal Class I malocclusion with variable degrees of overbite and overjet.

OBJECTIVE: To three-dimensionally evaluate the position and morphology of the TMJ in skeletal Class I with variable degrees of overbite and overjet in comparison with normal peers. METHODS: Pretreatment CBCT scans of 126 adults were retrieved. Based on the severity of overjet and overbite, the sample was divided into three main groups and six subgroups (18 patients each): the first group with a normal overbite and variable overjet degree and the second group with normal overjet and variable overbite degree. These six subgroups were compared with a third control group of normal overjet and overbite. RESULTS: There were significant differences in vertical condylar position, vertical and anteroposterior condylar inclinations, condylar height, and significant posterior condylar positioning in severe deep overbite, compared with the control group. CONCLUSION: There were significant changes in the TMJ components in severe deep overbite cases. Therefore, sever deep overbite could be considered a predisposing factor for temporomandibular disorders.

Three-dimensional assessment of asymmetric mid-palatal suture expansion assisted by a customized microimplant-supported rapid palatal expander in non-growing patients: Uncontrolled Clinical Trial.

OBJECTIVES: The objective was to evaluate the magnitude, incidence and possible factors of asymmetric expansion with a customized microimplant-supported rapid palatal expander (MARPE) in non-growing patients. SETTING AND SAMPLE POPULATION: This retrospective study included a sample of 49 patients (mean age: 23.9 ± 3.9 years) treated with a customized microimplant-supported rapid palatal expander. Based on the symmetry of expansion, the sample was divided into Group S (symmetric expansion group, n = 26) and Group A (asymmetric expansion group, n = 23). METHODS: Pre- and post-treatment cone-beam computed tomography (CBCT) images were superimposed to assess skeletal change in both studied groups. Seven variables were tested: unilateral crossbite, maxillary base cant, chin deviation, the initial asymmetrical position of the mid-palatal suture, split pattern of frontomaxillary suture, Angle's classification and dental arch crowding. Paired t-test and logistic regression analyses were utilized to evaluate the possible factors behind the asymmetric expansion. RESULTS: There was a significant difference (P < .01) between the studied groups. The average expansion was 4.26 mm at the anterolateral maxillary walls (BB) and 3.83 mm at the greater palatine foramen region (GPF). The average expansion at the GPF was 90% of that at the BB. The frequency of asymmetric expansion was 46.9%. Among the seven tested variables, the presence of the initial asymmetric position of the mid-palatal suture is the only variable that showed correlation with asymmetric expansion. CONCLUSION: Initial asymmetric position of the mid-palatal suture is considered a contributing factor of skeletal asymmetric expansion following microimplant-supported rapid palatal expansion in skeletally comparable patients.

Three-dimensional morphological and positional analysis of the temporomandibular joint in adults with posterior crossbite: A cross-sectional comparative study.

OBJECTIVES: The purpose of this study was to three-dimensionally (3D) evaluate the morphological and positional features of the temporomandibular joint (TMJ) in adults with unilateral and bilateral posterior crossbite compared with aligned control subjects. MATERIALS AND METHODS: This cross-sectional comparative study analysed cone beam computed tomography (CBCT) images of 90 adult subjects' divided into three equal groups: bilateral posterior crossbite (BCG), unilateral posterior crossbite (UCG) and control group (CG). 3D measurements of the TMJ included the following: (a) position, angulation and inclination of the mandibular condyles; (b) centralisation of the condyles in their respective mandibular fossae; and (c) volumetric measurements of the TMJ spaces. Intra- and intergroup differences were identified using the paired Student's t test and an analysis of variance (ANOVA) followed by Tukey's post hoc test, respectively. RESULTS: Regarding the intra-group side-based comparisons, there were significant differences in the anterior and superior joint spaces and the anteroposterior condylar joint position in the UCG. Intergroup comparisons revealed significant differences in the vertical condylar inclination, medial condylar position, condylar width and height, and volumetric joint space between the unaffected side of the UCG and left sides of the other groups. There were significant differences in the anteroposterior condylar inclination, medial condylar position, condylar width and height, anterior, posterior, superior and volumetric joint spaces, and anteroposterior condylar joint position between the crossbite side of the UCG and the right sides of the other groups. CONCLUSION: Skeletal crossbite accompanied with characteristic morphological and positional TMJ features associated with unilateral posterior crossbite and are associated with side-specific TMJ asymmetry.

Three dimensional reliability analyses of currently used methods for assessment of sagittal jaw discrepancy.

BACKGROUND: The objective of this study was to analyse three dimensionally the reliability and correlation of angular and linear measurements in assessment of anteroposterior skeletal discrepancy. MATERIAL AND METHODS: In this retrospective cross sectional study, a sample of 213 subjects were three-dimensionally analysed from cone-beam computed tomography scans. The sample was divided according to three dimensional measurement of anteroposterior relation (ANB angle) into three groups (skeletal Class I, Class II and Class III). The anterior-posterior cephalometric indicators were measured on volumetric images using Anatomage software (InVivo5.2). These measurements included three angular and seven linear measurements. Cross tabulations were performed to correlate the ANB angle with each method. Intra-class Correlation Coefficient (ICC) test was applied for the difference between the two reliability measurements. P value of < 0.05 was considered significant. RESULTS: There was a statistically significant (P<0.05) agreement between all methods used with variability in assessment of different anteroposterior relations. The highest correlation was between ANB and DSOJ (0.913), strong correlation with AB/FH, AB/SN/, MM bisector, AB/PP, Wits appraisal (0.896, 0.890, 0.878, 0.867,and 0.858, respectively), moderate with AD/SN and Beta angle (0.787 and 0.760), and weak correlation with corrected ANB angle (0.550). CONCLUSIONS: Conjunctive usage of ANB angle with DSOJ, AB/FH, AB/SN/, MM bisector, AB/PP and Wits appraisal in 3D cephalometric analysis provide a more reliable and valid indicator of the skeletal anteroposterior relationship. Clinical relevance: Most of orthodontic literature depends on single method (ANB) with its drawbacks in assessment of skeletal discrepancy which is a cardinal factors for proper treatment planning, this study assessed three dimensionally the degree of correlation between all available methods to make clinical judgement more accurate based on more than one method of assessment. Key words:Anteroposterior relationships, ANB angle, Three-dimension, CBCT.