Ishita Z Taneja, Guihua Zhai, Neal D Kravitz, Bill Dischinger, Mark Johnston, Chung-How Kau, Ejvis Lamani
{"title":"Evaluating the efficiency of mandibular molar protraction using Herbst appliances versus temporary anchorage devices: a retrospective case-controlled study.","authors":"Ishita Z Taneja, Guihua Zhai, Neal D Kravitz, Bill Dischinger, Mark Johnston, Chung-How Kau, Ejvis Lamani","doi":"10.1186/s40510-024-00533-3","DOIUrl":"10.1186/s40510-024-00533-3","url":null,"abstract":"<p><strong>Background: </strong>Mandibular second premolar agenesis is a common problem in orthodontics and is often treated in conjunction with maxillary counterbalancing extractions. However, in cases without maxillary crowding or dental protrusion, space closure may pose challenges leading to compromised occlusal results or patient profile. Multiple techniques have been described to treat these patients; nevertheless, there is a paucity of data comparing effectiveness of space closure utilizing various anchorage techniques. The goal of this study is to assess the effectiveness of the Herbst device during mandibular molar protraction and compare it to the use of temporary anchorage device (TADs) in patients with mandibular second premolar agenesis.</p><p><strong>Materials and methods: </strong>This retrospective study included 33 patients with mandibular premolar agenesis treated without maxillary extractions. Of these patients, 21 were treated with protraction Herbst devices and 12 with TADs. Changes in molar and incisor positions, skeletal base positions and occlusal plane angulations were assessed on pretreatment (T0) and post-treatment (T1) lateral cephalograms. Scans/photographs at T0 and T1 were used to evaluate canine relationship changes representing anchorage control. Space closure and breakage/failure rates were also compared. Data was analyzed with paired and unpaired t-tests at the significance level of 0.05.</p><p><strong>Results: </strong>Within the Herbst group, changes in mandibular central incisor uprighting and mandibular molar crown angulations were statistically significant. However, no significant differences were noted between the Herbst and TAD groups. Protraction rates as well as overall treatment times were comparable (0.77 mm/month vs. 0.55 mm/month and 3.02 years vs. 2.67 years, respectively). Canine relationships were maintained or improved toward a class I in 82.85% of the Herbst sample, compared to in 66.7% of the TAD sample. Emergency visits occurred in 80.1% of the Herbst group, with cementation failures or appliance breakages as the most common reasons.</p><p><strong>Conclusion: </strong>The Herbst device could be a viable modality in cases with missing mandibular premolars where maximum anterior anchorage is desired, or if patients/parents are resistant to TADs. Furthermore, they could be beneficial in skeletal class II patients with mandibular deficiency who also need molar protraction. However, the increased incidence of emergency visits must be considered when treatment is planned.</p>","PeriodicalId":56071,"journal":{"name":"Progress in Orthodontics","volume":"25 1","pages":"32"},"PeriodicalIF":4.8,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11366738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142115153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nora Alhazmi, Ali Alaqla, Bader Almuzzaini, Mohammed Aldrees, Ghaida Alnaqa, Farah Almasoud, Omar Aldibasi, Hala Alshamlan
{"title":"What could be the role of genetic tests and machine learning of AXIN2 variant dominance in non-syndromic hypodontia? A case-control study in orthodontically treated patients.","authors":"Nora Alhazmi, Ali Alaqla, Bader Almuzzaini, Mohammed Aldrees, Ghaida Alnaqa, Farah Almasoud, Omar Aldibasi, Hala Alshamlan","doi":"10.1186/s40510-024-00532-4","DOIUrl":"10.1186/s40510-024-00532-4","url":null,"abstract":"<p><strong>Background: </strong>Hypodontia is the most prevalent dental anomaly in humans, and is primarily attributed to genetic factors. Although genome-wide association studies (GWAS) have identified single-nucleotide polymorphisms (SNP) associated with hypodontia, genetic risk assessment remains challenging due to population-specific SNP variants. Therefore, we aimed to conducted a genetic analysis and developed a machine-learning-based predictive model to examine the association between previously reported SNPs and hypodontia in the Saudi Arabian population. Our case-control study included 106 participants (aged 8-50 years; 64 females and 42 males), comprising 54 hypodontia cases and 52 controls. We utilized TaqMan<sup>TM</sup> Real-Time Polymerase Chain Reaction and allelic genotyping to analyze three selected SNPs (AXIN2: rs2240308, PAX9: rs61754301, and MSX1: rs12532) in unstimulated whole saliva samples. The chi-square test, multinomial logistic regression, and machine-learning techniques were used to assess genetic risk by using odds ratios (ORs) for multiple target variables.</p><p><strong>Results: </strong>Multivariate logistic regression indicated a significant association between homozygous AXIN2 rs2240308 and the hypodontia phenotype (ORs [95% confidence interval] 2.893 [1.28-6.53]). Machine-learning algorithms revealed that the AXIN2 homozygous (A/A) genotype is a genetic risk factor for hypodontia of teeth #12, #22, and #35, whereas the AXIN2 homozygous (G/G) genotype increases the risk for hypodontia of teeth #22, #35, and #45. The PAX9 homozygous (C/C) genotype is associated with an increased risk for hypodontia of teeth #22 and #35.</p><p><strong>Conclusions: </strong>Our study confirms a link between AXIN2 and hypodontia in Saudi orthodontic patients and suggests that combining machine-learning models with SNP analysis of saliva samples can effectively identify individuals with non-syndromic hypodontia.</p>","PeriodicalId":56071,"journal":{"name":"Progress in Orthodontics","volume":"25 1","pages":"31"},"PeriodicalIF":4.8,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11345341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Michael Nemec, Giacomo Garzarolli-Thurnlackh, Stefan Lettner, Hemma Nemec-Neuner, André Gahleitner, Andreas Stavropoulos, Kristina Bertl, Erwin Jonke
{"title":"Prevalence and characteristics of and risk factors for impacted teeth with ankylosis and replacement resorption - a retrospective, 3D-radiographic assessment.","authors":"Michael Nemec, Giacomo Garzarolli-Thurnlackh, Stefan Lettner, Hemma Nemec-Neuner, André Gahleitner, Andreas Stavropoulos, Kristina Bertl, Erwin Jonke","doi":"10.1186/s40510-024-00531-5","DOIUrl":"10.1186/s40510-024-00531-5","url":null,"abstract":"<p><strong>Background: </strong>Large variation in the prevalence of ankylosis and replacement resorption (ARR) is reported in the literature and most studies have relatively small patient numbers. The present retrospective study aimed to provide an overview on prevalence, location of, and associated risk factors with ARR based on a large sample of computed tomography (CT) / cone beam computed tomography (CBCT) scans of impacted teeth. The results should allow clinicians to better estimate the risk of ARR at impacted teeth.</p><p><strong>Methods: </strong>The CT/CBCT scans of 5764 patients of a single center in Central Europe were screened with predefined eligibility criteria. The following parameters were recorded for the finally included population: gender, age, tooth type/position, number of impacted teeth per patient, and presence/absence of ARR. For teeth with ARR the tooth location in reference to the dental arch, tooth angulation, and part of the tooth affected by ARR were additionally registered.</p><p><strong>Results: </strong>Altogether, 4142 patients with 7170 impacted teeth were included. ARR was diagnosed at 187 impacted teeth (2.6%) of 157 patients (3.7%); 58% of these patients were female and the number of teeth with ARR per patient ranged from 1 to 10. Depending on the tooth type the prevalence ranged from 0 (upper first premolars, lower central and lateral incisors) to 41.2% (upper first molars). ARR was detected at the crown (57.2%), root (32.1%), or at both (10.7%). After correcting for confounders, the odds for ARR significantly increased with higher age; further, incisors and first/second molars had the highest odds for ARR, while wisdom teeth had the lowest. More specifically, for 20-year-old patients the risk for ARR at impacted incisors and first/second molars ranged from 7.7 to 10.8%, but it approximately tripled to 27.3-35.5% for 40-year-old patients. In addition, female patients had significantly less often ARR at the root, while with increasing age the root was significantly more often affected by ARR than the crown.</p><p><strong>Conclusion: </strong>ARR at impacted teeth is indeed a rare event, i.e., only 2.6% of 7170 impacted teeth were ankylosed with signs of replacement resorption. On the patient level, higher age significantly increased the odds for ARR and on the tooth level, incisors and first/second molars had the highest odds for ARR, while wisdom teeth had the lowest.</p>","PeriodicalId":56071,"journal":{"name":"Progress in Orthodontics","volume":"25 1","pages":"34"},"PeriodicalIF":4.8,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11330951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142001449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kuang Tan, Jiayi Wang, Xinyu Su, Yunfei Zheng, Weiran Li
{"title":"KAT6A/YAP/TEAD4 pathway modulates osteoclastogenesis by regulating the RANKL/OPG ratio on the compression side during orthodontic tooth movement.","authors":"Kuang Tan, Jiayi Wang, Xinyu Su, Yunfei Zheng, Weiran Li","doi":"10.1186/s40510-024-00530-6","DOIUrl":"10.1186/s40510-024-00530-6","url":null,"abstract":"<p><strong>Background: </strong>Orthodontic tooth movement (OTM) is a dynamic equilibrium of bone remodeling, involving the osteogenesis of new bone and the osteoclastogenesis of old bone, which is mediated by mechanical force. Periodontal ligament stem cells (PDLCSs) in the periodontal ligament (PDL) space can transmit mechanical signals and regulate osteoclastogenesis during OTM. KAT6A is a histone acetyltransferase that plays a part in the differentiation of stem cells. However, whether KAT6A is involved in the regulation of osteoclastogenesis by PDLSCs remains unclear.</p><p><strong>Results: </strong>In this study, we used the force-induced OTM model and observed that KAT6A was increased on the compression side of PDL during OTM, and also increased in PDLSCs under compression force in vitro. Repression of KAT6A by WM1119, a KAT6A inhibitor, markedly decreased the distance of OTM. Knockdown of KAT6A in PDLSCs decreased the RANKL/OPG ratio and osteoclastogenesis of THP-1. Mechanistically, KAT6A promoted osteoclastogenesis by binding and acetylating YAP, simultaneously regulating the YAP/TEAD axis and increasing the RANKL/OPG ratio in PDLSCs. TED-347, a YAP-TEAD4 interaction inhibitor, partly attenuated the elevation of the RANKL/OPG ratio induced by mechanical force.</p><p><strong>Conclusion: </strong>Our study showed that the PDLSCs modulated osteoclastogenesis and increased the RANKL/OPG ratio under mechanical force through the KAT6A/YAP/TEAD4 pathway. KAT6A might be a novel target to accelerate OTM.</p>","PeriodicalId":56071,"journal":{"name":"Progress in Orthodontics","volume":"25 1","pages":"29"},"PeriodicalIF":4.8,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11317454/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141918183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Mechanically induced M2 macrophages are involved in bone remodeling of the midpalatal suture during palatal expansion.","authors":"Lan Li, Mingrui Zhai, Chen Cheng, Shuyue Cui, Jixiao Wang, Zijie Zhang, Jiani Liu, Fulan Wei","doi":"10.1186/s40510-024-00529-z","DOIUrl":"10.1186/s40510-024-00529-z","url":null,"abstract":"<p><strong>Background: </strong>Palatal expansion is a common way of treating maxillary transverse deficiency. Under mechanical force, the midpalatal suture is expanded, causing local immune responses. This study aimed to determine whether macrophages participate in bone remodeling of the midpalatal suture during palatal expansion and the effects on bone remodeling.</p><p><strong>Methods: </strong>Palatal expansion model and macrophage depletion model were established. Micro-CT, histological staining, and immunohistochemical staining were used to investigate the changes in the number and phenotype of macrophages during palatal expansion as well as the effects on bone remodeling of the midpalatal suture. Additionally, the effect of mechanically induced M2 macrophages on palatal osteoblasts was also elucidated in vitro.</p><p><strong>Results: </strong>The number of macrophages increased significantly and polarized toward M2 phenotype with the increase of the expansion time, which was consistent with the trend of bone remodeling. After macrophage depletion, the function of osteoblasts and bone formation at the midpalatal suture were impaired during palatal expansion. In vitro, conditioned medium derived from M2 macrophages facilitated osteogenic differentiation of osteoblasts and decreased the RANKL/OPG ratio.</p><p><strong>Conclusions: </strong>Macrophages through polarizing toward M2 phenotype participated in midpalatal suture bone remodeling during palatal expansion, which may provide a new idea for promoting bone remodeling from the perspective of regulating macrophage polarization.</p>","PeriodicalId":56071,"journal":{"name":"Progress in Orthodontics","volume":"25 1","pages":"30"},"PeriodicalIF":4.8,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11298508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141891127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Wenyuanfeng Chen, Yuan Qu, Yining Liu, Guorui Zhang, Hasan M Sharhan, Xinzhu Zhang, Kunwu Zhang, Baocheng Cao
{"title":"Effects of fasudil on glial cell activation induced by tooth movement.","authors":"Wenyuanfeng Chen, Yuan Qu, Yining Liu, Guorui Zhang, Hasan M Sharhan, Xinzhu Zhang, Kunwu Zhang, Baocheng Cao","doi":"10.1186/s40510-024-00518-2","DOIUrl":"10.1186/s40510-024-00518-2","url":null,"abstract":"<p><strong>Background: </strong>Orthodontic pain affects the physical and mental health of patients. The spinal trigeminal subnucleus caudalis (SPVC) contributes to the transmission of pain information and serves as a relay station for integrating orofacial damage information. Recently, glial cells have been found to be crucial for both acute and maintenance phases of pain. It has also been demonstrated that rho kinase (ROCK) inhibitors can manage different pain models by inhibiting glial cell activation. Here, we hypothesized that orthodontic pain is related to glial cells in the SPVC, and Fasudil, a representative rho/rock kinase inhibitor, can relieve orthodontic pain by regulating the function of glial cells and the related inflammatory factors. In this study, we constructed a rat model of tooth movement pain and used immunofluorescence staining to evaluate the activation of microglia and astrocytes. Quantitative real-time PCR was used to detect the release of related cytokines and the expression of pain-related genes in the SPVC. Simultaneously, we investigated the effect of Fasudil on the aforementioned indicators.</p><p><strong>Results: </strong>In the SPVC, the expression of c-Fos peaked on day 1 along with the expression of OX42 (related to microglial activation), CD16 (a pro-inflammatory factor), and CD206 (an anti-inflammatory factor) on day 3 after tooth movement, followed by a gradual decrease. GFAP-staining showed that the number of activated astrocytes was the highest on day 5 and that cell morphology became complex. After Fasudil treatment, the expression of these proteins showed a downward trend. The mRNA levels of pro-inflammatory factors (IL-1β and TNF-α) peaked on day 3, and the mRNA expression of the anti-inflammatory factor TGF-β was the lowest 3 days after tooth movement. Fasudil inhibited the mRNA expression of pain-related genes encoding CSF-1, t-PA, CTSS, and BDNF.</p><p><strong>Conclusion: </strong>This study shows that tooth movement can cause the activation of glial cells in SPVC, and ROCK inhibitor Fasudil can inhibit the activation of glial cells and reduce the expression of the related inflammatory factors. This study presents for the first time the potential application of Fasudil in othodontic pain.</p>","PeriodicalId":56071,"journal":{"name":"Progress in Orthodontics","volume":"25 1","pages":"33"},"PeriodicalIF":4.8,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11265063/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141735820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Po-Jung Chen, Shivam Mehta, Eliane H Dutra, Sumit Yadav
{"title":"Alendronate treatment rescues the effects of compressive loading of TMJ in osteogenesis imperfecta mice.","authors":"Po-Jung Chen, Shivam Mehta, Eliane H Dutra, Sumit Yadav","doi":"10.1186/s40510-024-00526-2","DOIUrl":"10.1186/s40510-024-00526-2","url":null,"abstract":"<p><strong>Background: </strong>Osteogenesis imperfecta (OI) is a genetic disorder of connective tissue caused by mutations associated with type I collagen, which results in defective extracellular matrix in temporomandibular joint (TMJ) cartilage and subchondral bone. TMJ is a fibrocartilaginous joint expressing type I collagen both in the cartilage and the subchondral bone. In the present study the effects of alendronate and altered loading of the TMJ was analyzed both in male and female OI mice.</p><p><strong>Materials and methods: </strong>Forty-eight, 10-weeks-old male and female OI mice were divided into 3 groups: (1) Control group: unloaded group, (2) Saline + Loaded: Saline was injected for 2 weeks and then TMJ of mice was loaded for 5 days, (3) alendronate + loaded: alendronate was injected for 2 weeks and then TMJ of mice was loaded for 5 days. Mice in all the groups were euthanized 24-h after the final loading.</p><p><strong>Results: </strong>Alendronate pretreatment led to significant increase in bone volume and tissue density. Histomorphometrically, alendronate treatment led to increase in mineralization, cartilage thickness and proteoglycan distribution. Increased mineralization paralleled decreased osteoclastic activity. Our immunohistochemistry revealed decreased expression of matrix metallopeptidase 13 and ADAM metallopeptidase with thrombospondin type 1 motif 5.</p><p><strong>Conclusion: </strong>The findings of this research support that alendronate prevented the detrimental effects of loading on the extracellular matrix of the TMJ cartilage and subchondral bone.</p>","PeriodicalId":56071,"journal":{"name":"Progress in Orthodontics","volume":"25 1","pages":"25"},"PeriodicalIF":4.8,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11247069/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141617735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Djessyca Miranda E Paulo, Letícia Fernanda Moreira-Santos, Maisa Costa Tavares, Tony Weir, Maurice J Meade, Carlos Flores-Mir
{"title":"Clear aligner therapy practices among orthodontists practicing in Canada.","authors":"Djessyca Miranda E Paulo, Letícia Fernanda Moreira-Santos, Maisa Costa Tavares, Tony Weir, Maurice J Meade, Carlos Flores-Mir","doi":"10.1186/s40510-024-00525-3","DOIUrl":"10.1186/s40510-024-00525-3","url":null,"abstract":"<p><strong>Background: </strong>The acceptability and preference for clear aligner therapy (CAT) has been increasing among orthodontists, but there is still a lack of consensus regarding CAT best practices. Consequently, this study aimed to investigate CAT practices among orthodontists practicing in Canada.</p><p><strong>Methods: </strong>The survey was conducted among orthodontists practicing in Canada using a modified previously published survey. Sixty orthodontists participated (6.1% response rate). It consisted of 11 sections with open and closed questions related to demographic information and particularities about using or not using CAT. The survey responses were exported from REDCap to a Microsoft Excel (Microsoft, Redmond, Wash) spreadsheet, then statistically analyzed using SPSS software (SPSS for Windows, version 21.0; IBM Inc., Armonk, NY, USA). The comments were categorized under themes and subthemes. Data were organized in descriptive statistics, expressing frequencies and percentages.</p><p><strong>Results: </strong>Almost 30% of the orthodontist's annual caseload was treated with CAT, most frequently prescribed to adult patients. Case complexity and patient cooperation were the factors that most influenced the decision to prescribe CAT. Almost half of orthodontists reported sometimes combining CAT with adjunctive fixed appliances.</p><p><strong>Conclusions: </strong>Most orthodontists prescribe CAT, and its use is based on the malocclusion's complexity. Orthodontists who do not prescribe CAT believe that fixed appliance therapy has superior treatment outcomes.</p>","PeriodicalId":56071,"journal":{"name":"Progress in Orthodontics","volume":"25 1","pages":"27"},"PeriodicalIF":4.8,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11228011/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141556032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Obstructive sleep apnea: What is an orthodontist's role?","authors":"Robert H Kazmierski","doi":"10.1186/s40510-024-00524-4","DOIUrl":"10.1186/s40510-024-00524-4","url":null,"abstract":"<p><strong>Background: </strong>The American Association of Orthodontists white paper on obstructive sleep apnea and orthodontics remains the most authoritative statement on the topic. This was produced in 2019 due to increasing orthodontic interest in obstructive sleep apnea (OSA) and the lack of formal guidelines for orthodontists. Since the white paper's release, advocacy for contrarian ideas and practices remain. Orthodontists are sometimes acting as primary care providers for OSA. Procedures appropriate only for screening are sometimes being used for diagnosis. The side effects of effective treatments such as mandibular advancement devices need further consideration. Also, research has clarified the effectiveness and ineffectiveness of treatments such as palatal expansion.</p><p><strong>Results: </strong>Part of an orthodontist's role is screening for OSA. The correct action when this is suspected remains referral to the appropriate physician specialist for diagnosis and treatment or coordination of treatment. Orthodontists may participate in the treatment of patients with OSA as a member of a multi-disciplinary team. Effective orthodontic treatments may include orthognathic surgery with maxillomandibular advancement and mandibular advancement devices. The negative effects of the latter make this a choice of last resort. Current research indicates that OSA alone is not sufficient indication for palatal expansion.</p><p><strong>Conclusions: </strong>Orthodontists should appropriately screen for obstructive sleep apnea. This may be done as part of our health histories, our clinical examination, and review of radiographs taken for purposes other than the diagnosis and screening for OSA. Orthodontic treatment for OSA can be helpful and effective. However, this may be done only after referral to the appropriate physician specialist, as part of a multi-disciplinary team, with consideration of the likely effectiveness of treatment, and after all likely and potential negative consequences have been considered and thoroughly discussed with the patient.</p>","PeriodicalId":56071,"journal":{"name":"Progress in Orthodontics","volume":"25 1","pages":"21"},"PeriodicalIF":4.8,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11214936/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141473101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Estimating mandibular growth stage based on cervical vertebral maturation in lateral cephalometric radiographs using artificial intelligence.","authors":"Sajjad Alipour Shoari, Seyed Vahid Sadrolashrafi, Aydin Sohrabi, Reza Afrouzian, Pooya Ebrahimi, Maryam Kouhsoltani, Minou Kouh Soltani","doi":"10.1186/s40510-024-00527-1","DOIUrl":"10.1186/s40510-024-00527-1","url":null,"abstract":"<p><strong>Introduction: </strong>Determining the right time for orthodontic treatment is one of the most important factors affecting the treatment plan and its outcome. The aim of this study is to estimate the mandibular growth stage based on cervical vertebral maturation (CVM) in lateral cephalometric radiographs using artificial intelligence. Unlike previous studies, which use conventional CVM stage naming, our proposed method directly correlates cervical vertebrae with mandibular growth slope.</p><p><strong>Methods and materials: </strong>To conduct this study, first, information of people achieved in American Association of Orthodontics Foundation (AAOF) growth centers was assessed and after considering the entry and exit criteria, a total of 200 people, 108 women and 92 men, were included in the study. Then, the length of the mandible in the lateral cephalometric radiographs that were taken serially from the patients was calculated. The corresponding graphs were labeled based on the growth rate of the mandible in 3 stages; before the growth peak of puberty (pre-pubertal), during the growth peak of puberty (pubertal) and after the growth peak of puberty (post-pubertal). A total of 663 images were selected for evaluation using artificial intelligence. These images were evaluated with different deep learning-based artificial intelligence models considering the diagnostic measures of sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV). We also employed weighted kappa statistics.</p><p><strong>Results: </strong>In the diagnosis of pre-pubertal stage, the convolutional neural network (CNN) designed for this study has the higher sensitivity and NPV (0.84, 0.91 respectively) compared to ResNet-18 model. The ResNet-18 model had better performance in other diagnostic measures of the pre-pubertal stage and all measures in the pubertal and post-pubertal stages. The highest overall diagnostic accuracy was also obtained using ResNet-18 model with the amount of 87.5% compared to 81% in designed CNN.</p><p><strong>Conclusion: </strong>The artificial intelligence model trained in this study can receive images of cervical vertebrae and predict mandibular growth status by classifying it into one of three groups; before the growth spurt (pre-pubertal), during the growth spurt (pubertal), and after the growth spurt (post-pubertal). The highest accuracy is in post-pubertal stage with the designed networks.</p>","PeriodicalId":56071,"journal":{"name":"Progress in Orthodontics","volume":"25 1","pages":"28"},"PeriodicalIF":4.8,"publicationDate":"2024-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11194253/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141443811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}