Orthodontics & Craniofacial Research最新文献

{"title":"Individualised Therapy for Obstructive Sleep Apnoea: Predictive Models and Anatomical Phenotyping of Mandibular Advancement Devices Responses","authors":"Sara Camañes-Gonzalvo,&nbsp;José María Montiel-Company,&nbsp;Marina García-Selva,&nbsp;Andrés Plaza-Espín,&nbsp;Tomàs Pérez-Carbonell,&nbsp;Vanessa Paredes-Gallardo,&nbsp;Carlos Bellot-Arcís,&nbsp;Rocío Marco-Pitarch","doi":"10.1111/ocr.12900","DOIUrl":"10.1111/ocr.12900","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This non-randomised clinical study aimed to identify the phenotypic characteristics that distinguish responders from non-responders. Additionally, it sought to establish a predictive model for treatment response to obstructive sleep apnoea (OSA) using mandibular advancement devices (MAD), based on the analysed phenotypic characteristics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and Methods</h3>\u0000 \u0000 <p>This study, registered under identifier NCT05596825, prospectively analysed MAD treatment over 6 years using two-piece adjustable appliances according to a standardised protocol. Two response definitions aligned with the latest International Consensus Statement on OSA severity were established. Logistic regression and CHAID models integrated baseline clinical, anthropometric, cephalometric anatomical, soft tissue characteristics and physiological upper airway variables.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 112 patients completed the study: 64 responders and 48 non-responders according to response definition 1, and 81 responders and 31 non-responders according to response definition 2. Responders to MAD treatment had lower body mass index (BMI), neck and waist circumference, Epworth Sleepiness Scale scores, apnoea–hypopnea index (AHI), snoring intensity on the Visual Analog Scale, CPAP pressure, and higher T90% and minSaO₂. Patients exhibiting greater anatomical imbalance, smaller airway volume, smaller minimum cross-sectional area (CSAmin) and longer airway length demonstrated a poorer response to treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Airway length, initial T90% and anterior facial height collectively formed a highly predictive logistic regression model for response definition 1. Jarabak's ratio, gonial angle, CSAmin, airway length, initial BMI and baseline AHI constituted a highly predictive model for the second response definition. Furthermore, the CHAID regression tree established cutoff values for the variables that form the predictive models.</p>\u0000 </section>\u0000 </div>","PeriodicalId":19652,"journal":{"name":"Orthodontics & Craniofacial Research","volume":"28 3","pages":"485-495"},"PeriodicalIF":2.4,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143033695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Reliability and Validity of Intraoral Photographs in Assessing Orthodontic Treatment Need","authors":"Emma Göranson,&nbsp;Mikael Sonesson,&nbsp;Malin Gullbrand,&nbsp;Per-Erik Isberg,&nbsp;Lillemor Dimberg","doi":"10.1111/ocr.12896","DOIUrl":"10.1111/ocr.12896","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Orthodontic treatment need has commonly been assessed using treatment need indices during clinical examinations or using photographs in combination with plaster casts. Recently, the use of intraoral photographs alone to screen malocclusions has increased.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objective&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This study aimed to validate intraoral photographs for the assessment of orthodontic treatment need.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Materials and Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The study sample consisted of case files from 30 pre-orthodontic patients aged 12–19 years. Each case file included intraoral photographs and casts. The cases were consecutively recruited from two orthodontic treatment waiting lists: 15 from the Department of Orthodontics at Folktandvården Eastmaninstitutet, Stockholm, Sweden and 15 from the Center for Orthodontics and Pediatric Dentistry, Norrköping, Public Dental Service Östergötland. Their orthodontic treatment need was assessed by four raters (calibrated orthodontists) using the indices IOTN-AC, IOTN-DHC, ICON, and DAI. The four raters individually assessed the 30 cases on three occasions: (1) photos only, (2) photos and casts, and (3) photos only. Finally, the four raters jointly made a consensus assessment using both photos and casts. For IOTN-AC and IOTN-DHC, interrater agreement was assessed with Fleiss' kappa, and validity with the Wilcoxon signed-rank test. For ICON and DAI, interrater agreement was assessed with Intra Class Correlation (ICC) (1, 2) and validity with a paired &lt;i&gt;t&lt;/i&gt;-test.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Interrater agreement for IOTN-AC was slight (0.14–0.18) and moderate for IOTN-DHC (0.51–0.57), regardless of whether photographs were used alone or combined with casts. ICON demonstrated moderate interrater agreement (0.57–0.72), while DAI showed moderate to excellent (0.70–0.91), similarly unaffected by the use of photographs alone or in combination with casts. The validity analysis, which compared the individual assessments to the consensus one, revealed equivalent differences whether the assessment involved intraoral photographs alone or in combination with casts.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Intraoral photographs are sufficient for assessing orthodontic treatment need because interrater agreement and validity are similar whether photos are used alone or with casts. However, interrater variability was substantial for both assessment method","PeriodicalId":19652,"journal":{"name":"Orthodontics & Craniofacial Research","volume":"28 3","pages":"474-484"},"PeriodicalIF":2.4,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ocr.12896","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ability of Orthodontists to Detect, Interpret and Propose Management Strategies for Incidental Findings on Pre-Treatment Panoramic Radiographs","authors":"Madeleine Edmonds,&nbsp;Susanne Perschbacher,&nbsp;Iacopo Cioffi,&nbsp;Marco Magalhaes","doi":"10.1111/ocr.12897","DOIUrl":"10.1111/ocr.12897","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Radiographs are routinely acquired for orthodontic evaluation, and incidental findings (IFs) may be detected early as part of this routine care. This study aimed to assess the prevalence of IFs on panoramic radiographs taken for orthodontic assessment and evaluate the ability of orthodontists to detect, interpret and recommend management for IFs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>A retrospective analysis of 1756 patients aged 7–21 with a panoramic image taken for orthodontic evaluation was performed. IFs were categorised by anatomic region and assigned a significance level based on a custom-made risk assessment tool. Twelve selected images were evaluated by 30 orthodontists via a standardised online survey. Participants were tasked with reviewing each image, providing a radiological interpretation, and indicating whether a referral would be needed prior to commencing orthodontic treatment. The responses were scored against those of an expert oral and maxillofacial radiologist (OMFR). Inter-observer agreement was evaluated by computing the Cohen's <i>K</i>.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The prevalence of IFs was 30.8%. The most common findings were impacted teeth (17.7%), hypodontia (14.9%) and dense bone islands (14.7%). After applying the risk assessment tool, 35% of the findings were considered highly significant. The overall agreement between the orthodontists and OMFR was <i>k =</i> 0.32 (95% CI = 0.30–0.34). The agreement for location was 0.52 (95% CI = 0.47–0.58), whereas it was <i>k =</i> 0.45 (95% CI = 0.40–0.50) for diagnosis and <i>k =</i> 0.19 (95% CI = 0.13–0.24) for referral need.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Orthodontists may benefit from additional education and training focused on interpretation and management of IFs on panoramic radiographs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":19652,"journal":{"name":"Orthodontics & Craniofacial Research","volume":"28 3","pages":"449-457"},"PeriodicalIF":2.4,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142952152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of Clinical Predictability of Overbite Reduction and Curve of Spee Levelling in Clear Aligner Treatment","authors":"Simona Dianiskova,&nbsp;Roberto Rongo,&nbsp;Domenico Sirignano,&nbsp;Rosalinda D'Amelio,&nbsp;Giorgio Oliva,&nbsp;Rosa Valletta,&nbsp;Vincenzo D'Antò","doi":"10.1111/ocr.12894","DOIUrl":"10.1111/ocr.12894","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This retrospective study aims to assess the predictability of Overbite (OVB) reduction and Curve of Spee (COS) levelling in patients with deep bite malocclusion treated with Clear Aligner Therapy (CAT). The research evaluates the accuracy of the prescribed movements in growing and non-growing patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Thirty-six patients treated with Invisalign from January 2018 using SmartTrack were included. Digital models at pre-treatment, virtual plan and post-treatment phases were collected and analysed using Geomagic Control X. Accuracy was assessed for COS levelling, OVB reduction and individual tooth movements. Statistical analyses included descriptive statistics, paired <i>t</i>-tests and linear regression between accuracy of the movements and the age of the patient.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study found that the prescribed movements in ClinCheck often overestimated the achieved outcomes. The mean accuracy for COS levelling was 62%, and for OVB reduction, it was 61%. No significant association was observed between the accuracy and the age of the patient.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Clear Aligner Therapy demonstrated moderate accuracy in achieving prescribed movements for COS levelling and OVB reduction. Clinicians should exercise caution in virtual treatment planning and may need to consider potential modifications to software projections to enhance desired outcomes. Further research comparing different aligner protocols and brands is warranted to advance understanding and improve treatment predictability.</p>\u0000 </section>\u0000 </div>","PeriodicalId":19652,"journal":{"name":"Orthodontics & Craniofacial Research","volume":"28 3","pages":"458-465"},"PeriodicalIF":2.4,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ocr.12894","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142952639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Invisalign Wear Protocol on the Efficacy of Tooth Movement in Four First-Premolar Extraction in Adolescent Patients: A Randomised Controlled Trial","authors":"YaoHui Yu,&nbsp;Yu Zhou","doi":"10.1111/ocr.12898","DOIUrl":"10.1111/ocr.12898","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Different protocols exist regarding wear time of invisible aligners. There is no study that compared the effect of different protocols. The aim of this study was to assess the effect of Invisalign aligners in four first-premolar extraction treatments in adolescents using three aligner wear protocols, every 7, 10 and 14 days.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>In the experimental set-up, 50 participants were divided into three distinct groups: group A, with a regimen of changing aligners every 7 days; group B, with a 10-day interval for aligner replacement; and group C, where aligners were replaced every 14 days. The evaluation of occlusal adjustments was conducted employing the Discrepancy Index (DI) and the Cast-Radiograph Evaluation (CRE), as defined by the American Board of Orthodontics for the purpose of recording orthodontic outcomes. The treatment duration, number of maxillary and mandibular Invisalign aligners, and number of Invisalign restarts were simultaneously recorded and evaluated. The data set was statistically examined using ANOVA, complemented by the <i>F</i>-test, least significant difference (LSD) method and Tamhane's T2 test.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The final sample size for analysis is 45 cases, with five cases lost to follow-up. Before treatment, the three groups showed no significant difference in the degree of malocclusion or each item of DI (<i>p</i> &gt; 0.05). Posttreatment, within groups, and regardless of the wearing protocol, the total CRE scores demonstrated no statistically significant differences (<i>p</i> &gt; 0.05). For the other items, groups A and C completed occlusal relations and interproximal contacts significantly better than did group B (<i>p</i> &lt; 0.05). The group C cases had the least number of Invisalign refinement (3.93 ± 0.96 vs. 4.93 ± 0.70 vs. 6.00 ± 1.25, <i>p</i> &lt; 0.05), but the treatment duration and number of Invisalign aligners were not significantly different (<i>p</i> &gt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The different treatment timing protocols showed equivalent effectiveness regarding treatment outcome, with significantly improved results for the 7- and 14-day protocol in terms of occlusal relations and interproximal contacts. The attainment of comparable clinical accuracy between the 7- and 14-day protocol, within a treatment duration of fewer than 3 months, indicates that the 7-day protocol can be deemed an effective treatment approach.</p>\u0000 </section>\u0000 </div>","PeriodicalId":19652,"journal":{"name":"Orthodontics & Craniofacial Research","volume":"28 3","pages":"466-473"},"PeriodicalIF":2.4,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142952658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep Learning-Based Three-Dimensional Analysis Reveals Distinct Patterns of Condylar Remodelling After Orthognathic Surgery in Skeletal Class III Patients","authors":"Selene Barone,&nbsp;Lucia Cevidanes,&nbsp;Jonas Bianchi,&nbsp;Joao Roberto Goncalves,&nbsp;Amerigo Giudice","doi":"10.1111/ocr.12895","DOIUrl":"10.1111/ocr.12895","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This retrospective study aimed to evaluate morphometric changes in mandibular condyles of patients with skeletal Class III malocclusion following two-jaw orthognathic surgery planned using virtual surgical planning (VSP) and analysed with automated three-dimensional (3D) image analysis based on deep-learning techniques.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Pre-operative (T1) and 12–18 months post-operative (T2) Cone-Beam Computed Tomography (CBCT) scans of 17 patients (mean age: 24.8 ± 3.5 years) were analysed using 3DSlicer software. Deep-learning algorithms automated CBCT orientation, registration, bone segmentation, and landmark identification. By utilising voxel-based superimposition of pre- and post-operative CBCT scans and shape correspondence, the overall changes in condylar morphology were assessed, with a focus on bone resorption and apposition at specific regions (superior, lateral and medial poles). The correlation between these modifications and the extent of actual condylar movements post-surgery was investigated. Statistical analysis was conducted with a significance level of <i>α</i> = 0.05.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall condylar remodelling was minimal, with mean changes of &lt; 1 mm. Small but statistically significant bone resorption occurred at the condylar superior articular surface, while bone apposition was primarily observed at the lateral pole. The bone apposition at the lateral pole and resorption at the superior articular surface were significantly correlated with medial condylar displacement (<i>p</i> &lt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The automated 3D analysis revealed distinct patterns of condylar remodelling following orthognathic surgery in skeletal Class III patients, with minimal overall changes but significant regional variations. The correlation between condylar displacements and remodelling patterns highlights the need for precise pre-operative planning to optimise condylar positioning, potentially minimising harmful remodelling and enhancing stability.</p>\u0000 </section>\u0000 </div>","PeriodicalId":19652,"journal":{"name":"Orthodontics & Craniofacial Research","volume":"28 3","pages":"441-448"},"PeriodicalIF":2.4,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ocr.12895","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142927138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Automated Cone Beam Computed Tomography Segmentation of Multiple Impacted Teeth With or Without Association to Rare Diseases: Evaluation of Four Deep Learning-Based Methods","authors":"Eloi Sinard,&nbsp;Laurent Gajny,&nbsp;Muriel de La Dure-Molla,&nbsp;Rufino Felizardo,&nbsp;Gauthier Dot","doi":"10.1111/ocr.12890","DOIUrl":"10.1111/ocr.12890","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To assess the accuracy of three commercially available and one open-source deep learning (DL) solutions for automatic tooth segmentation in cone beam computed tomography (CBCT) images of patients with multiple dental impactions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Twenty patients (20 CBCT scans) were selected from a retrospective cohort of individuals with multiple dental impactions. For each CBCT scan, one reference segmentation and four DL segmentations of the maxillary and mandibular teeth were obtained. Reference segmentations were generated by experts using a semi-automatic process. DL segmentations were automatically generated according to the manufacturer's instructions. Quantitative and qualitative evaluations of each DL segmentation were performed by comparing it with expert-generated segmentation. The quantitative metrics used were Dice similarity coefficient (DSC) and the normalized surface distance (NSD).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The patients had an average of 12 retained teeth, with 12 of them diagnosed with a rare disease. DSC values ranged from 88.5% ± 3.2% to 95.6% ± 1.2%, and NSD values ranged from 95.3% ± 2.7% to 97.4% ± 6.5%. The number of completely unsegmented teeth ranged from 1 (0.1%) to 41 (6.0%). Two solutions (Diagnocat and DentalSegmentator) outperformed the others across all tested parameters.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>All the tested methods showed a mean NSD of approximately 95%, proving their overall efficiency for tooth segmentation. The accuracy of the methods varied among the four tested solutions owing to the presence of impacted teeth in our CBCT scans. DL solutions are evolving rapidly, and their future performance cannot be predicted based on our results.</p>\u0000 </section>\u0000 </div>","PeriodicalId":19652,"journal":{"name":"Orthodontics & Craniofacial Research","volume":"28 3","pages":"433-440"},"PeriodicalIF":2.4,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ocr.12890","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Comparative Evaluation of Presurgical Infant Orthopaedics of Modified Grayson's Technique With Rhinoplasty Appliance System in Patients With Unilateral Cleft Lip and Palate","authors":"Martha Mejia,&nbsp;Puneet Batra,&nbsp;Monica Dominguez,&nbsp;Daniela Scarlett Escobar,&nbsp;Mayra Alvarez,&nbsp;Tatiana Castillo,&nbsp;Dhruv Ahuja","doi":"10.1111/ocr.12892","DOIUrl":"10.1111/ocr.12892","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the effects of presurgical infant orthopaedics using the Modified Grayson technique and Rhinoplasty Appliance System on the maxillary alveolus and nasolabial region in infants with unilateral cleft lip and palate (UCLP).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>This prospective study looked at 26 patients with a mean age of 6.3 ± 1.48 days, having complete UCLP. The study sample was divided into two groups of 13 UCLP infants: Group 1, treated by the modified Grayson technique, and Group 2, treated with the Rhinoplasty Appliance System (RAS). The scanned cast parameters were assessed before and after PSIO treatment, assessing treatment changes in the alveolar arch, which was further supplemented with standardised anteroposterior, Worms-eye view and profile photographs assessing sift tissue facial parameters. Descriptive statistics were applied, and a two-tailed <i>t</i>-test for intergroup comparison was used to determine cast and facial parameters across the two techniques.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Intra-group assessment of cast and facial parameters showed a significant difference (<i>p</i> &lt; 0.005) across pre and post-treatment assessment using two different treatment modalities. However, intergroup comparison showed no significant difference (<i>p</i> &gt; 0.005) between modified Grayson's and RAS techniques.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In infants with UCLP, both techniques significantly impacted the alveolus and nasolabial region while reducing cleft defects. However, an intergroup comparison of both the treatment modalities showed similar effects on intraoral and extraoral parameters. Integrating RAS into PSIO protocols shows promise in treating lip-and-palate cleft deformities. The study emphasises the value of digital technology in enhancing PSIO protocols, with potential benefits for treatment standardisation and improvement in patient experience.</p>\u0000 </section>\u0000 </div>","PeriodicalId":19652,"journal":{"name":"Orthodontics & Craniofacial Research","volume":"28 3","pages":"423-432"},"PeriodicalIF":2.4,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142910024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Efficacy of Nasoalveolar Moulding Using Aligner NAM During Presurgical Infant Orthopaedics (PSIO) in Infants With Unilateral Cleft Lip and Palate (UCLP): A Retrospective Study","authors":"Batra Puneet,&nbsp;Bruno Frazao Gribel,&nbsp;Talwar Aditya,&nbsp;Arora Garima","doi":"10.1111/ocr.12891","DOIUrl":"10.1111/ocr.12891","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The study compares and evaluates planned virtual outcomes with actual post-treatment outcomes to assess the accuracy and predictability of clinical results during presurgical infant orthopaedics (PSIO) with AlignerNAM in infants with unilateral cleft lip and palate.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Institutional study. Participants: 14 UCLP patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Digital models for infants with unilateral cleft lip and palate (UCLP) who had undergone PSIO with AlignerNAM between 1 and 6 weeks were obtained at three stages—pretreatment (T_o), planned (T_p) and post-treatment (T₁). Linear and angular measurements were made on these using the OrthoAnalyser software (3Shape, Copenhagen, Denmark). A paired <i>t</i>-test and Bland–Altman analysis assessed the accuracy between predicted and achieved movements, while inter- and intra-rater reliabilities were also calculated using digital records of seven patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study found no significant difference (<i>p</i> &gt; 0.05) between the clinical outcome (post-treatment) values and the predicted values (obtained from the virtual post-treatment simulation/planned movement). The sagittal reduction in the cleft defect demonstrated the highest accuracy (97.71%), followed by the transverse reduction (95.1%). Overall, linear measurements achieved an accuracy of 94.57% and angular measurements an accuracy of 93.64%. All measurements were within the limits of agreement based on the Bland–Altman plots. The widths of limits of agreement were narrow and similar for both linear and angular measurements showing high levels of agreement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>AlignerNAM showed high accuracy in reducing cleft size and aligning alveolar segments in UCLP patients, achieving accuracy rates above 90% in both linear and angular dimensions. AlignerNAM appliance is a suitable alternative to conventional PSIO techniques.</p>\u0000 </section>\u0000 </div>","PeriodicalId":19652,"journal":{"name":"Orthodontics & Craniofacial Research","volume":"28 3","pages":"413-422"},"PeriodicalIF":2.4,"publicationDate":"2024-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142895721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accuracy of Preliminary Maxillary Canine and Anchorage Tooth Movement in Premolar Extraction Cases Using 12 In-House Clear Aligners: A Randomised Control Trial Comparing Power Arm and Control","authors":"Natnicha Vongtiang,&nbsp;Nathaset Tongkitcharoen,&nbsp;Sawitt Eurutairat,&nbsp;Somchai Manopatanakul,&nbsp;Peerapong Santiwong,&nbsp;Nita Viwattanatipa","doi":"10.1111/ocr.12889","DOIUrl":"10.1111/ocr.12889","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To investigate maxillary canine movement accuracy and anchorage during space closure in first premolar extraction cases (maximum anchorage) using In-House Clear Aligners (IHCAs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>A randomised controlled trial with a split-mouth design recruited 16 adults in university setting. Each patient was randomly assigned by side for canine retraction using 12 IHCAs to both the experimental palatal power arm (Pa) and non-Pa control (C). Accuracy was assessed using GOM Inspect by superimposing the virtual and actual digital models between pretreatment and 12th IHCA. Paired t-test or Wilcoxon signed-rank test was used to compare virtual-power arm (VPa) versus actual-power arm (APa) and virtual-control (VC) versus actual-control (AC). Root mean square error (RMSE) was calculated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Pa displayed a significant difference in preliminary canine distalisation (VPa 2.0 mm vs. APa 2.4 mm), while the control did not differ. Both Pa and control exhibited significantly greater actual distal crown tipping than virtual movement (VPa 4.4° vs. APa −6.3°/VC 4.4° vs. AC −4.3°). AC achieved more canine rotation than VC. RMSE was slightly greater in Pa than control for canine distalisation (Pa 0.6 vs. C 0.55 mm) and distal crown tipping (Pa 10.9° vs. C 8.99°). Conversely, Pa displayed better accuracy in canine rotation. For anchorage, Pa and control exhibited significantly greater actual mesialisation and mesial tipping than virtual. RMSE for anchorage mesialisation and mesial tipping were comparable between Pa and control.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Preliminary canine retraction using Pa may result in greater error in distal crown tipping but less rotation than control.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>ISRCTN 14020146 by the International Standard Randomised Controlled Trial Registry</p>\u0000 </section>\u0000 </div>","PeriodicalId":19652,"journal":{"name":"Orthodontics & Craniofacial Research","volume":"28 2","pages":"400-411"},"PeriodicalIF":2.4,"publicationDate":"2024-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ocr.12889","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142895434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}