Effects of Hydroxyapatite on Bone Graft Resorption in an Experimental Model of Maxillary Alveolar Arch Defects

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Ozgur Pilanci

2013-06-01

Full Text Available Most commonly used treatments use autologous bone grafts to address bony defects in patients with cleft palate. Major disadvantages of autogenous bone grafts include donor site morbidity and resorption. Suggestions to overcome such problems include biomaterials that can be used alone or in combination with bone. We examined the effect of hydroxyapatite cement on bone graft resorption in a rabbit maxillary alveolar defect model. We divided 16 young adult albino New Zealand rabbits into two groups. A defect 1 cm wide was created in each rabbit's maxillary arch. In Group 1, the removed bone was disrupted, and the pieces were replaced in the defect. In the other group, the pieces were replaced after mixing (1:1 with hydroxyapatite cement. Quantitative computed tomographic evaluation of these grafts was performed in axial and coronal planes for each rabbit at 2 and 12 weeks. In axial images at 12 weeks, the group without cement showed mean bone resorption of 15%. In the cement group, a mean volumetric increase of 68% was seen. No resorption occurred when bone grafts were mixed with hydroxyapatite cement. [Arch Clin Exp Surg 2013; 2(3.000: 170-175

Perpendicular serial maxillary distraction osteogenesis in cleft lip and palate patients.

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Ylikontiola, Leena P; Sándor, George K; Harila, Virpi

2015-01-01

Cleft lip and palate patients often have a retruded maxilla with a severely narrowed deficient maxillary arch. This report aims to describe the management of severe maxillary retrusion and constriction in cleft lip and palate patients using distraction osteogenesis applied in serial sequence in two directions perpendicular to each other. Two adult male cleft lip and palate patients were treated with maxillary distraction osteogenesis in two stages. In the first stage, surgically assisted rapid palatal expansion with a tooth-borne device was performed to significantly expand the maxillary arch in the transverse dimension. After the teeth were orthodontically aligned, the horizontal distraction of the maxilla was made by two internal maxillary distraction devices. In the first patient, the maxilla was initially widened by 11 mm and then distracted forward by 20 mm. Despite the breakage of the shaft of one of the two distractors at the end of distraction, a satisfactory occlusion was found at the time of distractor device removal. The maxillary position has remained stable through 8 years of follow-up. In the second patient, the palate was widened by 14 mm and the maxilla was distracted forward by 22 mm. The maxillary position has remained stable through 3 years of follow-up. Sequential serial distraction of maxilla in two planes perpendicular to each other is a safe and stable approach for the treatment of cleft lip and palate patients with severe transverse and anteroposterior discrepancies.

Use of anterior maxillary distraction osteogenesis in two cleft lip and palate patients

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Srivastava, Dhirendra; Ghassemi, Alireza; Ghassemi, Mehrangiz; Showkatbakhsh, Rahman; Jamilian, Abdolreza

2015-01-01

Distraction osteogenesis (DO) has become a mainstream surgical technique for patients with jaw deformities. The aim of this study was to report the effect of DO done by a hyrax screw incorporated in an acrylic plate in the treatment of two maxillary deficient cases with cleft lip and palate. Two patients, a 24-year-old female and a 29-year-old male who suffered from maxillary deficiency and cleft lip and palate, were treated by DO. After making vertical cuts between the premolars on both sides and horizontal cuts similar to Le Fort 1, a hyrax screw was mounted on an acrylic plate for the slow anteroposterior expansion of maxillary arch. The expansion was achieved by turning the hyrax screw 0.8 mm per day after the latency period. Treatment was discontinued after achieving satisfactory over jet and occlusion. This study showed that anterior maxillary distraction is a reliable technique for correction of midfacial deformity arising out of cleft lip and palate. Incidences of complications are negligible compared to total maxillary distraction. PMID:26668459

Use of anterior maxillary distraction osteogenesis in two cleft lip and palate patients.

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Srivastava, Dhirendra; Ghassemi, Alireza; Ghassemi, Mehrangiz; Showkatbakhsh, Rahman; Jamilian, Abdolreza

2015-01-01

Distraction osteogenesis (DO) has become a mainstream surgical technique for patients with jaw deformities. The aim of this study was to report the effect of DO done by a hyrax screw incorporated in an acrylic plate in the treatment of two maxillary deficient cases with cleft lip and palate. Two patients, a 24-year-old female and a 29-year-old male who suffered from maxillary deficiency and cleft lip and palate, were treated by DO. After making vertical cuts between the premolars on both sides and horizontal cuts similar to Le Fort 1, a hyrax screw was mounted on an acrylic plate for the slow anteroposterior expansion of maxillary arch. The expansion was achieved by turning the hyrax screw 0.8 mm per day after the latency period. Treatment was discontinued after achieving satisfactory over jet and occlusion. This study showed that anterior maxillary distraction is a reliable technique for correction of midfacial deformity arising out of cleft lip and palate. Incidences of complications are negligible compared to total maxillary distraction.

Morphological and dimensional characteristics of dental arch in children with beta thalassemia major

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Disha Kumar

2018-01-01

Full Text Available Background and Objectives: The aim of this study was to examine the arch dimensions of beta thalassemia major patients in comparison with normal individuals. Materials and Methods: Dental arch dimensions were compared between thalassemic patients and normal individuals in the age group of 12–16 years in the maxillary and mandibular arch corresponding to each other regarding age, sex and Angle's molar relationship. A total number of sixty cases in each group were taken. Maxillary and mandibular impressions were made with alginate for all the sixty participants in each group and poured with die stone. Measurement of inter incisor, inter canine, inter premolar and intermolar arch width, arch depth, right anterior, right posterior, left anterior, and left posterior arch length was carried out from each cast using digital Vernier caliper.Results: Unpaired t-test was used for comparison between the two groups. Statistically, a significant difference was found between the case and control groups in the maxillary arch in intercanine width, inter premolar width, intermolar width, right anterior arch length, right posterior arch length, and left anterior arch length. However, no statistically significant difference was found between the groups in inter incisor width, left posterior arch length, and arch depth in the maxillary arch. In the mandibular arch, statistically significant difference was found between the case and control groups in inter canine width, inter premolar width, inter molar width, and left anterior arch length. However, no statistically significant difference was found between the case and control groups in the mandibular arch in interincisor width, right anterior arch length, right posterior arch length, and left posterior arch length. Conclusion: Dental arch widths and arch lengths were significantly reduced in thalassemic patients as compared to normal individuals for the maxillary and mandibular arches.

Managing the severely proclined maxillary anteriors by extracting traumatized right maxillary central incisor

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Mahesh Jain

2014-01-01

Full Text Available A 14-year-old girl reported with severely proclined maxillary anterior teeth with fractured and discolored right maxillary central incisor with questionable prognosis. Autotransplantation of premolar to replace central incisor was considered a risky option as patient was 14-year-old with presence of advanced root development of premolar. The immediate placement of the prosthetic implant was also not possible because of patient′s age. Therefore, it was decided to use the space obtained by extracting questionable maxillary right central incisor for orthodontic purpose and also sacrificing the healthy premolar is invariably an excessive biological cost for a modest functional and aesthetic gain. Hence, the treatment plan for this case includes extraction of right maxillary central incisor and left maxillary first premolar, movement of right maxillary lateral incisor mesially, achieving normal axial inclination of maxillary anteriors with normal overjet and overbite. Mandibular arch was treated nonextraction due to congenitally missing central incisors with presence of normally inclined lower anteriors thereby maintaining Angles class I occlusion. Tipping, usually, seen in Begg mechanotherapy was used for our advantage to correct severely proclined maxillary anteriors with simultaneous bite opening mechanics. Case was completed in 19 months and posttreatment records including photographs, radiographs and study models were made. Begg wrap around the retainer was placed in the maxillary arch allowing natural settling of occlusion.

Anterior maxillary segmental distraction for correction of maxillary hypoplasia and dental crowding in cleft palate patients: a preliminary report.

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Wang, X-X; Wang, X; Li, Z-L; Yi, B; Liang, C; Jia, Y-L; Zou, B-S

2009-12-01

To evaluate the feasibility of anterior maxillary segmental distraction (AMSD) to correct maxillary hypoplasia and severe dental crowding in cleft lip and palate (CLP) patients, 7 patients (average age 16.4 years) with maxillary hypoplasia, shortened maxillary dental arch length and severe anterior dental crowding secondary to CLP were selected for this study. After anterior maxillary segmental osteotomy, 3 patients were treated using bilateral internal distraction devices, and 4 patients were treated using rigid external distraction devices. Photographs and radiographs were taken to review the improvement in facial profile and occlusion after distraction. An average 10.25 mm anterior maxillary advancement was obtained in all patients after 10-23 days of distraction and 9-16 weeks of consolidation. The sella-nasion-point A (SNA) angle increased from 69.5 degrees to 79.6 degrees. Midface convexity was greatly improved and velopharyngeal competence was preserved. The maxillary dental arch length was greatly increased by 10.1 mm (P<0.01). Dental crowding and malocclusion were corrected by orthodontic treatment. These results show that AMSD can effectively correct the hypoplastic maxilla and severe dental crowding associated with CLP by increasing the midface convexity and dental arch length while preserving velopharyngeal function, and dental crowding can be corrected without requiring tooth extraction.

Anchorage onto deciduous teeth: effectiveness of early rapid maxillary expansion in increasing dental arch dimension and improving anterior crowding.

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Mutinelli, Sabrina; Manfredi, Mario; Guiducci, Antonio; Denotti, Gloria; Cozzani, Mauro

2015-01-01

Anchorage onto permanent dentition is a common procedure in rapid maxillary expansion. However, replacing first permanent molars with the second deciduous molars seems to be an option to reduce some negative side effects during orthodontic treatment. The purpose of this study was to evaluate the dental effect of rapid maxillary expansion with anchorage exclusively onto deciduous teeth performed in the first period of transition. Twenty patients with a lateral cross-bite treated exclusively by a Haas expander in early mixed dentition were retrospectively analyzed before treatment, at appliance removal, and at 21 months out of retention. The sagittal and transverse dimensions, together with the inter-canine arch and irregularity index, were digitally measured on scanned images of dental casts. The patients were compared with three balanced control groups (in total, 60 individuals) matched for gender. Two control groups had the same canine dental class as the treated group at T1, were in the inter-transitional period, and either had or lacked a lateral cross-bite. The last control group was comprised of adolescents in permanent dentition with a dental class I. The statistical analysis was performed by means of repeated-measures ANOVA for paired data and one-way ANOVA, the Kruskal-Wallis test, and the Mann-Whitney test for independent measures (α-level p dentition), the dental arch dimensions of treated patients were similar to those of adolescents with a dental class I and significantly wider than those of patients with a lateral cross-bite. Also, the anterior irregularity index was lower among patients who had undergone expansion treatments than in all untreated study participants. The Haas expander anchored to the deciduous teeth is effective in increasing the dental arch width in patients with a lateral cross-bite. The dimensions of the dental arch were modified earlier toward the values of the permanent dentition.

Asymmetric rapid maxillary expansion in true unilateral crossbite malocclusion: a prospective controlled clinical study.

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Ileri, Zehra; Basciftci, Faruk Ayhan

2015-03-01

To investigate the short-term effects of the asymmetric rapid maxillary (ARME) appliance on the vertical, sagittal, and transverse planes in patients with true unilateral posterior crossbite. Subjects were divided into two groups. The treatment group was comprised of 21 patients with unilateral posterior crossbite (mean age  =  13.3 ± 2.1 years). Members of this group were treated with the ARME appliance. The control group was comprised of 17 patients with Angle Class I who were kept under observation (mean age  =  12.3 ± 0.8 years). Lateral and frontal cephalograms were taken before the expansion (T1), immediately after expansion (T2), and at postexpansion retention (T3) in the treatment group and at preobservation (T1) and postobservation (T2) in the control group. A total of 34 measurements were assessed on cephalograms. For statistical analysis, the Wilcoxon test and analysis of covariance were used. The ARME appliance produced significant increases in nasal, maxillary base, upper arch, and lower arch dimensions (P ARME appliance created asymmetric increments in the transversal dimensions of the nose, maxilla, and upper arch in the short term. Asymmetric expansion therapy for subjects with unilateral maxillary deficiency may provide satisfactory outcomes in adolescents, with the exception of mandibular arch expansion. The triangular pattern of expansion caused clockwise rotation of the mandible and the occlusal plane and produced significant alterations in the vertical facial dimensions, whereas it created no displacement in maxilla in the sagittal plane.

Mandibular dental arch short and long-term spontaneous dentoalveolar changes after slow or rapid maxillary expansion: a systematic review

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Arthur César de Medeiros Alves

Full Text Available ABSTRACT Objective: The aim of this systematic review was to analyze the short and long-term spontaneous dentoalveolar changes of the mandibular dental arch after slow (SME or rapid (RME maxillary expansion in the mixed and early permanent dentitions. Methods: An electronic search was performed in the following databases: PubMed/Medline, Cochrane Library, Scopus, Embase and Web of Science. Eligibility criteria for article selection included randomized controlled trials and prospective studies written in English, with no restriction of year of publication, involving patients who underwent SME or RME during the mixed or early permanent dentitions. A double-blind search of articles was performed by two reviewers. Initially, the title and the abstract of the studies were read, and their references were also hand-searched for possible missing studies. A methodological quality scoring scale was used to analyze the selected articles. Results: The search retrieved 373 articles, but only 6 were selected for review after application of the eligibility and exclusion criteria. Non-clinically significant spontaneous dentoalveolar changes of approximately 1mm were found in the mandibular dental arch in the short and long-term, after slow or rapid maxillary expansions. Furthermore, no significant differences were found between treated and control groups. Conclusions: There is enough evidence to conclude that negligible short and long-term spontaneous dentoalveolar changes tend to occur in the mandibular dental arch after SME or RME in the mixed and early permanent dentitions. More randomized studies with appropriate control group are required to better evaluate this issue.

Light weight hollow maxillary complete denture: A case series

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Laxman Singh Kaira

2012-01-01

Full Text Available Retention, stability and support are the basic principles on which the success of a complete denture relies on. The skill lies in applying these principles efficiently in critical situations. Residual ridge resorption occurs at a three times faster rate in mandibular arch than in the maxillary arch. The severely resorbed maxillary and mandibular edentulous arches that are narrow and constricted with increased interarch space provide decreased support, retention and stability. The consequent weight of the processed complete denture only compromises them further. The severely resorbed jaw can have various treatment options. Extreme resorption of the maxillary denture-bearing area may lead to problems with prosthetic rehabilitation. The advantage of a hollow maxillary or mandibular denture is the reduction of excessive weight of acrylic resin, which normally replaces lost alveolar ridge in the interridge space of the denture wearer. This clinical report describes two case reports of edentulous patients with resorbed ridges where a simplified technique of fabricating a light weight hollow maxillary complete denture was used for the preservation of denture bearing areas.

Is there a correlation between nasal septum deviation and maxillary transversal deficiency? A retrospective study on prepubertal subjects.

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Ballanti, Fabiana; Baldini, Alberto; Ranieri, Salvatore; Nota, Alessandro; Cozza, Paola

2016-04-01

Deviated nasal septum may cause a reduction of the nasal airflow, thus, during the craniofacial development, a reduced nasal airflow could originate a chronic mouth-breathing pattern, related with moderate to severe maxillary constriction. The aim of this retrospective study is to analyze the correlation between maxillary transverse deficiency and nasal septum deviation. Frontal cephalograms were performed on 66 posterior-anterior radiographs of subjects (34M, 32F; mean age 9.95±2.50 years) with maxillary transverse deficiency and on a control group of 31 posterior-anterior radiographs of subjects (13M, 18F; 9.29±2.08 years). Angular parameters of the nasal cavities were recorded and compared between the two groups using a Student's t-test. Generally all the parameters are very similar between the two groups except for the ASY angle that differs for about the 27%; anyway the Student's t-test showed no statistically significant differences between the two groups (mostly p>0.20). This study failed to show an association between transverse maxillary deficiencies and nasal septum deviations. Moreover, no significant differences were found between the mean nasal cavities dimensions in subjects with transverse maxillary deficiency and the control group. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Effect of wire size on maxillary arch force/couple systems for a simulated high canine malocclusion.

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Major, Paul W; Toogood, Roger W; Badawi, Hisham M; Carey, Jason P; Seru, Surbhi

2014-12-01

To better understand the effects of copper nickel titanium (CuNiTi) archwire size on bracket-archwire mechanics through the analysis of force/couple distributions along the maxillary arch. The hypothesis is that wire size is linearly related to the forces and moments produced along the arch. An Orthodontic Simulator was utilized to study a simplified high canine malocclusion. Force/couple distributions produced by passive and elastic ligation using two wire sizes (Damon 0.014 and 0.018 inch) measured with a sample size of 144. The distribution and variation in force/couple loading around the arch is a complicated function of wire size. The use of a thicker wire increases the force/couple magnitudes regardless of ligation method. Owing to the non-linear material behaviour of CuNiTi, this increase is less than would occur based on linear theory as would apply for stainless steel wires. The results demonstrate that an increase in wire size does not result in a proportional increase of applied force/moment. This discrepancy is explained in terms of the non-linear properties of CuNiTi wires. This non-proportional force response in relation to increased wire size warrants careful consideration when selecting wires in a clinical setting. © 2014 British Orthodontic Society.

Transpalatal distraction--state of the art for the individual management of transverse maxillary deficiency--a review of 50 consecutive cases.

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Adolphs, Nicolai; Ernst, Nicole; Menneking, Horst; Hoffmeister, Bodo

2014-12-01

Transpalatal distraction has been established as a technique for surgical assisted rapid palatal/maxillary expansion (SARPE/SARME) in order to correct transverse maxillary deficiency. From 2007 until 2013 bone borne transpalatal distraction devices have been inserted in 50 patients affected by transverse maxillary deficiency and transpalatal distraction has been performed by the same surgical team. Patient records were retrospectively evaluated after ending of the active distraction phase with respect to indication, achieved expansion, additional procedures and side effects. In all cases the existing transverse maxillary deficiency was corrected by means of transpalatal distraction according to the individual needs. No complications were observed that interfered with that therapeutic aim. Evaluation of the records showed a wide variance of parameters which impedes evidence based statements. According to that series transpalatal distraction is a safe, powerful and reliable procedure and can be recommended as a state of the art procedure for the individually adapted correction of transverse maxillary deficiency if well known parameters of distraction are respected. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Three dimensional analysis of CT image on naso-maxillary complex in cleft lip and palate patients

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Ma, Rong-Rong

1994-01-01

This study was designed to clarify the three dimensional features of naso-maxillary complex in cleft lip and palate (CLP) by using computed tomography (CT) and to examine its change following an upper dental arch expansion. Sequential CT images with 2mm-thickness were obtained for 11 unilateral CLP boys (UCLP), 6 bilateral CLP boys (BCLP) and 4 boys without cleft (non-cleft). Additionally, two serial sets of upper dental cast before and after dental arch expansion coupled with CT images in UCLP were used to evaluate the effect of dental arch expansion on the naso-maxillary complex. UCLP demonstrated a remarkable naso-maxillary deformity characterized by a decreased volume of maxillary sinus in comparison with the non-cleft patients. Both the volume and shape of nasal cavity were significantly different between the cleft and non cleft side. Naso-maxillary morphology of BCLP, however, was similar to that of the non cleft except for the decreased volume of alveolar arch. Comparative study of UCLP and BCLP showed a significant difference in naso-maxillary morphology. There were some significant correlations between the dental arch expansion and change of each naso-maxillary component, suggesting the effect of expansion stress on the naso-maxillary complex in UCLP. However, deformation caused by expansion stress varied, depending on each component of the naso-maxillary complex. (author) 61 refs

Three dimensional analysis of CT image on naso-maxillary complex in cleft lip and palate patients

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Ma, Rong-Rong [Tokyo Medical and Dental Univ. (Japan). School of Dentistry

1994-12-01

This study was designed to clarify the three dimensional features of naso-maxillary complex in cleft lip and palate (CLP) by using computed tomography (CT) and to examine its change following an upper dental arch expansion. Sequential CT images with 2mm-thickness were obtained for 11 unilateral CLP boys (UCLP), 6 bilateral CLP boys (BCLP) and 4 boys without cleft (non-cleft). Additionally, two serial sets of upper dental cast before and after dental arch expansion coupled with CT images in UCLP were used to evaluate the effect of dental arch expansion on the naso-maxillary complex. UCLP demonstrated a remarkable naso-maxillary deformity characterized by a decreased volume of maxillary sinus in comparison with the non-cleft patients. Both the volume and shape of nasal cavity were significantly different between the cleft and non cleft side. Naso-maxillary morphology of BCLP, however, was similar to that of the non cleft except for the decreased volume of alveolar arch. Comparative study of UCLP and BCLP showed a significant difference in naso-maxillary morphology. There were some significant correlations between the dental arch expansion and change of each naso-maxillary component, suggesting the effect of expansion stress on the naso-maxillary complex in UCLP. However, deformation caused by expansion stress varied, depending on each component of the naso-maxillary complex. (author) 61 refs.

Rapid maxillary expansion in contemporary orthodontic literature

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Sabrina Mutinelli

2016-01-01

Full Text Available We have reviewed our retrospective research about rapid maxillary expansion performed in the early mixed dentition to summarize the results of different studies regarding maxillary dental arch width variation and crowding improvement in light of contemporary literature. The aim is to define the effects of treatments followed until the end of dental arch growth. In all studies, a Haas expander anchored to the deciduous dentition was used. The samples consisted of treated patients with and without a lateral crossbite and homogeneous untreated individuals as controls. Two additional control groups of adolescents and adults in dental Class 1 were also compared. As a result of the analysis, rapid maxillary expansion with anchorage to the deciduous dentition was found to be effective in increasing transverse width in intermolar and intercanine areas, and the change was preserved until the full permanent dentition stage. When performed before maxillary lateral incisors have fully erupted, this procedure allows for a rapid increase in the arch length in the anterior area and consequently, in the space available for permanent incisors with a stable reduction in crowding over time.

Nonsurgical, nonextraction management of impacted maxillary canine

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Jasneet Singh

2018-01-01

Full Text Available NS, a 12 year 2 months old female patient, presented with the chief complaint of irregular teeth. Diagnosis revealed skeletal Class II jaw base relation, with average (toward vertical growth pattern, dentoalveolar angles Class I molar relationship with severe crowding in upper and moderate crowding in the lower arch, normally positioned maxillary incisors but proclined lower incisors, “V” shape constricted maxillary arch with first premolar in crossbite, overretained deciduous molar and a high placed buccoversion canine in the first quadrant and an impacted canine in the second quadrant, constricted mandibular arch with first premolar blocked out in the third quadrant. Treatment with a nonsurgical, nonextraction treatment plan by expansion of the upper arch and taking advantage of natural eruptive forces of the tooth was planned. The final outcome solved the patient's complaints and achieved an esthetically pleasing and functionally adequate occlusal result.

Management of compromised anterior maxillary edentulous arch with symphyseal bone graft

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Sunil Kumar Mishra

2018-01-01

Full Text Available Achieving optimal aesthetics, function and phonetics with implant-supported restorations depends largely on the amount of bone present at the site where implant has to be placed. Sometimes, patient reports with compromised conditions which makes the implant placement difficult. Today, reconstruction procedures such as autogenous bone graft and guided bone regeneration make the implant placement possible in different ridge deficient cases. This case report describes step-by-step procedure of restoring the missing maxillary right central incisor with implant-supported prostheses. In missing left central incisor region, the alveolar bony defect was corrected by autogenous bone graft obtained from symphysis region, for restoration with implant prostheses.

Maxillary canine impactions related to impacted central incisors: two case reports.

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Bayram, Mehmet; Ozer, Mete; Sener, Ismail

2007-09-01

The purpose of this case report is to describe the combined surgical and orthodontic treatment of two cases with an impacted maxillary central incisor and canine in the same quadrant and to discuss the causal relationship between them. The most common causes of canine impactions are usually the result of one or more factors such as a long path of eruption, tooth size-arch length discrepancies, abnormal position of the tooth bud, prolonged retention or early loss of the deciduous canine, trauma, the presence of an alveolar cleft, ankylosis, cystic or neoplastic formation, dilaceration of the root, supernumerary teeth, and odontomas. Although impaction of the maxillary central incisor is almost as prevalent as impacted canines its etiology is different. The principal factors involved in causing the anomaly are supernumerary teeth, odontomas, and trauma. Case #1: A 10.5-year-old girl in the early mixed dentition stage presented with a chief complaint of the appearance of her anterior teeth. She had a Class I skeletal pattern and a history of trauma to the maxillary central incisors at age five with premature exfoliation. Radiographs revealed an impacted upper right central incisor in the region of the nasal floor, delayed eruption of the maxillary permanent central incisor, and the adjacent lateral incisor was inclined toward the edentulous space. Treatment was done in two stages consisting of surgical exposure and traction of the impacted central incisor and fixed orthodontic treatment. Case #2: An 11.5-year-old girl presented for orthodontic treatment with the chief complaint of an unerupted tooth and the appearance of her upper anterior teeth. She was in the late mixed dentition period with a Class III skeletal pattern along with an anterior cross-bite with some maxillary transverse deficiency. The maxillary right canine and central incisor were absent, but the maxillary right deciduous canine was still present. Treatment included arch expansion followed by

Immediate and six-month space changes after premature loss of a primary maxillary first molar.

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Lin, Yai-Tin; Lin, Wen-Hsien; Lin, Yng-Tzer J

2007-03-01

Premature loss of primary maxillary first molars has been associated with a number of consequences (such as tipping of the first permanent molar). The aim of the authors' study was to investigate dental-arch space problems arising as a result of premature loss of a primary maxillary first molar. This study was composed of 19 children who experienced unilateral premature loss of a primary maxillary first molar. The authors used each patient's intact contralateral arch segment as a control. The authors obtained maxillary dental study casts two or three days after the tooth was extracted, as well as six months later. The D + E space from the extraction side six months after removal of the tooth (mean +/- standard deviation, 15.62 +/- 1.13 millimeters) was significantly smaller than the space on the control side (16.88 +/- 1.12 mm) and the initial D + E space (16.70 +/- 0.69 mm). The authors found a significantly shorter arch length (25.47 +/- 1.58 mm) and larger intercanine width (31.29 +/- 2.49 mm) six months after the tooth was extracted compared with the initial arch length (25.66 +/- 1.64 mm) and intercanine width (30.42 +/- 2.64 mm). The early space changes to the maxillary arch subsequent to premature loss of a primary maxillary first molar are primarily distal drift of the primary canines toward the extraction space and palatal migration of the maxillary incisors. Although 1 mm of space was lost, which is statistically significant, this is not likely to be of sufficient clinical significance to warrant use of a space maintainer. If palatal movement appears to be needed, the dentist should consider use of a palatal arch rather than a band-and-loop maintainer. The effects of space maintainers need to be re-evaluated in cases of unilateral premature loss of a primary maxillary first molar.

Maxillary segmental distraction in children with unilateral clefts of lip, palate, and alveolus.

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Zemann, Wolfgang; Pichelmayer, Margit

2011-06-01

Alveolar clefts are commonly closed by a bone grafting procedure. In cases of wide clefts the deficiency of soft tissue in the cleft area may lead to wound dehiscence and loss of the bony graft. Segmental maxillary bony transfer has been mentioned to be useful in such cases. Standard distraction devices allow unidirectional movement of the transported segment. Ideally the distraction should strictly follow the dental arch. The aim of this study was to analyze distraction devices that were adapted to the individual clinical situation of the patients. The goal was to achieve a distraction strictly parallel to the dental arch. Six children with unilateral clefts of lip, palate, and alveolus between 12 and 13 years of age were included in the study. The width of the cleft was between 7 and 19 mm. Dental cast models were used to manufacture individual distraction devices that should allow a segmental bony transport strictly parallel to the dental arch. Segmental osteotomy was performed under general anesthesia. Distraction was started 5 days after surgery. All distracters were tooth fixed but supported by palatal inserted orthodontic miniscrews. In all patients, a closure of the alveolar cleft was achieved. Two patients required additional bone grafting after the distraction procedure. The distraction was strictly parallel to the dental arch in all cases. In 1 case a slight cranial displacement of the transported maxillary segment could be noticed, leading to minor modifications of the following distractors. Distraction osteogenesis is a proper method to close wide alveolar clefts. Linear segmental transport is required in the posterior part of the dental arch, whereas in the frontal part the bony transport should run strictly parallel to the dental arch. An exact guided segmental transport may reduce the postoperative orthodontic complexity. Copyright © 2011 Mosby, Inc. All rights reserved.

Adjustable selective maxillary expansion combined with maxillomandibular surgery: A case report.

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Leyder, Patrick; Altounian, Gérard; Chardain, Jacques; Quilichini, Julien

2015-09-01

Surgically assisted rapid maxillary expansion (SARME) is usually considered the gold standard for maxillary transverse expansion in adults. However, a second surgical procedure is needed in cases of associated sagittal or vertical discrepancies. We describe the use of two new innovative devices for the correction of discrepancies in all dimensions during a single surgical procedure, thus reducing treatment duration. We report the case of a 21-year-old female patient, referred to our department for skeletal Class III malocclusion associated with right-side laterognathism and transverse maxillary deficiency. The patient underwent one-stage surgery, using sliding osteosynthesis plates and an adjustable bone-borne distractor. Pre-surgical orthodontics consisted in leveling and aligning the mandibular arch; maxillary leveling was initiated 3 months before surgery. Postoperative palatal distraction combined with orthodontic finishing enabled complete correction of dental and bony discrepancies after 3 months. In our experience, treatment of transverse, sagittal and vertical discrepancies has been possible in a single surgical procedure, using two innovative techniques: sliding osteosynthesis and an adjustable bone distractor. Two years post-surgery, the correction is stable in all dimensions. Copyright © 2015. Published by Elsevier Masson SAS.

Modified protrusion arch for anterior crossbite correction - a case report.

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Roy, Abhishek Singha; Singh, Gulshan Kr; Tandon, Pradeep; Chaudhary, Ramsukh

2013-01-01

Borderline and mild skeletal Class III relationships in adult patients are usually treated by orthodontic camouflage. Reasonably rood results have been achieved with nonsurgical teatment of anterior crossbite. Class III malocclusion may be associated with mandibular prognathism, maxillary retrognathism, or both. Class III maxillary retrognathism generally involves anterior crossbite, which must be opened if upper labial brackets are to be bonded. If multiple teeth are in crossbite, after opening the bite usual step is to ligate forward or advancement arch made of 0.018" or 0.020" stainless steel or NiTi wire main arch that must be kept separated 2 mm from the slot ofupper incisor braces. Two stops or omegas are made 1 mm mesial to the tubes of the molar bands that will impede main arch from slipping,and in this manner the arch will push the anterior teeth forward Here we have fabricated a modified multiple loop protrusion arch to correct an anterior crossbite with severe crowding that was not amenable to correct by advancement arches.

Evaluation of apical root resorption in orthodontic patients with maxillary anterior intrusion using utility arches and mini screws: A comparative clinical trial

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Muraleedhara Bhat

2014-01-01

Full Text Available Objectives: The purpose of this study was to compare the amount of apical root resorption in orthodontic patients undergoing maxillary anterior intrusion using utility arches and mini screws; and to compare the efficacy of mini screws and utility arches in reducing over bite. Materials and Methods: The study sample consisted of 20 patients, divided in two groups. Group A consisted of ten patients in whom titanium mini-screws were used Group B consisted of 10 patients in whom utility arches made of 0.017 × 0.25" TMA were used. Diagnostic records (study models and radiovisiography [RVG] were taken at 2 time intervals, T1 (just before implant/utility arch placement and T2 (at the end of intrusion 6 months later. The pre and post radiographic images were measured from incisal tip to the root apex with the help of intrascan DC software. Root resorption was computed as the difference between the pre-treatment total tooth length and the post treatment total tooth length. These values were subjected to statistical analyses using SPSS 16.00 statistical software. (Statistical Package for the Social Sciences, IBM Corporation, December 2007 Results: The results showed that root resorption was seen in both groups. Amount of resorption seen was higher in mini implant group than utility arch group. Mini implants were more efficient in reducing the overbite when compared to utility arches. Conclusion: It was concluded from the study that intrusion using mini implant resulted in more root resorption than utility arch; and mini implant was more effective in intruding the incisors than utility arch.

Young adult patient with two palatally maxillary impacted canines and forced traction on rigid arches of stabilization. Case report.

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Mucedero, M; Pezzuto, C; Rozzi, M; Ricchiuti, M R; Cozza, P

2016-01-01

Young adult patient treated for impaction of two maxillary canines. C.S., 15 years, female. Diagnostic evaluation by clinical and radiographic examinations shows permanent dentition with persistence of 5.3 and 6.3, impaction of 1.3 and 2.3, dento-skeletal Cl I malocclusion, normodivergence of bone bases. Analysis of TC dentalscan confirms the palatal impaction of 1.3 and 2.3. The treatment plan provided an orthodontic-surgical approach for adequate space management in dental arch, evaluation of eruption movements, choice of anchorage device, surgical exposure and application of the brackets. Deciduous canines have been extracted and an edgewise appliance with rigid rectangular full thickness archwires has been used to align the arches and to obtain maximum anchorage during the forced traction. The surgical phase, for exposure of 1.3 and 2.3 respectively, performed an open technique by excisional uncovering and a close technique by a repositioned flap. The case has been finalized for the achievement of the right occlusal keys. The possibility to choose the surgical technique depending on the intraosseous position of impacted teeth in association to the edgewise therapy with full thickness arches allows to realize an effectiveness surgical-orthodontic approach for the forced traction of impacted teeth in a favourable position.

Three-dimensional dental arch changes of patients submitted to orthodontic-surgical treatment for correction of Class II malocclusion.

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Peixoto, Adriano Porto; dos Santos Pinto, Ary; Garib, Daniela Gamba; Gonçalves, João Roberto

2014-01-01

This study assessed the three-dimensional changes in the dental arch of patients submitted to orthodontic-surgical treatment for correction of Class II malocclusions at three different periods. Landmarks previously identified on upper and lower dental casts were digitized on a three-dimensional digitizer MicroScribe-3DX and stored in Excel worksheets in order to assess the width, length and depth of patient's dental arches. During orthodontic preparation, the maxillary and mandibular transverse dimensions measured at the premolar regions were increased and maintained throughout the follow-up period. Intercanine width was increased only in the upper arch during orthodontic preparation. Maxillary arch length was reduced during orthodontic finalization, only. Upper and lower arch depths were stable in the study periods. Differences between changes in centroid and gingival points suggested that upper and lower premolars buccaly proclined during the pre-surgical period. Maxillary and mandibular dental arches presented transverse expansion at premolar regions during preoperative orthodontic preparation, with a tendency towards buccal tipping. The transverse dimensions were not altered after surgery. No sagittal or vertical changes were observed during the follow-up periods.

Determining shapes and dimensions of dental arches for the use of straight-wire arches in lingual technique.

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Kairalla, Silvana Allegrini; Scuzzo, Giuseppe; Triviño, Tarcila; Velasco, Leandro; Lombardo, Luca; Paranhos, Luiz Renato

2014-01-01

This study aims to determine the shape and dimension of dental arches from a lingual perspective, and determine shape and size of a straight archwire used for lingual Orthodontics. The study sample comprised 70 Caucasian Brazilian individuals with normal occlusion and at least four of Andrew's six keys. Maxillary and mandibular dental casts were digitized (3D) and the images were analyzed by Delcam Power SHAPET 2010 software. Landmarks on the lingual surface of teeth were selected and 14 measurements were calculated to determine the shape and size of dental arches. Shapiro-Wilk test determined small arch shape by means of 25th percentile (P25%)--an average percentile for the medium arch; and a large one determined by means of 75th percentile (P75%). T-test revealed differences between males and females in the size of 12 dental arches. The straight-wire arch shape used in the lingual straight wire technique is a parabolic-shaped arch, slightly flattened on its anterior portion. Due to similarity among dental arch sizes shown by males and females, a more simplified diagram chart was designed.

Three-dimensional dental arch changes of patients submitted to orthodontic-surgical treatment for correction of Class II malocclusion

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Adriano Porto Peixoto

2014-08-01

Full Text Available INTRODUCTION: This study assessed the three-dimensional changes in the dental arch of patients submitted to orthodontic-surgical treatment for correction of Class II malocclusions at three different periods. METHODS: Landmarks previously identified on upper and lower dental casts were digitized on a three-dimensional digitizer MicroScribe-3DX and stored in Excel worksheets in order to assess the width, length and depth of patient's dental arches. RESULTS: During orthodontic preparation, the maxillary and mandibular transverse dimensions measured at the premolar regions were increased and maintained throughout the follow-up period. Intercanine width was increased only in the upper arch during orthodontic preparation. Maxillary arch length was reduced during orthodontic finalization, only. Upper and lower arch depths were stable in the study periods. Differences between centroid and gingival changes suggested that upper and lower arch premolars buccaly proclined during the pre-surgical period. CONCLUSIONS: Maxillary and mandibular dental arches presented transverse expansion at premolar regions during preoperative orthodontic preparation, with a tendency towards buccal tipping. The transverse dimensions were not altered after surgery. No sagittal or vertical changes were observed during the follow-up periods.

Mid-maxillary distraction osteogenesis of cleft patients using a special custom-made tooth-borne device.

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Dias, D K; De Silva, H L; Senadeera, W M

2011-09-01

A relatively new approach to maxillary advancement by maxillary distraction using a combined surgical and modified orthodontic technique is described. This protocol and the technique have been used for the past 3 years (2006 to 2009) on more than 60 patients, aged between 14-29 years. Distraction of between 7 and 18 mm has been achieved, creating class 1 or mild class 2 arch relationships in cleft lip and cleft palate patients who had class 3 arch relationship compounded by significant maxillary retrusion. The technique is simple, inexpensive and less time consuming.

A Peduncular Cystic Compound Odontoma on the Posterior Wall of the Maxillary Sinus

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Kang, Byung Chul [Dept. of Oral and Maxillofacial Radiology, College of Dentistry, Chonam National University, Kwangju (Korea, Republic of)

1998-08-15

A cystic compound odontoma in the maxillary sinus occurred in a 13-years-old boy, who had missing right upper third molar without having the history of extraction of the wisdom tooth. He complained nasal stuffiness, headache, and pain on the affected face, resembling any sign and symptoms of the maxillary sinus problems. The cysteic compound, sized 2 x 1.5 cm in diameter was pedunculated and attached on the posterior wall of the right maxillary sinus and above the antral floor. The location of the compound odontoma in the maxillary sinus was confirmed after panoramic, waters, spiral tomographic, CT examinations and surgical exploration. Irs location was on the medical, posterior, superior to the normal position of the maxillary third molar or the maxillary dental arch. The cystic odontoma in the maxillary sinus made the patient have the sings and symptoms of maxillary sinusitis. The cystic compound odontoma might be originated from the dental lamina of the missing upper right third molar. The 'V principle' of the upper jaw growth and the pneumatization process of the maxillary sinus could explain why the compound odontoma had peduncular shape and the location of odontoma was on the medial, superior to the normal position of the maxillary dental arch.

Twelve-month space changes after premature loss of a primary maxillary first molar.

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Lin, Yai-Tin; Lin, Wen-Hsien; Lin, Yng-Tzer J

2011-05-01

Many early investigations concerning space changes following premature extraction of primary molars had a cross-sectional design, a small sample size, and a somewhat crude methodology, which may have led to misunderstandings. The aim of this study was to use established longitudinal data to investigate ongoing (12-month) dental-arch space problems arising as a result of premature loss of a primary maxillary first molar. Thirteen children (mean ± SD age at time of tooth extraction, 6.0 ± 0.74 years) with unilateral premature loss of a primary maxillary first molar were selected for this study. Maxillary dental study casts were obtained from participants 2 or 3 days after the tooth was removed, as well as at a follow-up appointment 12 months later. Six reference lines were measured on the study cast: D + E space, arch width, arch length, intercanine width, intercanine length, and arch perimeter. For each participant, the D + E space of the contralateral intact primary molar served as a control. A paired t-test was used to compare the cast measurements between initial examination and 12-month follow-up. A t-test was used to compare D + E space changes with those of the control group. The D + E space of the extraction side after 12 months was significantly smaller than that of the control side (P 0.05). The 12-month space changes in the maxillary dental arch after premature loss of a primary maxillary first molar consist mainly of distal drift of the primary canine toward the extraction site. Mesial movement of permanent molars or tilting of the primary molars did not occur. An increased arch dimension was found especially in the anterior segment (intercanine width and length). There is no need for the use of space maintainers from the results in this study in cases of premature loss of a primary first molar. © 2010 The Authors. International Journal of Paediatric Dentistry © 2010 BSPD, IAPD and Blackwell Publishing Ltd.

Análise morfológica do arco superior de portadores de fissura labiopalatal submetidos a diferentes protocolos de expansão rápida maxilar: avaliação das alterações maxilares Morphological analysis of the maxillary arch in patients with cleft lip and palate submitted to different protocols of rapid maxillary expansion: maxillary alterations evaluation

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Maíra Massuia de Souza

2009-10-01

Full Text Available INTRODUÇÃO: em portadores de malformações labiopalatais, a boa conformação do arco superior constitui um dos principais requisitos para a obtenção de uma oclusão adequada e para o aperfeiçoamento estético e funcional. Para tanto, a expansão ortopédica da maxila é frequentemente necessária, uma vez que é alta a incidência de colapso dos segmentos. OBJETIVOS: analisar, por meio de modelos de gesso, as dimensões do arco superior de 15 portadores de fissura transforame incisivo unilateral, com deficiências transversal e anteroposterior da maxila, submetidos à expansão com dois diferentes protocolos de ativação. MÉTODOS: um grupo foi submetido à Expansão Rápida da Maxila (ERM com protocolo de ativação convencional (Grupo 1, enquanto no outro grupo foi utilizado o protocolo de ativação preconizado por Liou e Tsai em 2005, com expansões e contrações alternadas (Grupo 2, sendo ambos submetidos posteriormente à protração maxilar com máscara de tração reversa. Os modelos foram obtidos em dois momentos: antes da cimentação do disjuntor do tipo Haas modificado (T1 e após 24 semanas de tratamento (T2. As distâncias transversais entre os primeiros pré-molares superiores (região anterior e a distância entre os primeiros molares superiores (região posterior foram registradas com um paquímetro digital. Os dados obtidos foram submetidos ao teste t de Student. RESULTADOS E CONCLUSÕES: os dois protocolos de ativação mostraram-se igualmente efetivos na expansão maxilar, não havendo diferença entre os grupos em relação ao aumento transversal obtido.INTRODUCTION: Harmonious conformation of the maxillary arch in patients with cleft lip and palate is one of the main requirements for achievement of adequate occlusion and for esthetic and functional improvement. For this purpose, orthopedic maxillary expansion is often required due to the high frequency of the segments collapse. AIM: This study aimed to evaluate the

Maxillary molar distalization with first class appliance.

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Ramesh, Namitha; Palukunnu, Biswas; Ravindran, Nidhi; Nair, Preeti P

2014-02-27

Non-extraction treatment has gained popularity for corrections of mild-to-moderate class II malocclusion over the past few decades. The distalization of maxillary molars is of significant value for treatment of cases with minimal arch discrepancy and mild class II molar relation associated with a normal mandibular arch and acceptable profile. This paper describes our experience with a 16-year-old female patient who reported with irregularly placed upper front teeth and unpleasant smile. The patient was diagnosed to have angles class II malocclusion with moderate maxillary anterior crowding, deep bite of 4 mm on a skeletal class II base with an orthognathic maxilla and retrognathic mandible and normal growth pattern. She presented an ideal profile and so molar distalization was planned with the first-class appliance. Molars were distalised by 8 mm on the right and left quadrants and class I molar relation achieved within 4 months. The space gained was utilised effectively to align the arch and establish a class I molar and canine relation.

Determining shapes and dimensions of dental arches for the use of straight-wire arches in lingual technique

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Silvana Allegrini Kairalla

2014-10-01

Full Text Available INTRODUCTION: This study aims to determine the shape and dimension of dental arches from a lingual perspective, and determine shape and size of a straight archwire used for lingual Orthodontics. METHODS: The study sample comprised 70 Caucasian Brazilian individuals with normal occlusion and at least four of Andrew's six keys. Maxillary and mandibular dental casts were digitized (3D and the images were analyzed by Delcam Power SHAPET 2010 software. Landmarks on the lingual surface of teeth were selected and 14 measurements were calculated to determine the shape and size of dental arches. RESULTS: Shapiro-Wilk test determined small arch shape by means of 25th percentile (P25% - an average percentile for the medium arch; and a large one determined by means of 75th percentile (P75%. T-test revealed differences between males and females in the size of 12 dental arches. CONCLUSION: The straight-wire arch shape used in the lingual straight wire technique is a parabolic-shaped arch, slightly flattened on its anterior portion. Due to similarity among dental arch sizes shown by males and females, a more simplified diagram chart was designed.

Three-dimensional space changes after premature loss of a maxillary primary first molar.

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Park, Kitae; Jung, Da-Woon; Kim, Ji-Yeon

2009-11-01

A space maintainer is generally preferred when a primary first molar is lost before or during active eruption of the first permanent molars in order to prevent space loss. However, controversy prevails regarding the space loss after eruption of the permanent first molars. The purpose of this study was to examine spatial changes subsequent to premature loss of a maxillary primary first molar after the eruption of the permanent first molars. Thirteen children, five girls and eight boys, expecting premature extraction of a maxillary primary first molar because of caries and/or failed pulp therapy, were selected. Spatial changes were investigated using a three-dimensional laser scanner by comparing the primary molar space, arch width, arch length, and arch perimeter before and after the extraction of a maxillary primary first molar. Also, the inclination and angulation changes in the maxillary primary canines, primary second molars, and permanent first molars adjacent to the extraction site were investigated before and after the extraction of the maxillary primary first molar in order to examine the source of space loss. There was no statistically significant space loss on the extraction side compared to the control side (P = 0.33). No consistent findings were seen on the inclination and angulation changes on the extraction side. The premature loss of a maxillary primary first molar, in cases with class I molar relationship, has limited influence on the space in permanent dentition.

Transverse maxillary distraction in patients with periodontal pathology or insufficient tooth anchorage using custom-made devices.

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Fernández-Sanromán, Jacinto; Donascimento, Montserrat González; López, Alberto Costas; Ferro, Martín Fernández; Berrondo, Ibon Almandoz

2010-07-01

We present our experience using modified Hyrax devices for treating transverse deficiencies of the maxilla in adult patients with periodontal pathology or insufficient tooth anchorage. The surgical technique, clinical indications, and results are discussed. Eight adult patients (6 females, 2 males) requiring maxillary expansion were studied prospectively between July 2002 and July 2007. All the patients had periodontal pathology or insufficient tooth anchorage preventing the use of conventional Hyrax devices. Patients underwent surgically assisted rapid maxillary expansion with the use of custom-made modified Hyrax devices (bone-borne or tooth-bone-borne devices). Patients received preoperatively (T1), at the end of distraction (T2), at removal of the expansion device (T3), and 12 months after surgery (T4) lateral and posterior anterior cephalograms and study models to measure the width of the anterior and posterior dental arches with a digital sliding calliper. Mean age was 28.5 years (range, 18-45 years). A significant widening of the anterior (6.3 +/- 1.6 mm) and posterior (7.1 +/- 1.2 mm) dental arches was demonstrated. No significant differences were found when comparing T3 with T4 measures. No significant complications were found. The results indicated that maxillary expansion with custom-made devices in adults was an easy, affordable, predictable and stable technique without significant complications in patients who suffer periodontal pathology or patients without enough dental support. Copyright 2010 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

eRME - Rapid Maxillary Expansion in the economic way

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Sonali Mahadevia

2011-01-01

Full Text Available Aim and Objectives: Rapid Maxillary Expansion constitutes a routine clinical procedure in orthodontics, involving separation of mid-palatine suture which is usually done with help of the Hyrax screw. However, because of its high cost, the use has been limited, especially in institutions. So, the purpose of this study was to construct an economical device which can expand the maxillary arch in growing patients. Materials and Methods: Six patients having constricted maxilla and posterior skeletal crossbite were randomly selected from the Department of Orthodontics. A unique, easy and simple alternative device for expanding the maxillary arch called economic Rapid Maxillary Expander (eRME has been fabricated at about one-tenth the cost of the conventional Hyrax. Pre- and post-treatment effects were statistically tested by using paired t-test at 0.05 level of significance. Results and Conclusion: The study results showed an average expansion in canine, premolar and molar regions of 4.4 mm, 6.8 mm and 9.4 mm, respectively, having significant difference pre-and post-treatment. Thus, it shows that maxillary expansion is efficiently possible with the application of this newly constructed device named eRME. This appliance also acts as a fixed retainer to avoid relapse, hence negating the need for a separate retainer.

Complications and Clinical Considerations of the Implant-Retained Zirconia Complete-Arch Prosthesis with Various Opposing Dentitions.

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Gonzalez, Jorge; Triplett, Robert G

To evaluate the performance of the implant-retained zirconia complete-arch prosthesis with various opposing dentitions. The 40 patients included in this retrospective case series study were treated with one or two implant-retained zirconia complete-arch prostheses (ZIRCAP) using the Zirkonzahn protocol. Prettau zirconia frames were created with strategic cutbacks in the structure to extend zirconia incisal coverage of the esthetic anterior sextants and complete monolithic zirconia in the molar areas; subsequent layers of porcelain were applied to nonfunctional and esthetic areas. Patients had three possible occlusal scenarios: (1) maxillary ZIRCAP and mandibular ZIRCAP, (2) maxillary ZIRCAP and mandibular natural dentition, and (3) maxillary ZIRCAP and mandibular conventional hybrid prosthesis. Complications were recorded during follow-up appointments 3, 6, and 12 months after definitive prosthesis delivery. The mean treatment observation period was 33 months. Eight prosthetic complications were noted for the 40 implant-retained zirconia complete-arch prostheses (18.18%), including six cases of minor porcelain chipping and two cases of debonding of the metal insert from the zirconia framework. Maxillary ZIRCAP opposing mandibular ZIRCAP and maxillary ZIRCAP opposing mandibular natural dentition occlusal scenarios presented the same complication ratio of 4. No complications were seen in the maxillary ZIRCAP opposing mandibular conventional hybrid prosthesis group, yet 16 complications were found as denture tooth fractures in 12 mandibular conventional hybrid prostheses (ratio of 0.75). The results indicate that the implant-retained zirconia complete-arch prosthesis offers acceptable performance for use as an alternative to the conventional titanium framework acrylic veneer prosthesis for complete edentulism with a lower incidence of prosthetic complications and fewer maintenance appointments. Chipping of veneering porcelain was the most common complication, but a

Correction of complete maxillary crossbite with severe crowding using Hyrax expansion and fixed appliance.

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Wangsrimongkol, Tasanee; Manosudprasit, Montian; Pisek, Poonsak; Leelasinjaroen, Pornnapha

2013-09-01

An 18-year-old Thai man who presented with a secondary cleft palate, maxillary hypoplasia and severe crowding was treated by rapid maxillary expansion and fixed orthodontic appliances. Initial assessment found skeletal Class III malrelationship and dental Class II malocclusion with anterior and bilateral posterior crossbites. Camouflage orthodontic treatment was planned using a rapid maxillary expansion appliance and correcting crowding with extraction all four premolar teeth. A Hyrax appliance and vertical loop arch wire were placed for maxillary arch expansion of 9.5 mms at first molars and canines, and 5.5 mms at the premolars and obtained positive overjet. Both acceptable skeletal and soft tissue relationships and satisfactory occlusion were produced. After 14 months of postoperative follow-up, the occlusal result was stable and no skeletal reversals could be detected.

Incisive papilla and positions of maxillary anterior teeth among ...

African Journals Online (AJOL)

Results: One hundred and twelve maxillary casts generated from participants aged 18-35 years (mean age 22.39±2.00 years), with well aligned arches were studied. The maxillary central incisor exhibited a mean of 14.93±1.52mm from the posterior limit of the incisive papilla while the inter-canine line scored a mean of ...

Differences between dentitions with palatally and labially located maxillary canines observed in incisor width, dental morphology and space conditions

DEFF Research Database (Denmark)

Artmann, L; Larsen, H J; Sørensen, H B

2010-01-01

To analyze the interrelationship between incisor width, deviations in the dentition and available space in the dental arch in palatally and labially located maxillary ectopic canine cases.......To analyze the interrelationship between incisor width, deviations in the dentition and available space in the dental arch in palatally and labially located maxillary ectopic canine cases....

Maxillary Arch Dimension Changes of 3-5 Years Old Filipino Children

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Abdol Hamid Zafarmand

2014-11-01

Full Text Available Background: The purpose of this study was to assess the dental arch dimensions in primary dentition of 3-5 years old Filipino children and determining the existence of sexual dimorphism.Materials and Methods: In this descriptive study, 60 Filipino preschool children aged 3-5 years old were selected from Manila city. Study casts were used for measurements of 3 arch dimensions: bicanine width, bimolar width, and arch length. The analyses were performed to compare values within age-groups and within gender-groups, besides reporting mean and standard deviations. The data were subjected to One-way ANOVA and Student t-test.Results: Significant differences were observed regarding dental arch dimensions among different ages and genders (p<0.05. Comparison between genders showed a statistically significant difference in bicanine width at the age of 4 (p=0.04, in bimolar width at age of 5 (p=0.006, and in arch length at age of 4 (p=0.03 and 5 (p=0.02. Differences within male group for different ages showed only arch length dimension was statistically significant (p=0.021. In females, however the comparison between age-groups also revealed a statistically significant difference in bicanine (p= 0.016 and bimolar widths (p=0.027 dimensions.Conclusion: The present study showed that dental arch dimensions, vary among different ages and genders of children. It also showed that a sexual dimorphism does exist between the gender groups.

Mini-screw implant or transpalatal arch-mediated anchorage reinforcement during canine retraction: a randomized clinical trial.

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Sharma, Mohit; Sharma, Vineet; Khanna, Bharat

2012-06-01

To compare mesial movement of upper first molars during maxillary canine retraction using a pre-adjusted edgewise appliance provided by anchorage reinforcement and a transpalatal arch or mini-screw implant. Randomized clinical trial. Department of Orthodontics and Dentofacial Orthopedics, Armed Forces Medical College, Pune, India. From a cohort of subjects requiring the extraction of both upper first premolars and pre-adjusted edgewise appliances to correct their malocclusion, a total of 30 were randomly allocated to receive two different forms of anchorage reinforcement: group A--receiving mini-screw implant and group B--receiving a transpalatal arch Group A subjects received titanium mini-screw implants placed at the start of treatment between the maxillary second premolar and maxillary first molar. Maxillary second premolars were secured to the mini-screw implants using of 0.010-inch stainless steel ligature wire. Group B subjects received a custom-made transpalatal arch which was soldered to maxillary first molar bands. Active canine retraction was initiated in both groups on placement of a 0.019×0.025-inch stainless steel archwire using nickel titanium closed coil springs. Mesial movement of the upper first molars as measured on pre- (T1) and post-treatment (T2) lateral skull radiographs. The results showed that in group A the mean mesial movement of the first molars between T1 and T2 was 0.0 mm (SD 0.02; P = 0.90), whereas in Group B there was a mean forward movement of the first maolars of 2.48 mm (SD 0.71; Pimplants placed prior to levelling and aligning were able to provide absolute anchorage during maxillary canine retraction, in contrast to a transpalatal arch.

Interceptive treatment of palatal impaction of maxillary canines with rapid maxillary expansion: a randomized clinical trial.

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Baccetti, Tiziano; Mucedero, Manuela; Leonardi, Maria; Cozza, Paola

2009-11-01

Our aim in this prospective randomized clinical study was to assess the prevalence rate of eruption of palatally displaced canines, diagnosed at an early developmental stage with posteroanterior radiographs and consequently treated by rapid maxillary expansion. A sample of 60 subjects in the early mixed dentition with palatally displaced canines diagnosed on posteroanterior radiographs was enrolled in the trial. Their age range at the first observation (T1) was 7.6 to 9.6 years, with a prepubertal stage of skeletal maturity (CS1 or CS2). The 60 subjects were randomly allocated to the treatment group (TG, 35 subjects) or the no-treatment group (NTG, 25 subjects). The TG was treated with a banded rapid maxillary expander; after expansion, all patients were retained with the expander in place for 6 months. Thereafter, the expander was removed, and the patients wore a retention plate at night for a year. The NTG received no treatment. All subjects were reevaluated in the early permanent dentition (T2) (postpubertal CS4). The number of dropouts was recorded. The main outcome recorded at T2 was successful or unsuccessful eruption of the maxillary permanent canines. The starting forms at T1 for measurements on posteroanterior and panoramic films were compared in the 2 groups with the Mann-Whitney U test (P <0.05). The prevalence rates of successful and unsuccessful treatments in the TG were compared with those in NTG with chi-square tests (P <0.05). From T1 to T2, there were 3 dropouts in each group. The final sample comprised 32 subjects in the TG and 22 subjects in the NTG. No statistically significant differences were found for any variable at T1. The prevalence rates of successful eruption of the maxillary canines were 65.7% (21 subjects) in the TG and 13.6% (3 subjects) in the NTG. The comparison was statistically significant (chi-square = 12.4; P <0.001). Subjects with palatally displaced canines in the early mixed dentition do not have transverse deficiency of the

Morphological and Dimensional Characteristics of Dental Arch among Tribal and Non-tribal Population of Central India: A Comparative Study

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Yadav, Naveen S; Saxena, Vrinda; Vyas, Rajesh; Sharma, Rohit; Sharva, Vijayta; Dwivedi, Ashish; Jain, Manish

2014-01-01

Background: Differences in the dental arch among Bhil Aboriginals were investigated and compared with non-tribal individuals residing in a tribal zone of Central India. Plaster models (120) were made with the help of alginate impression of tribal adults as well as non-tribal adults residing in the same area. The supposition as aboriginals being primitive due to dietary practices maxillary arch size and mandibular arch size is distended in comparison to the non-tribal population as adaptation of soft refined diet has disrupted the growth of the jaws. Hence, an attempt was made to evaluate the arch widths of tribal population and to associate it with non-tribe population in the same area of Central India. Materials and Methods: Difference in morphology and dimension of the maxillary and mandibular arches was aimed at Bhil tribes as well as non-tribal residents of tribe rich zone of Central India. The study was steered amid 120 individuals both tribal and non-tribe equally around 60 each through a well-organized out-reach program intermittently. Study models were made of dental arches of all participants. All measurements of the arch dimension were patent on the study casts using an electronic digital sliding caliper. Pair t-test was applied by using SPSS software version-19.0. Results: In the maxillary arch, on appraisal the non-tribal and Bhil tribe’s subjects, it showed a statistically significant difference in inter-incisor width (2.95 mm), inter-canine width (2.60 mm), arch depth (3.25 mm). While inter premolar width (0.20 mm) and inter molar width (0.80 mm) anterior arch length (0.60 mm), and posterior arch length (0.10 mm) showed statistically not significant difference between non-tribal population and Bhil tribe subjects. In the mandibular arch, it showed a statistically significant difference in inter-canine width (1.00 mm). Although, inter-incisor width (0.72 mm), inter-molar width (0.80 mm), arch depth (0.90 mm), anterior arch length (0.30 mm), posterior

Ankyloglossia as a risk factor for maxillary hypoplasia and soft palate elongation: A functional - morphological study.

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Yoon, A J; Zaghi, S; Ha, S; Law, C S; Guilleminault, C; Liu, S Y

2017-11-01

To characterize associations between restricted tongue mobility and maxillofacial development. Cross-sectional cohort study of 302 consecutive subjects from an orthodontic practice. Tongue mobility (measured with tongue range of motion ratio [TRMR] and Kotlow free tongue measurement) was correlated with measurements of the maxillofacial skeleton obtained from dental casts and cephalometric radiographs. Tongue range of motion ratio and Kotlow measures of restricted tongue mobility were associated with (i) ratio of maxillary intercanine width to canine arch length, (ii) ratio of maxillary intermolar width to canine arch length and (iii) soft palate length. Restricted tongue mobility was not associated with hyoid bone position or Angle's skeletal classification. Restricted tongue mobility was associated with narrowing of the maxillary arch and elongation of the soft palate in this study. These findings suggest that variations in tongue mobility may affect maxillofacial development. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The influence of erupting lateral teeth on maxillary anterior crowding in two Angle Class I maloclussion cases with high and low angles

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Hiroshi Ueda

2016-01-01

Full Text Available Two cases of anterior crowding, both Skeletal Class I and Angle Class I maloclussion, one being low angle and the other high angle respectively, respectively, were treated and evaluated to ascertain whether or not there is a relationship among disproportionate mesial axial angulation of the maxillary lateral teeth and the Frankfurt Horizontal-Functional Occlusal plane, therefore generating maxillary anterior crowding. Both cases were Japanese boys, the first one aged 9 years 10 months with chief complaint being anterior crowding and the second case aged 7 years and 8 months complaining of inadequate space for satisfying canine eruption. During and after the second stage of orthodontic treatment on both cases, several radiographic analysis were performed to assess treatment progress and retention; from these radiographs, it was noticed among other findings that in the high-angle case, the axial angulations of the maxillary lateral incisors were markedly smaller than in the low-angle case, thus indicating mesial tipping in the upper dental arch. This decreased mesial axial angulation of the lateral teeth observed at high angles may potentially cause maxillary space deficiency.

Orthodontic and surgical approach to the treatment of bilaterally impacted maxillary canines: a case report.

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Ertan Erdinc, Aslihan M

2008-01-01

Impaction of maxillary canines is a common orthodontic anomaly that causes facial and dentoalveolar system problems, both functional and esthetic. A combination of surgery and orthodontics is important in bringing impacted canines to their ideal position in the dental arch. In this case report of a 14-year-old patient with impacted right and left maxillary canines, the crowns of these teeth were surgically exposed, brackets were bonded, and light orthodontic forces were delivered for 2 years to align the teeth in the dental arch.

Dentoskeletal outcomes of a rapid maxillary expander with differential opening in patients with bilateral cleft lip and palate: A prospective clinical trial

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Garib, Daniela; De Cássia Moura Carvalho Lauris, Rita; Calil, Louise Resti; De Medeiros Alves, Arthur César; Janson, Guilherme; De Almeida, Araci Malagodi; Cevidanes, Lúcia Helena Soares; Lauris, José Roberto Pereira

2017-01-01

Introduction The purpose of this 2-arm parallel study was to evaluate the dentoskeletal effects of rapid maxillary expansion with differential opening (EDO) compared with the hyrax expander in patients with complete bilateral cleft lip and palate. Methods A sample of patients with complete bilateral cleft lip and palate was prospectively and consecutively recruited. Eligibility criteria included participants in the mixed dentition with lip and palate repair performed during early childhood and maxillary arch constriction with a need for maxillary expansion before the alveolar bone graft procedure. The participants were consecutively divided into 2 study groups. The experimental and control groups comprised patients treated with rapid maxillary expansion using EDO and the hyrax expander, respectively. Cone-beam computed tomography examinations and digital dental models of the maxillary dental arches were obtained before expansion and 6 months postexpansion. Standardized cone-beam computed tomography coronal sections were used for measuring maxillary transverse dimensions and posterior tooth inclinations. Digital dental models were used for assessing maxillary dental arch widths, arch perimeters, arch lengths, palatal depths, and posterior tooth inclinations. Blinding was used only during outcome assessment. The chi-square test was used to compare the sex ratios between groups (P <0.05). Intergroup comparisons were performed using independent t tests with the Bonferroni correction for multiple tests. Results Fifty patients were recruited and analyzed in their respective groups. The experimental group comprised 25 patients (mean age, 8.8 years), and the control group comprised 25 patients (mean age, 8.6 years). No intergroup significant differences were found for age, sex ratio, and dentoskeletal variables before expansion. No significant differences were found between the EDO and the hyrax expander groups regarding skeletal changes. The EDO promoted significantly

Transverse maxillary distraction with a bone-anchored appliance: dento-periodontal effects and clinical and radiological results.

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Ramieri, G A; Spada, M C; Austa, M; Bianchi, S D; Berrone, S

2005-06-01

In 29 adult patients presenting with maxillary deficiency, a bone-anchored palatal distractor (Surgi-Tec NV, Brugge, Belgium) was applied after osteotomy of the anterolateral walls of the maxillary sinuses, midpalatal suture, and, eventually, separation of the pterygomaxillary sutures. Expansion proceeded at a rate of 0.33-0.66 mm per day and the device was retained for 4-6 months for consolidation. Active orthodontic therapy was started after 8-10 weeks. The increment of arch width and the perimeter were evaluated using dental casts. Tooth thermal sensitivity and the periodontal side effects of treatment were monitored clinically after distraction, at device removal, and after 1 year. Bone healing was also investigated during the procedure using conventional radiological techniques. This experience confirms that transverse maxillary distraction is an effective technique in adult patients, leading to the formation of new bone. There were no noticeable intraoperative complications, but postsurgical periodontal side effects were documented. The procedure offers advantages over traditional teeth-borne appliances in terms of rapidity of treatment and the absence of mechanical forces acting on the teeth. Further evaluation is required to assess the long-term stability and periodontal consequences of this technique.

Bilateral supernumerary primary maxillary canines

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Santanu Mukhopadhyay

2018-01-01

Full Text Available Supernumerary teeth are more common in the permanent than in primary dentition. In the primary dentition, the anomaly is most frequently observed in the maxillary lateral incisor region, followed by the maxillary midline where they are termed as mesiodens. Supernumerary teeth in the primary canine region are rare. This paper describes a rare case of nonsyndromic supernumerary primary maxillary canine distributed bilaterally in a 4-year-old boy. Both the supernumeraries resembled size and shape of normal primary canine. The right supplemental canine is high labially placed, whereas the left one is seen normally aligned in the dental arch distal to lateral incisor. One of the most significant sequelae of primary supernumerary teeth is their duplication in the permanent series. Radiographic examination of supernumerary primary canine did not indicate any such anomaly in the permanent dentition. The patient was kept under observation.

Maxillary tridimensional changes after slow expansion with leaf expander in a sample of growing patients: a pilot study.

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Lanteri, V; Gianolio, A; Gualandi, G; Beretta, M

2018-03-01

The aim of this study is to evaluate the dento-alveolar effects of slow maxillary expansion using the Leaf Expander in a sample of growing patients with maxillary transverse deficiency, unilateral cross bite and mandibular shift. The study included 10 patients, 3 male and 7 female (mean age 7.5 + 7 months), treated with Leaf Expander anchored on the upper deciduous teeth. Digital models were obtained by a lab scan of the pvs impressions at the beginning of the therapy (T1) and at the removal of the palatal expander (T2). Five parameters were measured: 1) the distance between the first upper permanent molars; 2) the distance between the upper second deciduous molars; 3) the distance between the upper canine cusps 4) the distance between the first lower permanent molars; 5) the distance of the lower canine cusps. In all patients complete correction of posterior crossbite was achieved on average in 4 months, with a spontaneous expansion of the upper first permanent molars. Significant increases in the dento-alveolar transversal diameters were obtained. Increases were also observed in the anterior mandibular arch diameter (+ 1 mm). These findings suggest that slow maxillary expansion using Leaf Expander appliance could be a reasonable alternative to conventional maxillary expansion therapy in the early mixed dentition.

A comparative study on the stress distribution around dental implants in three arch form models for replacing six implants using finite element analysis.

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Zarei, Maryam; Jahangirnezhad, Mahmoud; Yousefimanesh, Hojatollah; Robati, Maryam; Robati, Hossein

2018-01-01

Dental implant is a method to replacement of missing teeth. It is important for replacing the missed anterior teeth. In vitro method is a safe method for evaluation of stress distribution. Finite element analysis as an in vitro method evaluated stress distribution around replacement of six maxillary anterior teeth implants in three models of maxillary arch. In this in vitro study, using ABAQUS software (Simulia Corporation, Vélizy-Villacoublay, France), implant simulation was performed for reconstruction of six maxillary anterior teeth in three models. Two implants were placed on both sides of the canine tooth region (A model); two implants on both sides of the canine tooth region and another on one side of the central incisor region (B model); and two implants on both sides of the canine tooth region and two implants in the central incisor area (C model). All implants evaluated in three arch forms (tapered, ovoid, and square). Data were analyzed by finite analysis software. Von Mises stress by increasing of implant number was reduced. In a comparison of A model in each maxillary arch, the stress created in the cortical and cancellous bones in the square arch was less than ovoid and tapered arches. The stress created in implants and cortical and cancellous bones in C model was less than A and B models. The C model (four-implant) reduced the stress distribution in cortical and cancellous bones, but this pattern must be evaluated according to arch form and cost benefit of patients.

Prevalence rate and dentoskeletal features associated with buccally displaced maxillary canines.

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Mucedero, Manuela; Ricchiuti, Maria Rosaria; Cozza, Paola; Baccetti, Tiziano

2013-06-01

The aim of the study was to analyse the prevalence and distribution of buccally displaced canines (BDCs) in subjects scheduled for orthodontic treatment and to investigate the association between BDC and sagittal, vertical, and transverse dentoskeletal relationships. A study sample of 1852 subjects was examined, and it was divided randomly into two groups. A first group of 252 subjects served as control group: the 'reference' prevalence rates for the examined parameters were calculated in this group. The remaining 1600 subjects comprised the sample from which the experimental BDC group was derived. Presence of unilateral or bilateral maxillary BDC, ANB, and SN GOGn angles for sagittal and vertical skeletal relationships, intercanine and intermolar distances, and tooth crowding at the maxillary arch were recorded for each subject. The statistical significance of differences between the BDC and the control groups in transverse relations and tooth crowding at the upper arch was tested by means of independent sample t-tests. Chi-square tests were performed to compare the prevalence rates of BDC and also sagittal and vertical skeletal features in the two groups. The prevalence rate of BDC was 3.06 per cent with a male-to-female ratio of 1:1. BDC subjects exhibited a significant association with hyperdivergent skeletal relationships (38.8%), reduced maxillary intercanine width, and crowding in the upper arch. The presence of specific dentoskeletal characteristics can be considered as a risk indicator for developing a buccal displacement of upper permanent canines.

Maxillary Anterior Segmental Distraction Osteogenesis to Correct Maxillary Deficiencies in a Patient With Cleft Lip and Palate.

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Kageyama-Iwata, Asuka; Haraguchi, Seiji; Iida, Seiji; Aikawa, Tomonao; Yamashiro, Takashi

2017-07-01

This report describes a case of successful orthodontic treatment using maxillary anterior segmental distraction osteogenesis with an internal maxillary distractor and bilateral sagittal split ramus osteotomy in a girl with cleft lip and palate. A 16-year-old girl with unilateral cleft lip and palate exhibited midface retrusion because of growth inhibition of the maxillary complex and mandibular excess. After the presurgical orthodontic treatment, 6.0-mm advancement of the maxillary anterior segment and 4.0-mm set back of the mandible were performed. After a retention period, the patient's midface convexity was greatly improved and the velopharyngeal competence was preserved without relapse.

Alteration of maxillary and mandibular growth of adult patients with unoperated isolated cleft palate.

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Yang, Yunqiang; Wu, Yeke; Gu, Yifei; Yang, Qijian; Shi, Bing; Zheng, Qian; Wang, Yan

2013-07-01

The objective of this study was to investigate the effects of cleft palate itself on the growth of maxilla and mandible. Fifty-two adult female patients with unoperated isolated cleft palate and 52 adult female individuals with normal occlusion were included in our study. Computer software was used for lateral cephalometry measurement. Manual measurement was performed for dental cast measurements, and sample t test analysis was applied to analyze the differences between the 2 groups using SPSS 17.0. The sella-nasion-subspinale point angle, subspinale-nasion-supramentale point angle, and maxillary arch length of the cleft group were significantly smaller than those of the control group (P cleft group were significantly larger compared with the control group (P palate height, and palate shelf inclination did not differ between the 2 groups. The measurements did not differ between the submucosal cleft and the overt cleft patients. Cleft palate itself has adverse effects on the maxilla growth with shorter maxillary arch length and wider posterior dental arch width.

Long-term space changes after premature loss of a primary maxillary first molar

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Yng-Tzer J. Lin

2017-03-01

Conclusion: The anterior and posterior arch dimensions significantly increased 81 months after premature loss of a primary maxillary first molar, which suggested that space maintainers were not needed in these cases.

Orthodontic Treatment of Maxillary Incisors with Severe Root Resorption Caused by Bilateral Canine Impaction in a Class II Division 1 Patient.

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Chang, Na-Young; Park, Jae Hyun; Lee, Mi-Young; Cho, Jin-Woo; Cho, Jin-Hyoung; An, Ki-Yong; Chae, Jong-Moon

2016-01-01

This case report shows the successful alignment of bilateral impacted maxillary canines. A 12-year-old male with the chief complaint of the protrusion of his maxillary anterior teeth happened to have bilateral maxillary canine impaction on the labial side of his maxillary incisors. Four maxillary incisors showed severe root resorption because of the impacted canines. The patient was diagnosed as skeletal Class II malocclusion with proclined maxillary incisors. The impacted canine was carefully retracted using sectional buccal arch wires to avoid further root resorption of the maxillary incisors. To distalize the maxillary dentition, two palatal miniscrews were used. After 25 months of treatment, the maxillary canines were well aligned without any additional root resorption of the maxillary incisors.

Comparison of dental arch dimensions in models of preschool children with cleft lip/palate repaired by means of surgery alone versus controls.

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Burhan, Ahmad S; Nawaya, Fehmieh R

2016-09-01

Cleft lip and palate (CLP) anomaly is one of the most prevalent congenital defects causing disturbances of dental arch dimensions. This study aimed at investigating differences in these dimensions between preschool children with cleft lip/palate and a matched control group representing healthy individuals with normal occlusion (NO). The sample of this cross-sectional analytical study consisted of 108 plaster models of children aged from 4 to 5.5 years. They were divided into five groups: the cleft lip group, the cleft palate (CP) group, the unilateral cleft lip and palate group, the bilateral cleft lip and palate group, and the NO group. The NO group was used as a control group. All cleft-affected children were treated only with surgery. Dental arch length and widths were measured. The dental arch dimensions of the cleft lip group were nearly similar to those in the controls. Moreover, the mandibular transverse widths of the CP group were close to those in the controls. However, the mandibular arch length and all maxillary dimensions of the CP group were smaller than those in the controls. In the unilateral cleft lip and palate group, the arch lengths in both jaws and the maxillary transverse widths were smaller than those in the controls, whereas the mandibular transverse widths were similar to those in the controls. In the bilateral cleft lip and palate group, the arch lengths in both jaws were close to those in the controls, but both arches were narrower than those in the controls. The various types of CLP were found to be associated with differences in most maxillary and some mandibular arch dimensions. These data can be used for cleft patient counseling and treatment planning.

Early Complications of Immediate Loading in Edentulous Full-Arch Restorations: A Retrospective Analysis of 88 Cases.

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Cercadillo-Ibarguren, Iñaki; Sánchez-Torres, Alba; Figueiredo, Rui; Valmaseda-Castellón, Eduard

To describe the clinical outcomes and complications related to provisional prostheses after full-arch implant-supported rehabilitation by means of an immediate loading protocol. This retrospective cohort study included patients who were consecutively treated with full-arch implant-supported restorations with a minimum of four implants (Replace Select Tapered TiUnite, Nobel Biocare AB) per arch and conical abutments (multi-unit, Nobel Biocare AB) by means of an immediate loading protocol. The surgical procedures were performed between May 2006 and June 2014 by a single oral surgeon. Demographic, surgical, and prosthetic variables were collected, and biologic and mechanical complications were registered. A total of 61 maxillae (57%) and 46 mandibles (43%) were treated in 88 patients (40 men and 48 women) with a mean age of 62.4 years. A total of 558 implants were placed, 295 in postextraction sockets. A total of 331 implants (59.3%) were placed in the maxilla and 227 (40.7%) in the mandible. Within a 9-month period, 18 prostheses (16.8%) fractured (15 maxillary and 3 mandibular); in nine of these patients the opposing dentition was a full-arch, implant-supported restoration, and in the remaining nine patients, it was natural dentition. Six (1.1%) maxillary and three (0.5%) mandibular implants failed. A high implant survival rate is expected in the short term following this immediate loading protocol. Fracture of the provisional prosthesis is a common finding, affecting 17% of patients, and is significantly more prevalent in patients with bruxism and in maxillary prostheses.

Vertical growth control during maxillary expansion using a bonded Hyrax appliance

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Francisco Marcelo Paranhos Pinto

2012-02-01

Full Text Available INTRODUCTION: Rapid maxillary expansion (RME for the treatment of maxillary deficiency and posterior crossbite may induce changes in the vertical dimension. Expanders with occlusal splints have been developed to minimize unwanted vertical effects. OBJECTIVE: This preliminary study used cephalometri radiographs to evaluate the vertical effects of RME using a Hyrax appliance in children with maxillary deficiency. METHOD: Twenty-six patients (11 boys; mean age = 8 years and 5 months with maxillary deficiency and posterior crossbite were treated using a Hyrax appliance with an acrylic occlusal splint. Radiographs and cephalometric studies were performed before the beginning of the treatment (T1 and after RME active time (T2, at a mean interval of 7 months. Results were compared with normative values. RESULTS AND CONCLUSIONS: At the end of treatment, there were no statistically significant changes, and measurements were similar to the normative values. Data showed that there were no significant effects on vertical growth, which suggests that appliances with occlusal splints may be used to correct transverse deficiencies regardless of the patient's growth pattern.

Treatment of Severe Maxillary Hypoplasia With Combined Orthodontics and Distraction Osteogenesis.

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Lucchese, Alessandra; Albertini, Paolo; Asperio, Paolo; Manuelli, Maurizio; Gastaldi, Giorgio

2018-01-05

Distraction osteogenesis (DO) is a technique that allows the generation of new bone in a gap between 2 vascularized bone surfaces in response to the application of graduated tensile stress across the bone gap.Distraction osteogenesis has become a routine treatment of choice to correct skeletal deformities and severe bone defects in the craniofacial complex over the past decade. Distraction osteogenesis has been successfully chosen in lengthening the maxilla and the mandible; in the maxilla and recently in the mandible, the jawbones have been distracted and widened transversely to relieve severe anterior dental crowding and transverse discrepancies between the dental arches.Distraction osteogenesis for maxillary advancement started in 1993 and is now widely used, especially in patients with skeletal Class III malocclusion caused by maxillary hypoplasia.The aim of this study was to present the efficiency of combined orthodontic and DO in the severe maxillary hypoplasia.A 35-year-old Italian man presented to our clinical practice with the chief complaint of esthetic and functionally problems because of skeletal Class III malocclusion with anterior crossbite.Considering that the severity of the skeletal discrepancy is remarkable but compensated by the DO potential, the combined orthodontic and DO treatment was considered adequate, like less invasive and equally effective.It was obtained a good alignment with the upper and lower arch dental alveolar maxillary advancement that allowed to correct the sagittal relationships.The patient was satisfied for the treatment results and had considerable improvement in his self-esteem.

Digital models: How can dental arch form be verified chairside?

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Alana Tavares

Full Text Available ABSTRACT Introduction: Plaster dental casts are routinely used during clinical practice to access maxillary dental arch form and assist on fabrication of individualized orthodontic archwires. Recently introduced, digital model technology may offer a limitation for the obtainment of a dental physical record. In this context, a tool for dental arch form assessment for chairside use is necessary when employing digital models. In this regard, paper print of the dental arch seems thus to be useful. Methods: In the present study, 37 lower arch models were used. Intercanine and intermolar widths and dental arch length measurements were performed and compared using plaster dental casts, digital models and paper print image of the models. Ortho Insight 3D scanner was employed for model digitalization. Results: No statistically significant differences were noted regarding the measurements performed on the plaster or digital models (p> 0.05. Paper print images, however, showed subestimated values for intercanine and intermolar widths and overestimated values for dental arch length. Despite being statistically significant (p< 0.001, the differences were considered clinically negligible. Conclusion: The present study suggests that paper print images obtained from digital models are clinically accurate and can be used as a tool for dental arch form assessment for fabrication of individualized orthodontic archwires.

Digital models: How can dental arch form be verified chairside?

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Tavares, Alana; Braga, Emanuel; de Araújo, Telma Martins

2017-01-01

ABSTRACT Introduction: Plaster dental casts are routinely used during clinical practice to access maxillary dental arch form and assist on fabrication of individualized orthodontic archwires. Recently introduced, digital model technology may offer a limitation for the obtainment of a dental physical record. In this context, a tool for dental arch form assessment for chairside use is necessary when employing digital models. In this regard, paper print of the dental arch seems thus to be useful. Methods: In the present study, 37 lower arch models were used. Intercanine and intermolar widths and dental arch length measurements were performed and compared using plaster dental casts, digital models and paper print image of the models. Ortho Insight 3D scanner was employed for model digitalization. Results: No statistically significant differences were noted regarding the measurements performed on the plaster or digital models (p> 0.05). Paper print images, however, showed subestimated values for intercanine and intermolar widths and overestimated values for dental arch length. Despite being statistically significant (p< 0.001), the differences were considered clinically negligible. Conclusion: The present study suggests that paper print images obtained from digital models are clinically accurate and can be used as a tool for dental arch form assessment for fabrication of individualized orthodontic archwires. PMID:29364382

Difference between manual and digital measurements of dental arches of orthodontic patients.

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Jiménez-Gayosso, Sandra Isabel; Lara-Carrillo, Edith; López-González, Saraí; Medina-Solís, Carlo Eduardo; Scougall-Vilchis, Rogelio José; Hernández-Martínez, César Tadeo; Colomé-Ruiz, Gabriel Eduardo; Escoffié-Ramirez, Mauricio

2018-06-01

The objective of this study was to compare the differences between the measurements performed manually to those obtained using a digital model scanner of patients with orthodontic treatment.A cross-sectional study was performed in a sample of 30 study models from patients with permanent dentition who attended a university clinic between January 2010 and December 2015. For the digital measurement, a Maestro 3D Ortho Studio scanner (Italy) was used and Mitutoyo electronic Vernier calipers (Kawasaki, Japan) were used for manual measurement. The outcome variables were the measurements for maxillary intercanine width, mandibular intercanine width, maxillary intermolar width, mandibular intermolar width, overjet, overbite, maxillary arch perimeter, mandibular arch perimeter, and palate height. The independent variables, besides age and sex, were a series of arc characteristics. The Student t test, paired Student t test, and Pearson correlation in SPSS version 19 were used for the analysis.Of the models, 60% were from women. Two of nine measurements for pre-treatment and 6 of 9 measurements for post-treatment showed a difference. The variables that were different between the manual and digital measurements in the pre-treatment were maxillary intermolar width and palate height (P manually and digitally showed certain similarities for both vertical and transverse measurements. There are many advantages offered to the orthodontist, such as easy storage; savings in time and space; facilitating the reproducibility of information; and conferring the security of not deteriorating over time. Its main disadvantage is the cost.

Anterior maxillary segmental distraction in the treatment of severe maxillary hypoplasia secondary to cleft lip and palate.

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Li, Hongliang; Dai, Jiewen; Si, Jiawen; Zhang, Jianfei; Wang, Minjiao; Shen, Steve Guofang; Yu, Hongbo

2015-01-01

Anterior maxillary segmental distraction (AMSD) is an effective surgical procedure in the treatment of maxillary hypoplasia secondary to cleft lip and palate. Its unique advantage of preserving velopharyngeal function makes this procedure widely applied. In this study, the application of AMSD was described and its long-term stability was explored. Eight patients with severe maxillary hypoplasia secondary to CLP were included in this study. They were treated with AMSD using rigid external distraction (RED) device. Cephalometric analysis was performed twice at three time points for evaluation: before surgery (T1), after distraction (T2), and 2 years after treatment (T3). One-way analysis of variance was used to assess the differences statistically. All the distractions completed smoothly, and maxilla was distracted efficiently. The value of SNA, NA-FH, Ptm-A, U1-PP, overjet and PP (ANS-PNS) increased significantly after the AMSD procedure (P 0.05). Changes of palatopharyngeal depth and soft palatal length were insignificant. AMSD with RED device provided an effective way to correct maxillary hypoplasia secondary to CLP, extended the palatal and arch length, avoided damage on velopharyngeal closure function and reduced the relapse rate. It is a promising and valuable technique in this potentially complicated procedure.

Partial maxillary osteotomy following an unsuccessful forced eruption of an impacted maxillary canine: 10 year follow-up. Review and case report

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Edela Puricelli

2012-12-01

Full Text Available The maxillary canines are amongst the most frequently impacted teeth, second only to the third molars. Several conservative orthodontic and surgical techniques are available to position the teeth properly in the dental arch, even in severe cases. However, when an extraction is necessary, it often leaves a critical alveolar defect of difficult management. The authors present the technique of Partial Maxillary Osteotomy, in which a dento-alveolar segment is moved mesially, hence closing the remaining space, allowing for the formation of healthy periodontium and resulting in an adequate functional and aesthetic outcome. A case report is presented with a 10 year follow-up, proving the technique's stability in the long term.

MAXILLARY GROWTH PATTERNS IN ROMANIAN CHILDREN WITH CLEFT PALATE DURING THE FIRST 6 YEARS OF LIFE

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Liliana-Gabriela Halitchi

2012-12-01

Full Text Available In order to visualize, evaluate and measure the maxillary growth in patients with cleft palate and to identify the reactive morphological pattern that could be identified from the dimensional changes produced along the first six years of life, maxillary impressions were made in two groups of study, by means of standard trays and silicone impression materials. The maxillary casts resulted had been 3D scanned at Multinr, in Sf. Gheorghe. The study was carried on a number of 34 patients with cleft palate, 16 boys and 18 girls, with ages between 2 months and 6 years, operated by the same surgical team in “St. Mary” University Children Hospital of Iaşi, as well as on 60 normal children. Bivariate Student’s t test established statistically significant negative differences between the mean values of the anterior and posterior width of the maxillary alveolar arch, positive non significant differences for the length and positive differences for the depth of the dehiscent palate in the experimental group, comparatively with normal children. Cleft palate patients have narrowed and shorter maxillary alveolar arch and flattened palate. At least therapeutically, the cleft palate group, operated at different ages, from 2 to 4 years, could not react like other groups of study from important European Cleft Centers and benefit from a good residual growth.

Preoperative Cleft Lip Measurements and Maxillary Growth in Patients With Unilateral Cleft Lip and Palate.

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Antonarakis, Gregory S; Tompson, Bryan D; Fisher, David M

2016-11-01

Maxillary growth in patients with cleft lip and palate is highly variable. The authors' aim was to investigate associations between preoperative cleft lip measurements and maxillary growth determined cephalometrically in patients with complete unilateral cleft lip and palate (cUCLP). Retrospective cross-sectional study. Children with cUCLP. Preoperative cleft lip measurements were made at the time of primary cheiloplasty and available for each patient. Maxillary growth was evaluated on lateral cephalometric radiographs taken prior to any orthodontic treatment and alveolar bone grafting (8.5 ± 0.7 years). The presence of associations between preoperative cleft lip measurements and cephalometric measures of maxillary growth was determined using regression analyses. In the 58 patients included in the study, the cleft lateral lip element was deficient in height in 90% and in transverse width in 81% of patients. There was an inverse correlation between cleft lateral lip height and transverse width with a β coefficient of -0.382 (P = .003). Patients with a more deficient cleft lateral lip height displayed a shorter maxillary length (β coefficient = 0.336; P = .010), a less protruded maxilla (β coefficient = .334; P = .008), and a shorter anterior maxillary height (β coefficient = 0.306; P = .020) than those with a less deficient cleft lateral lip height. Patients with cUCLP present with varying degrees of lateral lip hypoplasia. Preoperative measures of lateral lip deficiency are related to later observed deficiencies of maxillary length, protrusion, and height.

The value of the Gothic arch tracing in the positioning of denture teeth.

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el-Gheriani, A S; Winstanley, R B

1988-07-01

Twenty-five subjects of three nationalities carried out Gothic arch tracings. Measurements between the side arms were compared with the upper intercuspid distances measured in the same subjects. A relationship was found which may be of value in the setting up of anterior maxillary denture teeth.

Periodontal and dental effects of surgically assisted rapid maxillary expansion, assessed by using digital study models

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Siqueira, Danilo Furquim; Cardoso, Mauricio de Almeida; Capelozza, Leopoldino; Goldenberg, Dov Charles; Fernandes, Mariana dos Santos

2015-01-01

OBJECTIVE: The present study assessed the maxillary dental arch changes produced by surgically assisted rapid maxillary expansion (SARME). METHODS: Dental casts from 18 patients (mean age of 23.3 years) were obtained at treatment onset (T1), three months after SARME (T2) and 6 months after expansion (T3). The casts were scanned in a 3D scanner (D-250, 3Shape, Copenhagen, Denmark). Maxillary dental arch width, dental crown tipping and height were measured and assessed by ANOVA and Tukey's test. RESULTS: Increased transversal widths from T1 and T2 and the maintenance of these values from T2 and T3 were observed. Buccal teeth tipping also showed statistically significant differences, with an increase in all teeth from T1 to T2 and a decrease from T2 to T3. No statistically significant difference was found for dental crown height, except for left first and second molars, although clinically irrelevant. CONCLUSION: SARME proved to be an effective and stable procedure, with minimum periodontal hazards. PMID:26154457

Maxillary implant-retained partial overdenture with Dolder bar attachment: a clinical report.

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Kim, Hyeongil; Buhite, Robert J; Monaco, Edward A

2015-03-01

This article describes a technique for maintaining a maxillary Kennedy III partial removable dental prosthesis design in a patient who had non-restorable failing abutments by replacing the abutments with dental implants. Two implants were placed immediately after extraction of the abutment teeth in the anterior maxilla. After the implants were fully integrated, a Dolder bar attachment was fitted onto the implants. A new maxillary partial removable dental prosthesis was fabricated using the implants and the remaining natural teeth as abutments to restore function and esthetics. With the aid of dental implants, this Kennedy III maxillary removable dental prosthesis design could provide additional retention and support by promoting cross-arch stability and tissue, implant and tooth support. The patient's satisfaction was significantly increased.

A 2D panoramic surgical stent imaging: Complete arch mandibular implant fixed prosthesis along with bar supported maxillary over denture

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Mukesh Kumar Singhal

2017-01-01

Full Text Available Successful rehabilitation of a patient should restore function, esthetic, and speech by prosthesis. Treatment modalities vary from patient to patient. Semi-precision attachments and implants offer several advantages over the traditional approach. The aim and objective of this report was to assess a case of a 55-year-old female patient who had lost all her teeth, except maxillary canines #13 and #23 and with severe bone loss in the mandible. Tooth-supported bar attachment was planned for maxilla, and a total of five dental implants were placed in the mandible using a flapless approach aided by radiographic gutta-percha surgical stents over panoramic two-dimensional imaging. Customized, radiographic stents help for the placement of implant in the view of paralleling and flapless surgery, completely. An immediate loading protocol is adopted as from day of the surgery to 6 weeks along with implant supported full arch fixed dentures after 4 months. The outcome of the treatment was impressive, and the patient gave a positive response with superb esthetics and functions.

Position and Eruption of Permanent Maxillary Canines in Cases of Maxillary Lateral Incisor Agenesis in Mixed Dentition.

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Lamas, Cátia; Lavall, Asela; Pinho, Teresa

2018-01-01

Assess whether the permanent maxillary canine (MC) has a natural tendency to erupt mesially in children with maxillary lateral incisors agenesis (MLIA), compared to children without agenesis. This retrospective, observational, cross-sectional study consisted of children between 5 and 12 years old divided into three groups: the first group with unilateral MLIA, in which an intraindividual analysis was performed, the second group presented bilateral MLIA, and the third group with patients without agenesis. These last two groups were matched for comparison interindividual, being pared by sex and maturation of the MC. The canine position in the horizontal sector showed a clear mesial positioning of the MC on the agenesis side in individuals with unilateral MLIA (group 1) when compared with the counter lateral side; and in individuals with bilateral MLIA (Group 2) compared with control Individuals without agenesis (group 3). Even with the maintenance of this deciduous tooth in the dental arch, the MC keeps its tendency to mesial eruption. There is a greater tendency for mesial angulation of the maxillary canine in patients with MLIA, regardless of the presence or absence of deciduous lateral incisor.

Unilateral maxillary molar distalization with zygoma-gear appliance.

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Kilkis, Dogan; Bayram, Mehmet; Celikoglu, Mevlut; Nur, Metin

2012-08-01

The aim of this study was to present the orthodontic treatment of a 15-year-old boy with a unilateral maxillary molar distalization system, called the zygoma-gear appliance. It consisted of a zygomatic anchorage miniplate, an inner bow, and a Sentalloy closed coil spring (GAC International, Bohemia, NY). A distalizing force of 350 g was used during the distalization period. The unilateral Class II malocclusion was corrected in 5 months with the zygoma-gear appliance. The maxillary left first molar showed distalization of 4 mm with an inclination of 3°. The maxillary premolars moved distally with the help of the transseptal fibers. In addition, there were slight decreases in overjet (-0.5 mm) and maxillary incisor inclination (-1°), indicating no anchorage loss from the zygoma-gear appliance. Preadjusted fixed appliances (0.022 × 0.028-in, MBT system; 3M Unitek, Monrovia, Calif) were placed in both arches to achieve leveling and alignment. After 14 months of unilateral distalization with the zygoma-gear appliance and fixed appliances, Class I molar and canine relationships were established with satisfactory interdigitation of the posterior teeth. Acceptable overjet and overbite were also achieved. This article shows that this new system, the zygoma-gear appliance, can be used for unilateral maxillary molar distalization without anchorage loss. Copyright © 2012 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Effects of early and late cheiloplasty on anterior part of maxillary dental arch development in infants with unilateral complete cleft lip and palate

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Silvia Valentová-Strenáčiková

2016-02-01

Full Text Available Objectives. The objective of this study is to compare the impact of early and late reconstruction of complete unilateral cleft lip and palate on the growth and development of the front of the dentoalveolar arch. Methods. This study was carried out in the years 2012–2015 at the Clinic of Plastic, Reconstructive and Aesthetic Surgery in Banska Bystrica. Infants with unilateral complete cleft lip and palate were divided into 2 groups according to the timing of lip reconstruction. Group A consisted of infants with early lip reconstruction–realised in the first 14 days of life. Group B consisted of infants with later lip reconstruction–realised in the third month of age. Maxillary dental casts were obtained for each child in four periods–in the first 14 days of life, in the third month, in the sixth month and in the age of one year. These were followed by the identification, measurement and evaluation of anthropometric parameters. Results. Significant differences were occurred after the reconstruction of the lips in linear and angle measurements between infants in the A and B groups. Conclusion. The early surgical reconstruction of the lips in the first 14 days of life has a positive effect on the growth and development of the anterior segment of the dentoalveolar arch. Early lip reconstruction forms a continuous pressure on the frontal segment, resulting in the earlier remedy of anatomical properties and creates appropriate conditions for the best development of this area.

Segmental maxillary distraction with a novel device for closure of a wide alveolar cleft.

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Bousdras, Vasilios A; Liyanage, Chandra; Mars, Michael; Ayliffe, Peter R

2014-01-01

Treatment of a wide alveolar cleft with initial application of segmental distraction osteogenesis is reported, in order to minimise cleft size prior to secondary alveolar bone grafting. The lesser maxillary segment was mobilised with osteotomy at Le Fort I level and, a novel distractor, facilitated horizontal movement of the dental/alveolar segment along the curvature of the maxillary dental arch. Following a latency period of 4 days distraction was applied for 7 days at a rate of 0.5 mm twice daily. Radiographic, ultrasonographic and clinical assessment revealed new bone and soft tissue formation 8 weeks after completion of the distraction phase. Overall the maxillary segment did move minimising the width of the cleft, which allowed successful closure with a secondary alveolar bone graft.

Role of Cone Beam Computed Tomography in Rehabilitation of a Traumatised Deficient Maxillary Alveolar Ridge Using Symphyseal Block Graft Placement

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Shipra Arora

2013-01-01

Full Text Available Deficiencies in the alveolar ridges cause multiple problems in achieving aesthetic and functional outcome of implant therapy and are commonly restored by using onlay graft from intraoral source. Careful assessment of the recipient as well as the donor site using cone beam computed tomography (CBCT is a prerequisite to ideal treatment planning. This paper highlights the critical role of CBCT in planning a successful rehabilitation of traumatised deficient anterior maxillary alveolar ridge using autogenous block graft from mandibular symphysis, followed by implant placement. A 21-year-old male reported with missing right maxillary lateral incisor due to traumatic avulsion 6 months back. A concavity was found on the labial aspect of edentulous area. Serial transplanar images on CBCT revealed gross irregular radiolucency in place of labial cortical plate. Using CBCT, size of the required block was estimated, and mandibular symphyseal area was evaluated for the feasibility of harvesting a graft of suitable dimension. Onlay block graft was harvested from mandibular symphysis and placed at the edentulous site to augment the alveolar ridge. Implants were placed 5 months later and loaded successfully after osseointegration. After 1 year of followup, implant-based prosthesis is working well, without any complications.

Modified hyrax splint for rapid maxillary expansion in esthetically concerned patients

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Sarabjeet Singh Sandhu

2015-01-01

Full Text Available The orthodontic treatment of Class III malocclusion with a maxillary deficiency is often treated with maxillary protraction either with or without maxillary expansion. The routine procedure for rapid maxillary expansion includes banding on first premolars/first deciduous molars and the permanent first molars. However in some patients who are esthetically very conscious, banding of the first premolar would not be a good esthetic option. So for such circumstances we have designed a modified hyrax splint, which does not need the first premolars to be banded.

Evaluation of sexual dimorphism using permanent maxillary first molar in Sri Ganganagar population

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Sakshi Mehta

2017-01-01

Full Text Available Aim of Study: The aim is to evaluate existence of sexual dimorphism by variation in right and left permanent maxillary molars using buccolingual width (BLW and mesio-distal width (MDW measured intraorally and on study casts among Sri Ganganagar population. Materials and Methods: Fifty patients (25 males and 25 females with 17–25 years of age were selected. Impressions of maxillary arch were taken and the BLW and MDW were measured using digital Vernier calipers on study casts and intraorally. Results: Highly significant correlation was found between MDW and BLW of both the maxillary permanent first molars for both genders (P < 0.05 intraorally. The MDW and BLW on study cast of both sides in both gender were more on left side in males while on right side in females. Conclusion: Left maxillary permanent first molar showed minimum mean difference of measurements on study cast and introrally than right, thus better predictor for gender dimorphism in forensics.

A simple approach to hollow maxillary complete denture fabrication: An innovative technique

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Kathleen Manuela D'souza

2017-01-01

Full Text Available A severely atrophic maxillary arch exhibits reduced denture bearing area and increased inter-ridge distance, thus, affecting retention of the complete denture. Such clinical situations necessitate the fabrication of a hollow complete denture to reduce the weight of the prosthesis and increase retention. This article describes a simple technique to fabricate a hollow maxillary complete denture using salt and thermoplastic poly (methyl methacrylate sheet. The vacuum-formed thermoplastic matrix regulates the quantity of salt and determines its placement in the unpolymerized denture base material during the denture packing stage. The matrix lining the hollow cavity also aids to reinforce the hollow denture base.

Effect of rapid maxillary expansion and transpalatal arch treatment associated with deciduous canine extraction on the eruption of palatally displaced canines: A 2-center prospective study.

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Sigler, Lauren M; Baccetti, Tiziano; McNamara, James A

2011-03-01

Our aim was to investigate the effect of rapid maxillary expansion and transpalatal arch therapy combined with deciduous canine extraction on the eruption rate of palatally displaced canines (PDCs) in patients in the late mixed dentition in a 2-center prospective study. Seventy subjects were enrolled based on PDCs diagnosed on panoramic radiographs. The treatment group (TG, 40 subjects) underwent RME followed by TPA therapy and extraction of the deciduous canines. The control group (CG, 30 subjects) received no orthodontic treatment. At the start of the trial, panoramic radiographs and dental casts were compared between the TG and the CG with the Mann-Whitney U test (P anomalies was reported. No statistically significant difference was found for any measurement at the start of the trial between the 2 groups. The prevalence rates of eruption of the maxillary canines were 80% for the TG and 28% in the CG, a statistically significant difference (chi-square =16.26, P mixed dentition with PDCs. Pretreatment variables indicating success of treatment on the eruption of PDCs were less severe sectors of displacement, prepubertal stages of skeletal maturity, and open root apices of PDCs. Several dental anomalies were associated significantly with PDCs, thus confirming the genetic etiology of this eruption disturbance. Copyright © 2011 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Impacted maxillary central incisor: surgical exposure and orthodontic treatment.

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Pinho, Teresa; Neves, Manuel; Alves, Célia

2011-08-01

This case report describes the treatment of a patient with a horizontally impacted maxillary central incisor, a canine in the same quadrant, and an inclusion tendency. Due to severe crowing in the maxilla and the Class II molar relationship on the impaction side, a 2-stage treatment plan was developed. In the first stage, the right first premolar and deciduous canine were extracted; this allowed enough space for the eruption of the maxillary right permanent canine. The second stage included surgical exposure and traction of the impacted central incisor with a fixed orthodontic appliance. An excisional uncovering technique was needed to expose the impacted incisor. After it erupted, an apically positioned partial-thickness flap was used to add keratinized attached gingiva in the area surrounding the crown, initially located in an area of unattached gingiva. The patient finished treatment with a normal and stable occlusion between the maxillary and mandibular arches and an adequate width of attached gingiva. Copyright © 2011 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Use of the bioactive resorbable plate system for zygoma and zygomatic arch replacement and fixation with modified Crockett's method for maxillectomy: A technical note.

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Sukegawa, Shintaro; Kanno, Takahiro; Shibata, Akane; Matsumoto, Kenichi; Sukegawa-Takahashi, Yuka; Sakaida, Kyousuke; Furuki, Yoshihiko

2017-07-01

As a surgical approach targeting the pterygopalatine fossa following maxillary cancer due to tumor invasion, Crockett's method is conventional and useful. However, if the tumor is confined to the area between the maxilla and pterygopalatine fossa, it is not necessary to include the zygomatico-orbital in the access osteotomy, and the orbital floor may be preserved. Depending on the range of tumor invasion, the current study reports a more minimally invasive, modified Crockett's surgery that may be considered, which includes resection with modified osteotomy lines and repositioning with fixation of the zygoma and zygomatic arch following maxillary cancer ablation. In addition, the majority of patients with advanced maxillary cancer may require postoperative radiotherapy or chemoradiotherapy following maxillectomy according to several guidelines. Therefore, using a low-profile bioactive resorbable plate system as a method of repositioning and fixing the resected and preserved zygoma and zygomatic arch may be more effective in this modified Crockett's method for maxillectomy.

Stress and displacement patterns in the craniofacial skeleton with rapid maxillary expansion—a finite element method study

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J. Priyadarshini

2017-07-01

Full Text Available Abstract Background Rapid maxillary expansion (RME, indicated in the treatment of maxillary deficiency directs high forces to maxillary basal bone and to other adjacent skeletal bones. The aim of this study is to (i evaluate stress distribution along craniofacial sutures and (ii study the displacement of various craniofacial structures with rapid maxillary expansion therapy by using a Finite Element model. Methods An analytical model was developed from a dried human skull of a 12 year old male. CT scan images of the skull were taken in axial direction parallel to the F-H plane at 1 mm interval, processed using Mimics software, required portion of the skull was exported into stereo-lithography model. ANSYS software was used to solve the mathematical equation. Contour plots of the displacement and stresses were obtained from the results of the analysis performed. Results At Node 47005, maximum X-displacement was 5.073 mm corresponding to the incisal edge of the upper central incisor. At Node 3971, maximum negative Y-displacement was -0.86 mm which corresponds to the anterior zygomatic arch, indicating posterior movement of craniofacial complex. At Node 32324, maximum negative Z-displacement was -0.92 mm representing the anterior and deepest convex portion of the nasal septum; indicating downward displacement of structures medial to the area of force application. Conclusions Pyramidal displacement of maxilla was evident. Apex of pyramid faced the nasal bone and base was located on the oral side. Posterosuperior part of nasal cavity moved minimally in lateral direction and width of nasal cavity at the floor of the nose increased, there was downward and forward movement of maxilla with a tendency toward posterior rotation. Maximum von Mises stresses were found along midpalatal, pterygomaxillary, nasomaxillary and frontomaxillary sutures.

Evaluation of stress patterns on maxillary posterior segment when intruded with mini implant anchorage: A three-dimensional finite element study

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Nikhita Pekhale

2016-01-01

Full Text Available Introduction: The aim of this study is to evaluate stress and displacement effects of maxillary posterior intrusion mechanics with mini-implant anchorage by using finite element method. Materials and Methods: A computer stimulation of three-dimensional model maxilla with all teeth, PDL, bone, mini-implants, brackets, arch wire, force element, and transpalatal arch was constructed on the basis of average anatomic morphology. Finite element analysis was done to evaluate the amount of stress and its distribution during orthodontic intrusive force. Results: Increased Von Mises stress values were observed in mesio-cervical region of first molar. The middle third of second premolar and second molar and regions adjacent to force application sites also showed relatively high stress values. Minimum stress values were observed in apical region of first premolar as it is away from force application. Conclusion: Using three mini-implant and transpalatal arches, this study demonstrates that significant amount of true intrusion of maxillary molars could be obtained with lesser concentration of stresses in the apical area recorded.

[Trauma induced left maxillary sinus dislocation of eyeball--a case report].

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Chen, Yu; Liu, Cuiping; Cui, Liping

2013-01-01

Patient male, 27 year old. Left facial and head trauma for 6 hours, due to motor vehicle accident. Patient state of mind was clear at arrival to hospital. Body temperature: 36C; Pulse: 80 Time/Minute; Breath: 20 Time/Minute; Blood pressure: 120/80 mm Hg. An irregular, horizontal laceration at arch of left eyebrow, approximately 8-10 cm. A laceration on left wing of nose skin, approximately 1 cm. A laceration also under lower eyelid skin of right eye, approximately 2 cm. Left blepharedema and enophthalmos. Orbital and nasal sinuses CT indications:contusion and laceration of the left frontal lobe of brain; fracture of the left orbital frontal, ethmoid, sphenoid bone, left nasal, maxillary sinus and zygoma with soft tissue contusion and laceration; the left eyeball and optic nerve sunk into the maxillary sinus (See figure 1). (1) Multiple orbital fractures; (2) Left maxillary sinus dislocation of eyeball; (3) The left frontal lobe contusion and laceration of brain.

Maxillary distraction complications in cleft patients.

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Jeblaoui, Y; Morand, B; Brix, M; Lebeau, J; Bettega, G

2010-06-01

Cleft lip and palate (CLP) patients often present with a class III malocclusion in connection with a three dimensional maxillary hypoplasia. Twenty-five to 60% of these patients need maxillary advancement. Two solutions are possible: orthognathic surgery and maxillary distraction. The purpose of this study was to evaluate the complications of maxillary distraction in CLP patients. Data was collected from the records of patients treated in our surgery unit between 2000 and 2007. Among the eight patients (four male and four female), five presented with a bilateral CLP, two with a unilateral CLP, and one with a unilateral cleft lip associated to a soft palate cleft. The average age at surgery was 17 years. All underwent a Le Fort I osteotomy with a pterygomaxillary disjunction. An external distractor was used for the first two patients and an internal distractor for the six following patients. After a seven-day latency, activation was implemented at a rate of 1mm twice a day. The average period of consolidation was four months. Maxillary advancement ranged between 7 and 19mm, with an average of 12.6mm. The average follow-up was four years. Complications were noted in seven patients: one intra-operative hemorrhage, one avulsion of a tooth anchored at the pterygoid process during osteotomy, three cases of device dysfunction, two cases of significant pain during activation, one loosening of the orthodontic arch in an external system, two cases of labial ulceration, and one maxillary sinusitis due to migration of a wisdom tooth. Complications of maxillary distraction in CLP patients were very frequent. Most were related to the device and did not interfere with the final result. This must be taken into account when indicating distraction and choosing the device. Two types of complications can occur during distraction: those related to the osteotomy and those related to the device. The complications related to the osteotomy are linked to the cicatricial ground of previous

Impact of rapid maxillary expansion on nasomaxillary complex volume in mouth-breathers

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Mario Cappellette Jr.

Full Text Available ABSTRACT Objective: To assess the volumetric changes that occur in the nasomaxillary complex of mouth-breathing patients with transverse maxillary deficiency subjected to rapid maxillary expansion (RME. Methods: This was a controlled, prospective intervention study involving 38 mouth-breathing patients presenting with transverse maxillary deficiency, regardless of malocclusion type or race. Twenty-three of them comprised the experimental group, which was composed of 11 (47.8% boys, and 12 (52.2% girls, with a mean age of 9.6 years, ranging from 6.4 to 14.2 years and standard deviation of 2.3 years; and 15 of them comprised the control group, composed of 9 (60% boys and 6 (40% girls with an mean age of 10.5 years, ranging from 8.0 to 13.6 years, and standard deviation of 1.9 years. All patients were scanned (CT according to a standard protocol: Initial CT (T1, and CT three months thereafter (T2, and the patients in the experimental group were treated with RME using a Hyrax expander for the correction of maxillary deficiency during the T1-T2 interval. The CT scans were manipulated using Dolphin® Imaging version 11.7 software for total and partial volumetric assessment of the nasomaxillary complex. Results: The results revealed that in the experimental group there was a significant increase in the size of the structures of interest compared to the control group, both in general aspect and in specific regions. Conclusions: Rapid maxillary expansion (RME provided a significant expansion in all the structures of the nasomaxillary complex (nasal cavity, oropharynx, right and left maxillary sinuses.

Orthodontic tooth movement after extraction of previously autotransplanted maxillary canines and ridge augmentation.

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Collett, A R; Fletcher, B

2000-12-01

A case report is detailed in which autotransplanted maxillary canines were removed and the spaces closed. Substantial surrounding bone loss was associated with the upper right canine, and a bone graft was needed to reestablish normal dentoalveolar ridge morphology. Bone was taken from the maxillary tuberosity and placed in the canine extraction site, fixed with a bone screw, and covered with GoreTex. Seven months after placement of the bone graft, the GoreTex and stabilizing screw were removed to allow for consolidation of the bone. The upper left canine and lower second premolars were extracted, and fixed appliances were placed in both arches to align the teeth and close the spaces. Protraction of the upper right first premolar and retraction of the lateral incisor into the graft site were kept slow and constant with continued periodontal assessment. During the space closure, there was some concern that the bone in the graft site might resorb, leaving the teeth with compromised periodontal support. However, no significant periodontal attachment loss occurred despite ongoing concern about the amount of keratinized tissue. Perhaps the relatively slow rate of tooth movement provided for bone to be maintained and recreated ahead of the tooth. Almost complete closure of the upper canine extraction spaces was achieved. The upper premolars were substituted for the maxillary canines, and unfavorable prosthetic options were thus avoided. The lower arch was aligned, and the extraction spaces completely closed.

Evaluation of arch width variations among different skeletal patterns in South Indian population.

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Prasad, Mandava; Kannampallil, Senny Thomas; Talapaneni, Ashok Kumar; George, Suja Ani; Shetty, Sharath Kumar

2013-01-01

Anterior cranial base can be taken as a reference line (SN) to determine the steepness of mandibular plane. Subjects with high mandibular plane angle tend to have a long face and one with low MP-SN angle has a shorter face. This study was done to investigate if dental arch widths correlated with vertical facial types and if there are any differences in arch widths between untreated male and female adults in South Indian population. Lateral cephalogram and dental casts were obtained from 180 untreated South Indian adults (90 males and 90 females) above 18 year old with no cross bite, minimal crowding and spacing. The angle between the anterior cranial base and the mandibular plane was measured on lateral cephalogram of each patient. Dental casts were used to obtain comprehensive dental measurements including maxillary and mandibular inter canine, inter premolar and inter molar widths, as well as amount of crowding or spacing. The results showed that male arch widths were significantly larger than those of females (P population. The results obtained in our study when compared with studies done in other population groups showed that there is difference in inter arch widths according to ethnicity and race. It was concluded that the dental arch width is associated with gender, race and vertical facial morphology. Thus using individualized arch wires according to each patient's pre treatment arch form and width is suggested during orthodontic treatment.

Indian Board of Orthodontics case report: Orthodontic management of a Class II malocclusion in a growing patient with bilateral maxillary molar distalization

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Salil Sunil Nene

2016-01-01

Full Text Available C.S., a 12-year, 1-month-old male patient, presented with the chief complaint of highly placed canines and irregular teeth. On examination and analysis of relevant records, he was diagnosed as an Angle's Class II malocclusion on an underlying Class I skeletal base, severely crowded maxillary arch with high labially placed canines, mild crowding in mandibular arch, retroclined lower incisors, an impacted mesiodens with convex profile, and acute nasolabial angle. He was treated with a nonextraction treatment plan that involved bilateral maxillary molar distalization using Hilgers pendulum appliance followed by fixed mechanotherapy. The posttreatment results were highly satisfactory showing improvement in facial esthetics and occlusal traits as well as good long-term stability as was evident in the 2-year, 6-month retention photographs.

Comparative study of different osteotomy modalities in maxillary distraction osteogenesis for cleft lip and palate.

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Yu, Hongbo; Wang, Xudong; Fang, Bing; Shen, Steve Guofang

2012-11-01

Conventional maxillary distraction osteogenesis and anterior maxillary segmental distraction were applied in the treatment of severe maxillary hypoplasia secondary to cleft clip and palate. The aim of the present study was to compare the difference between these 2 osteotomy modalities used for rigid external distraction. Ten patients with severe maxillary hypoplasia secondary to CLP were enrolled in our study. They were randomly divided into 2 groups. Conventional maxillary distraction osteogenesis was performed in 5 patients and anterior maxillary segmental distraction in 5 patients. The preoperative and postoperative lateral cephalograms were compared, and cephalometric analysis was performed. The independent sample t test was used to evaluate the differences between the 2 groups. All patients healed uneventfully, and the maxillae moved forward satisfactorily. The sella-nasion-point A angles, nasion-point A-Frankfort horizontal plane angles, overjets, and 0-meridian to subnasale distances had increased significantly after distraction osteogenesis. Significant differences were found in the changes in palatal length between the 2 groups (P maxillary segmental distraction group. No significant difference in the changes in palatopharyngeal depth or soft palatal length was found. With the ability of increasing the palatal and arch length, avoiding changes in palatopharyngeal depth, and preserving palatopharyngeal closure function, anterior maxillary segmental distraction has great value in the treatment of maxillary hypoplasia secondary to CLP. It is a promising and valuable technique in this potentially complicated procedure. Copyright © 2012 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Comparison of short-term effects between face mask and skeletal anchorage therapy with intermaxillary elastics in patients with maxillary retrognathia.

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Ağlarcı, Cahide; Esenlik, Elçin; Fındık, Yavuz

2016-06-01

The aim of this study was to compare the short-term dental and skeletal effects of a face mask (FM) with those of skeletal anchorage (SA) therapy with intermaxillary elastics in prepubertal patients with skeletal Class III malocclusion. Fifty patients with skeletal Class III malocclusion and maxillary deficiency were divided into two groups. In the FM group, an FM was applied by a bite plate with a force of 400g for each side. In the SA group, mini-plates were placed between mandibular lateral incisors and canines, and mini-implants were inserted between maxillary second premolars and first molars. A bite plate was inserted into the upper arch, and Class III elastics were applied with a force of 200g between each mini-plate and mini-implant. Mean treatment durations were 0.52±0.09 years for FM and 0.76±0.09 years for SA. After the treatment, statistically significant increases in SNA°, ANB°, A-y, 1-NA, SnGoGn°, Co-A, Co-Gn, and A-Nperp, and reductions in SNB° and FH┴N-Pg were observed in both groups, and these changes were similar in both groups. In the FM group, 1-NB decreased significantly, and in the SA group, it increased significantly (P journals.permissions@oup.com.

Assessment of the rate of premolar extraction space closure in the maxillary arch with the AcceleDent Aura appliance vs no appliance in adolescents: A single-blind randomized clinical trial.

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Miles, Peter; Fisher, Elizabeth; Pandis, Nikolaos

2018-01-01

The purpose of this 2-arm parallel trial was to assess the effect of the AcceleDent Aura appliance (OrthoAccel Technologies, Houston, Tex) on the rate of maxillary premolar extraction space closure in adolescent patients. Forty Class II adolescents treated with full fixed appliances and maxillary premolar extractions participated in this randomized clinical trial. They were recruited in a private practice and treated by 1 clinician. Randomization was accomplished in blocks of 10 patients assigned to either a no-appliance group or the AcceleDent Aura appliance group with the allocations concealed in opaque, sealed envelopes. Both the operator and the outcome assessor were blinded; however, it was not feasible to blind the patients. Models were taken of the maxillary arch at the start of space closure and just before complete space closure. The space was measured parallel to the occlusal plane from the cusp tips of the teeth mesial and distal to the extraction spaces. There was no clinically (0.05 mm per month; 95% confidence interval [CI], -0.24, 0.34) or statistically significant difference in the rate of space closure (P = 0.74). In both the univariable and multivariable analyses, the mean rate of tooth movement was slower by 0.13 mm per month (95% CI, -.26, .005) on the left side compared with the right side, but this was not statistically significant (P = 0.06). The AcceleDent Aura appliance had no effect on the rate of maxillary premolar extraction space closure. Only a few participants were considered to be good compliers with the appliance. However, the rate of space closure in the good compliers was similar to the overall group and did not appear to influence the result. This trial was not registered. The protocol was not published before trial commencement. Copyright © 2017 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

ArchE - An Architecture Design Assistant

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2007-08-02

Architecture Design Assistant Len Bass August 2, 2007 Report Documentation Page Form ApprovedOMB No. 0704-0188 Public reporting burden for the...ArchE - An Architecture Design Assistant 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e. TASK...X, Module X 3 Author / Presenter, Date if Needed What is ArchE? ArchE is a software architecture design assistant, which: • Takes quality and

Effects of Asthma and Inhalation corticosteroids on the dental arch morphology in children

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S S Kumar

2012-01-01

Full Text Available Background: Hereditary, environmental and developmental factors play an important role in dentofacial development, as well as the initiation of malocclusion disorder. Allergic phenomenon such as asthma that induces an alternative mode of breathing in patients is a contributing factor in development of the dental arch. Aim: Our aim in this study was to evaluate the dentoalveolar morphology in asthmatic children and to analyze the effects of asthmatic medications on the dental arch. Setting and Design : This study is centered on 44 asthmatic children aged between 6-12 years from J.S.S Hospital, Mysore. Selected variables from model analysis of the casts of the asthmatic group were subjected to comparison with those of the non-asthmatic group, which comprised of 44 non-asthmatic children. Selected parameters were arch width, arch length and palatal depth. Materials and Methods : Impressions of upper and lower arches were made with rubber based impression material. A sliding digital caliper was used to measure the casts for arch width and arch length. A palatal depth gauge was used to measure the palatal depth. Statistical Analysis : Differences in arch widths, arch lengths and palatal depths between asthmatics and non-asthmatics groups were evaluated by independent sample t-tests. Chi-square test was applied to assess the frequency of occurrence of malocclusion in the asthmatic children. Result: The results obtained revealed that the arch length and palatal depth of asthmatic group had higher values compared to that of non-asthmatic groups for both age groups (6 to 8-year-old males and females, 10 to 12-year-old males and females. Inter molar width showed a significant lower value in asthmatics in the maxillary arches of 10 to 12-year-old females. Fifty percent of the asthmatic children aged 10 to 12-years had open-bite. Children under regular medication showed significant deviation in the dentoalveolar morphology as compared to those under

Observation of horizontal mandibular positions in an edentulous patient using a digital gothic arch tracer: a clinical report.

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Watanabe, Yoshiyuki

2004-01-01

Dentures were fabricated for a 73-year-old woman using porcelain 20-degree maxillary posterior teeth and acrylic resin flat planes in the mandibular posterior region. A digital gothic arch tracing device was used to observe the horizontal mandibular positions before insertion and to evaluate the therapeutic effect of the diagnostic dentures at 1 and 3 months after insertion.

Pharyngeal arch deficiencies affect taste bud development in the circumvallate papilla with aberrant glossopharyngeal nerve formation.

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Okubo, Tadashi; Takada, Shinji

2015-07-01

The pharyngeal arches (PAs) generate cranial organs including the tongue. The taste placodes, formed in particular locations on the embryonic tongue surface, differentiate into taste buds harbored in distinct gustatory papillae. The developing tongue also has a complex supply of cranial nerves through each PA. However, the relationship between the PAs and taste bud development is not fully understood. Ripply3 homozygous mutant mice, which have impaired third/fourth PAs, display a hypoplastic circumvallate papilla and lack taste buds, although the taste placode is normally formed. Formation of the glossopharyngeal ganglia is defective and innervation toward the posterior tongue is completely missing in Ripply3 mutant embryos at E12.5. Moreover, the distribution of neuroblasts derived from the epibranchial placode is severely, but not completely, atenuated, and the neural crest cells are diminished in the third PA region of Ripply3 mutant embryos at E9.5-E10.5. In Tbx1 homozygous mutant embryos, which exhibit another type of deficiency in PA development, the hypoplastic circumvallate papilla is observed along with abnormal formation of the glossopharyngeal ganglia and severely impaired innervation. PA deficiencies affect multiple aspects of taste bud development, including formation of the cranial ganglia and innervation to the posterior tongue. © 2015 Wiley Periodicals, Inc.

Changes in root lengths of maxillary incisors during orthodontic retention period

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Ravanmehr H

2006-01-01

Full Text Available Background and Aim: External apical root resorption is a common iatrogenic consequence of orthodontic treatment. Much controversy exists in the literature about changes in root lengths at post treatment periods. Although many practitioners believe that resorption becomes stable after active treatment, quantitative data are scarce. The purpose of this study was to determine quantitative changes in root lengths of maxillary incisors during fixed orthodontic post treatment period, and to assess if it is influenced by gender and factors related to active treatment. Materials and Methods: This was a case cross over study, performed on 80 patients (52 females and 28 males aged between 13 and 22 years. At debonding stage and beginning of retention phase of fixed orthodontic treatment, Hawley type retainer was fabricated for maxillary arch. Periapical radiographs of maxillary incisors using standard parallel technique were obtained immediately after debonding, and 3 and 7 months later. Crown and root lengths of maxillary incisors were measured using computer program. Changes in root lengths were calculated considering correction factors. Also associations between some factors and the change in root lengths during post treatment periods were assessed. These included gender, type of treatment plan (non extraction/extraction, technique (standard edgewise/straight-wire edgewise and duration of active treatment (less than 2 years/2 years and more. T-test and 4-way ANOVA were used for statistical analysis with P0.05 as the limit of significance. Results: No significant relation was found between apical root resorption of maxillary central incisors and time elapsed after treatment. Significant relation was observed between apical root resorption of maxillary lateral incisors and the length of post treatment period. No significant relation was found between root length changes of maxillary incisors during post treatment period and gender, type of treatment

[Autotransplantation of a maxillary incisor and orthodontic care: a case study].

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Charpentier, Valentine; Makaremi, Masrour; Brondeau, François de

2017-12-01

Severely impacted teeth with atypical root anatomy do not respond well to orthodontic traction after surgical exposure. Consequently, they are often removed, but replacing them with dental prostheses can prove difficult in patients who are still growing. Thus, autotransplantation seems to be the only way to preserve a natural tooth and the alveolar bone. An upper central incisor impacted in the region of the nasal cavities with an open apex was diagnosed in an 8.5-year-old female patient. The tooth displayed a curved root pressed against the maxillary cortical bone preventing orthodontic traction treatment. Through this clinical case involving autotransplantation of a maxillary incisor report and a review of the literature, this article explores the indications and exposes the different stages of this orthodontic-surgical protocol. In this case, autotransplantation enabled restoration of maxillary arch continuity. After two years of orthodontic treatment, the bone reconstruction of the extraction site was very satisfactory. The benefits of this technique and the precautions to be taken are discussed as well as the various protocols. The increasing success rate of this surgical procedure makes it possible to consider it as a protocol for the future. © EDP Sciences, SFODF, 2017.

Crecimiento maxilar según severidad de hendidura labial, alveolar y palatina unilateral Maxillary growth according to the severity of unilateral cleft lip and palate

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M.C. Navas-Aparicio

2012-12-01

ón de crecimiento anterior del maxilar. Como conclusión, la asimetría transversal del arco maxilar fue el hallazgo más importante en este estudio. Se debe realizar un nueva investigación con respecto a la dimensión transversal del maxilar en niños con labio y paladar hendido, ya que existe una alteración de la misma. La posición anterior del maxilar y la longitud del maxilar no estuvieron influenciadas por la severidad de la hendidura. Es importante considerar que el crecimiento maxilar puede estar afectado por factores individuales, tales como el patrón facial genético. De igual manera, deberá efectuarse también un nueva medición hasta que el crecimiento de la cara haya finalizado.The inhibition of the growth and development resulting of a surgical treatment in patients with cleft lip and palate is a widely discussed topic in the world. According to literature, tissue deficiency, probably due to the cleft width and position of the alveolar segments, is a considerable variable that affects the growth of the maxilla, which is also influenced by the surgical correction of the lip, the nose and the palate by scarring, types of surgical treatment, time of the surgery, surgeon skills and pre-surgical orthopedics. The purpose of this study was to determine the possible associations between the severity of cleft and maxillary growth in patients with non-syndromic unilateral cleft lip and palate, who were born in 2001 and treated at the Hospital Nacional de Niños "Dr. Carlos Sáenz Herrera", Caja Costarricense de Seguro Social, San José, Costa Rica. The study was retrospective and descriptive, based on data obtained from medical records, initial maxillary study casts of the newborn child, cephalometric radiograph and the present study casts of the child at the age of 5 years. The study sample comprised of 13 patients. The maxillary transverse arch of 12 cases was asymmetric, indicating an alteration of growth in this direction. There is a statistically

Effective Maxillary Protraction with Tandem Traction Bow Appliance

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Pravin Kumar S Marure

2014-01-01

Full Text Available Tandem traction bow appliance (TTBA promotes patient compliance, because it is more esthetic and comfortable than extraoral appliances. TTBA should be used only in case where maxillary deficiency and normal mandible is present. Advantages of it includes good oral hygiene, early treatment of any Class III malocclusion, optimal retention, distribution of the forces for protraction to all maxillary teeth, free mandibular movement. It can be used in conjunction with fixed appliances if necessary. This paper includes two case reports. The treatment results in both the cases demonstrated significant skeletal and dental response to TTBA therapy. Skeletal change was primarily a result of anterior movement of the maxilla.

Establishment of sexual dimorphism in north indian population by odontometric study of permanent maxillary canine teeth

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Shalini Gupta

2014-01-01

Full Text Available Aim: To investigate whether sexual dimorphism can be established by odontometric study of permanent maxillary canine teeth as well as inter-canine width in north Indian population. Study Design: The study was carried out at department of oral and maxillofacial pathology, King George′s Medical University, Lucknow, India on students and patients reporting at OPD. Out of total 180 subjects examined 90 subjects were female and 90 were male. Impressions of the upper arch were made using alginate and casts poured in dental stone. The mesiodistal diameter (MD of the crown of permanent maxillary canine both on right and left sides and inter-canine width were measured. From these measurements, maxillary canine index was calculated. The percentage of sexual dimorphism (SD was assessed for all the parameters. Results: In the present study, the MD of maxillary canine for both right (P = 0.001 and left side (P = 0.005 was significantly higher among male subjects than females, Similar observation was found for inter-canine width too (P = 0.0001. However, the maxillary canine index for right and left was almost similar (P > 0.05 for both male and female subjects. The SD in right and left MDs of maxillary canine was 4.2% and 3.6% respectively. For, inter-canine width it was maximum (13.7%. However, SD in right and left canine index showed negative values (−2.1% and -0.9% respectively. Conclusion: There was SD in MD and inter-canine width of permanent maxillary canine teeth. SD was more on right permanent maxillary canine teeth than left permanent maxillary canine.

Cone-beam computed tomography evaluation of dental, skeletal, and alveolar bone changes associated with bonded rapid maxillary expansion

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Namrata Dogra

2016-01-01

Full Text Available Aims and Objectives: To evaluate skeletal changes in maxilla and its surrounding structures, changes in the maxillary dentition and maxillary alveolar bone changes produced by bonded rapid maxillary expansion (RME using cone-beam computed tomography (CBCT. Materials and Methods: The sample consisted of 10 patients (6 males and 4 females with age range 12 to 15 years treated with bonded RME. CBCT scans were performed at T1 (pretreatment and at T2 (immediately after expansion to evaluate the dental, skeletal, and alveolar bone changes. Results: RME treatment increased the overall skeletal parameters such as interorbital, zygomatic, nasal, and maxillary widths. Significant increases in buccal maxillary width was observed at first premolar, second premolar, and first molar level. There was a significant increase in arch width both on the palatal side and on the buccal side. Significant tipping of right and left maxillary first molars was seen. There were significant reductions in buccal bone plate thickness and increase in palatal bone plate thickness. Conclusions: Total expansion achieved with RME was a combination of dental, skeletal and alveolar bone changes. At the first molar level, 28.45% orthopedic, 16.03% alveolar bone bending, and 55.5% orthodontic changes were observed.

Treatment of maxillary cleft palate: Distraction osteogenesis vs. orthognathic surgery

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Rachmiel, Adi; Even-Almos, Michal; Aizenbud, Dror

2012-01-01

Purpose: The purpose of this paper is to compare the treatment of hypoplastic, retruded maxillary cleft palate using distraction osteogenesis vs. orthognathic surgery in terms of stability and relapse, growth after distraction and soft tissue profile changes. Materials and Methods: The cleft patients showed anteroposterior maxillary hypoplasia with class III malocclusion and negative overjet resulting in a concave profile according to preoperative cephalometric measurements, dental relationship, and soft tissue analysis. The patients were divided in two groups of treatment : S0 eventeen were treated by orthognathic Le Fort I osteotomy fixed with four mini plates and 2 mm screws, and 19 were treated by maxillary distraction osteogenesis with rigid extraoral devices (RED) connected after a Le Fort I osteotomy. The rate of distraction was 1 mm per day to achieve Class I occlusion with slight overcorrection and to create facial profile convexity. Following a 10 week latency period the distraction devices were removed. Results: In the RED group the maxilla was advanced an average of 15.80 mm. The occlusion changed from class III to class I. The profile of the face changed from concave to convex. At a 1-year follow up the results were stable. The mean orthognathic movement was 8.4 mm. Conclusion: In mild maxillary deficiency a one stage orthognathic surgery is preferable. However, in patients requiring moderate to large advancements with significant structural deficiencies of the maxilla or in growing patients the distraction technique is preferred. PMID:23483803

Cone-beam computed tomography evaluation of dentoskeletal changes after asymmetric rapid maxillary expansion.

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Baka, Zeliha Muge; Akin, Mehmet; Ucar, Faruk Izzet; Ileri, Zehra

2015-01-01

The aims of this study were to quantitatively evaluate the changes in arch widths and buccolingual inclinations of the posterior teeth after asymmetric rapid maxillary expansion (ARME) and to compare the measurements between the crossbite and the noncrossbite sides with cone-beam computed tomography (CBCT). From our clinic archives, we selected the CBCT records of 30 patients with unilateral skeletal crossbite (13 boys, 14.2 ± 1.3 years old; 17 girls, 13.8 ± 1.3 years old) who underwent ARME treatment. A modified acrylic bonded rapid maxillary expansion appliance including an occlusal locking mechanism was used in all patients. CBCT records had been taken before ARME treatment and after a 3-month retention period. Fourteen angular and 80 linear measurements were taken for the maxilla and the mandible. Frontally clipped CBCT images were used for the evaluation. Paired sample and independent sample t tests were used for statistical comparisons. Comparisons of the before-treatment and after-retention measurements showed that the arch widths and buccolingual inclinations of the posterior teeth increased significantly on the crossbite side of the maxilla and on the noncrossbite side of the mandible (P ARME treatment, the crossbite side of the maxilla and the noncrossbite side of the mandible were more affected than were the opposite sides. Copyright © 2015. Published by Elsevier Inc.

[Sequence orthodontic treatment of impacted dilacerated maxillary central incisors].

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Zheng, Yi; Pang, Xuannai; Nan, Lan; Mo, Shuixue

2012-06-01

To explore an effective orthodontic method for treating impacted dilacerated maxillary central incisors. 12 impacted teeth of 11 cases were chosen. The position of the impacted teeth and the relations with neighbour tissues were assessed by X-ray images, oral examination and plaster model, etc. The impacted teeth were induced to erupt with the closed-eruption technique and fixed orthodontic appliances, root canal therapy, apicoectomy and prosthetic treatment. 12 impacted teeth were moved into arches, and the occlusal relationship was normal. There were no root resorption or conglutination in those impacted teeth. The labial impacted teeth of nine cases had bigger labial crown torsion. The root apexes of four impacted teeth were palpable under mucosa of the labial sulcus and operated by root canal therapy and apicoectomy. One of them received prosthetic treatment. Others (five cases) hadn't accepted root canal therapy, and were observed temporarily. The effects of two palatal impacted teeth was stable. It was a good method to expand indication with sequence orthodontic treatment. The impacted dilacerated maxillary central incisors could be aligned with good esthetical and functional effect.

French Board of Orthodontics.

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De Sousa Beltrao, Paulo Augusto

2010-09-01

A. February 2001 (15.11 y). Molar Class I, skeletal Class I, normodivergent, anterior deficiency: -17 mm, bimaxillary protrusion. Preparation of arches (alignment, levelling, canine retraction). Correction of arches (space closure). Occlusal finishing (artistic bends). B. POSTTREATMENT RECORDS: February 2003 (17.11 y). Maxillary Hawley plate for nighttime use and bonded lingual wire from 33 to 43. C. POSTRETENTION RECORDS: December 2003 (18.9 y). Copyright © 2010 CEO. Published by Elsevier Masson SAS. All rights reserved.

Long-term follow-up of early cleft maxillary distraction.

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Park, Young-Wook; Kwon, Kwang-Jun; Kim, Min-Keun

2016-12-01

Most of cleft lip and palate patients have the esthetic and functional problems of midfacial deficiencies due to innate developmental tendency and scar tissues from repeated operations. In these cases, maxillary protraction is required for the harmonious facial esthetics and functional occlusion. A 7-year old boy had been diagnosed as severe maxillary constriction due to unilateral complete cleft lip and palate. The author tried to correct the secondary deformity by early distraction osteogenesis with the aim of avoiding marked psychological impact from peers of elementary school. From 1999 to 2006, repeated treatments, which consisted of Le Fort I osteotomy and face mask distraction, and complementary maxillary protraction using miniplates were performed including orthodontics. But, final facial profile was not satisfactory, which needs compromising surgery. The result of this study suggests that if early distraction treatment is performed before facial skeletal growth is completed, an orthognathic surgery or additional distraction may be needed later. Maxillofacial plastic and reconstructive surgeons should notify this point when they plan early distraction treatment for cleft maxillary deformity.

Classe II divisão 1 associada à deficiência transversal maxilar. Tratamento com disjuntor tipo Hyrax e aparelho de Herbst: relato de caso clínico Class II division 1 associated with maxillary transverse deficiency treated by Hyrax expander and Herbst appliance: clinical case report

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Camila Leite Quaglio

2009-10-01

Full Text Available A má oclusão de Classe II divisão 1 de Angle é, frequentemente, acompanhada da atresia maxilar. Esse problema transversal da maxila deve ser corrigido, sempre que possível, antes da correção anteroposterior, sendo que os aparelhos de expansão rápida são os mais utilizados para isso. Para a correção da Classe II, atualmente, os aparelhos funcionais fixos são os mais estudados e empregados, por serem aparelhos intrabucais e necessitarem de menor colaboração do paciente. O objetivo deste estudo é demonstrar a estabilidade dos resultados obtidos após seis anos de tratamento com expansor tipo Hyrax, seguido do aparelho funcional fixo de Herbst e aparelho fixo. Após uma revisão da literatura, será apresentado um caso clínico, com atresia maxilar e má oclusão de Classe II divisão 1, tratado com essa terapia. O tratamento foi realizado em um curto período de tempo, com resultados funcionais e estéticos satisfatórios e mantidos ao longo dos anos.The Angle Class II division 1 malocclusion is often accompanied by maxillary transverse deficiency. When ever is possible, this maxillary transverse problem must be corrected before the anteroposterior correction. The rapid maxillary expanders is the appliance more used to correct the transverse deficiency. For the Class II malocclusion correction the fixed functional appliances are more studied and used. They are a kind of intraoral appliance that almost don't need patient's collaboration. The aim of this study is to show the results' stability after six years of the orthodontic treatment with Hyrax expander, followed by Herbst and straight wire appliances. After a literature review, a clinical case with maxillary transverse deficiency and Class II division 1 malocclusion treated with this therapy is reported. The treatment duration was very brief and the results were functionally and esthetically satisfactory with a long-term stability.

Mandibular effects of maxillary distraction osteogenesis in cleft lip and palate.

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Doucet, J-C; Herlin, C; Bigorre, M; Bäumler, C; Subsol, G; Captier, G

2014-06-01

Maxillary distraction osteogenesis (DO) is a reliable treatment for severe maxillary deficiency in cleft lip and palate (CLP). The objective was to analyze its long-term effects on the mandible. A retrospective study of 24 CLP treated with maxillary DO using the Polley and Figueroa technique was done; patients were followed for more than 4 years. Preoperative (T0), 6-12 months postoperative (T1), and ≥ 4 years postoperative (T2) cephalometric radiographs were evaluated. A classical cephalometric analysis was used to assess treatment stability, and a Procrustes superimposition method was used to assess local changes in the shape of the mandible. The mean age of patients at T0 was 15.4 ± 4.1 years. SNA increased at T1 and T2 (P Maxillary DO in CLP had no significant effect on the shape or rotation of the mandible. The maxillary advancement remained stable after 1 year. Copyright © 2014 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Establishing the maxillary occlusal plane as a requisite for placement of an immediate implant-supported fixed prosthesis in the mandible: a case report

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Milton Edson Miranda

Full Text Available INTRODUCTION: In patients with Bruxism, the attrition can result in excessive occlusal wear that exceeds the compensatory mechanism and loss of occlusion vertical dimension occurs. OBJECTIVE: The purpose of this article is to show the importance of re-establishing an adequate occlusal plane for the non treated arch by means of a fixed acrylic overlay, compatible with the prosthetic treatment of the arch to be rehabilitated. An upper maxillary fixed acrylic overlay restored the patient’s occlusal plane in an appropriate vertical dimension of occlusion together with a fixed prosthesis in the mandible, supported by five dental implants. CONCLUSION: When there is severe wear due to dental attrition in one of the arches, it is important to re-establish the occlusal plane and compensation curves in conjunction with the prosthetic treatment of the arch to be rehabilitated.

Technical Modifications of Tooth-borne Distraction Device for Anterior Maxillary Distraction in Cleft Patients

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Dhivakar Selvaraj

2014-01-01

Full Text Available The tooth-borne distractor gained popularity for anterior maxillary distraction because of the effective treatment outcome, no need for external fixation, noninvasive, less chewing difficulty, social tolerance and economical. Tooth-borne distractor device needs modification in terms of maxillary deficiency, tooth position, retained deciduous tooth, and fistula. Hence, we recommend the following modifications in certain circumstances for the successful treatment outcome.

Maxillary Protraction With Intermaxillary Elastics to Miniplates Versus Bone-Anchored Face-Mask Therapy in Cleft Lip and Palate Patients.

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Jahanbin, Arezoo; Kazemian, Mozhgan; Eslami, Neda; Pouya, Iman Saeedi

2016-07-01

Cleft lip and palate patients usually have deficient maxilla due to postsurgical scars. The aim this study was to compare the effectiveness of miniplates-anchored face-mask therapy versus intermaxillary elastics to miniplates for maxillary traction in cleft lip and palate patients. This clinical trial included 11 prepubertal patients with cleft lip and palate. Initially, a w-arch expander was cemented and activated 3 mm per month to overcorrect the crossbite. Then, the patients were divided into 2 groups: mini-plate-anchored face-mask (n = 5): 2 miniplates were placed in the maxilla and the patients were instructed to wear a face-mask for 12 to 14 hours/per day. Intermaxillary elastics to miniplates (n = 6): 2 miniplates were inserted in the maxilla; 1 on each side and 2 miniplates were placed in the anterior mandible on both sides. Intermaxillary elastics with a force of 250 g per side were attached to the hooks. Cephalometric parameters before treatment (T1) and after achieving positive overjet (T2) were compared between the 2 groups. Fisher exact, paired, and independent t tests were used for statistical comparison. At T1 or T2 there was not a significant difference between the 2 groups in the skeletal, dental, and soft tissue variables. According to results of our preliminary study, intermaxillary elastics to miniplates might have a promising effect as an alternative for face mask therapy in maxillary protraction of cleft lip and palate patients.

Multidisciplinary Restoration of Traumatized and Displaced Maxillary Central Incisor by Bent Wire System-A Novel Approach.

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Sasalawad, Shilpa S; Jogani, Vivek; Pai, Suryakanth M; Chour, Rashmi C; Balehosur, Deepti V

2016-11-01

Management of traumatic injuries to teeth is a challenge to dental practice, as it occurs when dentists are least prepared for it. The direction and the force of the object or the fall significantly affects the diagnosis, treatment plan and therefore the outcome of the treatment. These traumatic injuries may present with different clinical situations which demand immediate attention and assessment by the clinician. The maxillary central incisor crown fractures are the most common variant of trauma, because of the anterior and protrusive positioning. This case report describes the novel method to produce expansion of the dental arches to correct the post-traumatic displacement of the central incisor along with aesthetic and functional rehabilitation of Ellis Class IV fracture of permanent maxillary central incisor.

Anchorage onto deciduous teeth: effectiveness of early rapid maxillary expansion in increasing dental arch dimension and improving anterior crowding

OpenAIRE

Mutinelli, Sabrina; Manfredi, Mario; Guiducci, Antonio; Denotti, Gloria; Cozzani, Mauro

2015-01-01

Background Anchorage onto permanent dentition is a common procedure in rapid maxillary expansion. However, replacing first permanent molars with the second deciduous molars seems to be an option to reduce some negative side effects during orthodontic treatment. The purpose of this study was to evaluate the dental effect of rapid maxillary expansion with anchorage exclusively onto deciduous teeth performed in the first period of transition. Methods Twenty patients with a lateral cross-bite tre...

Maxillary canine-first premolar transposition in the permanent dentition: treatment considerations and a case report.

LENUS (Irish Health Repository)

Synodinos, Philippos N

2010-12-01

Transposition is defined as the interchange of position between two adjacent teeth within the same quadrant of the dental arch. Permanent maxillary canine-premolar transposition is the most commonly observed transposition in the human dentition. Its prevalence is relatively low and its aetiology remains unclear, although it has been associated with genetic factors. It may also be related to a combination of localised factors such as malformation of adjacent teeth, tooth agenesis, retention of the deciduous canine and a history of local trauma. Treatment is selected on an individual case basis after thoroughly considering the overall facial and dental characteristics, duration of treatment, cost, patient preference and the orthodontist\\'s experience. This article provides a case report of maxillary canine transposition in the permanent dentition, successfully managed with orthodontic treatment.

Maxillary distraction osteogenesis in cleft lip and palate patients with skeletal anchorage.

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Minami, Katsuhiro; Mori, Yoshihide; Tae-Geon, Kwon; Shimizu, Hidetaka; Ohtani, Miyuki; Yura, Yoshiaki

2007-03-01

Maxillary distraction osteogenesis with the rigid external distraction (RED) system has been used to treat cleft lip and palate (CLP) patients with severe maxillary hypoplasia. We introduce maxillary distraction osteogenesis for CLP patients with skeletal anchorage adapted on a stereolithographic model. Six maxillary deficiency CLP patients treated according to our CLP treatment protocol had undergone maxillary distraction osteogenesis. In all patients, computed tomography (CT) images were recorded preoperatively, and the data were transferred to a workstation. Three-dimensional skeletal structures were reconstructed with CT data sets, and a stereolithographic model was produced. On the stereolithographic model, miniplates were adapted to the surface of maxilla beside aperture piriforms. The operation performed involved a high Le Fort I osteotomy with pterygomaxillary disjunction. Miniplates were fixed to the maxillary segment with three or four screws and used for anchorage of the RED system. Retraction of the maxillary segment was initiated after 1 week. The accuracy of the stereolithographic models was enough to adapt the miniplates so that there was no need to readjust the plates during surgery. Postoperative cephalometric analysis showed that the direction of the retraction was almost parallel to the palatal plane, and dental compensation did not occur. We performed maxillary distraction osteogenesis with skeletal anchorage adapted on the stereolithographic models. Excellent esthetic outcome and skeletal advancement were achieved without dentoalveolar compensations.

Frequency and Type of Prosthetic Complications Associated with Interim, Immediately Loaded Full-Arch Prostheses: A 2-Year Retrospective Chart Review.

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Drago, Carl

2016-08-01

The purpose of this report was to retrospectively evaluate implant and immediate full-arch prosthesis survival rates over a 24-month period; patients were consecutively treated with immediate occlusal loading. Dental arch, gender, and implant orientation (vertical vs. tilted) were also noted. All Brånemark System implants (Nobel Active) and interim, all-acrylic resin prostheses placed in patients following an All-on-Four™ protocol, in a single private practice were assessed by retrospective patient chart review. The amount of space provided surgically for implant restorative components and prostheses was determined from measurements of the vertical heights of the interim prostheses in the right/left anterior and posterior segments. These measurements were made in the laboratory. Interim prosthetic repairs (type, frequency, length of time from insertion) were analyzed by type, arch, gender, and implant orientation. Implant survival and insertion torque values were also measured. Inclusion criteria consisted of all Brånemark System implants placed with the All-on-Four protocol from September 1, 2011, until August 31, 2013. Specific dietary instructions were given for the first 7 days immediately postoperatively and for the weeks prior to insertion of the definitive prostheses. One hundred twenty-nine patients, comprising 191 arches (766 implants) from September 1, 2011, until August 31, 2013, were included in the study. One patient experienced implant failure yielding an overall implant survival rate (SR) of 99.5% (762 of 766). Four hundred twenty-six of 430 maxillary implants and 336 of 336 mandibular implants survived for SRs of 99.1% and 100%, respectively. Regarding implant orientation, 415 of 417 tilted implants (SR 99.5%) and 343 of 345 (CSR 95.6%) vertical implants were noted to be clinically stable. Interim, all-acrylic resin prostheses were in place for a mean of 199.2 days; mandibular prostheses were in place for an average of 195.4 days; maxillary

Evaluation of the maxillary sinus and adjacent structures on the orthopantomograph to the head positions

International Nuclear Information System (INIS)

Lee, Jin Kyung; Kim, Jae Duck

1992-01-01

The purpose of this study was to evaluate the utilization of the orthopantomogrph as a diagnostic aid to observe maxillary sinus and adjacent structures. For achieving this goal, the lead plates were attached to the five walls of the maxillary sinus of a human dry skull. The dry skull was placed in fourteen different positions ; standard, 20 mm forward, 20 mm backward, 10 degree upward, 10 degree downward, 20 mm lateral, forward and upward, forward and lateral, backward and upward, backward and downward, backward and lateral, upward and lateral, downward and lateral position. The obtained results were as follows: 1. The image of the medial wall was observed very differently according to the head positions. 2. The image of the anterior wall was observed at medial third to half of the maxillary sinus in each head position. 3. The image of the posterior wall was always observed at lateral third of the maxillary sinus in all head positions and more obviously in the downward-lateral position. 4. The image of the superior wall was observed at the inferior third to half of the orbit in each head position. 5. The image of the inferior wall was always observed at the inferior third of maxillary sinus in all head positions and observed more obviously in the standard and downward-lateral positions. 6. The image of the zygomatic process, zygomatic arch and zygomaticotemporal suture were observed very well in the downward-lateral position.

Analysis of the width ratio and wear rate of maxillary anterior teeth in the Korean population.

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Oh, Yeon-Ah; Yang, Hong-So; Park, Sang-Won; Lim, Hyun-Pil; Yun, Kwi-Dug; Park, Chan

2017-04-01

The purpose of this study was to compare the width ratio of maxillary anterior teeth according to age in the Korean population and to evaluate the maxillary central incisor width-to-length (W/L) ratio, given differences in age and gender. Ninety-three Korean adults were divided into 3 groups (n = 31) by age. Group I was 20 - 39 years old, Group II was 40 - 59 years old, and Group III was over 60 years of age. After taking an impression and a cast model of the maxillary arch, the anterior teeth width ratio and central incisor W/L ratio were calculated from standard digital images of the cast models using a graph paper with a digital single lens reflex (DSLR) camera. The calculated ratios were compared among all groups and central incisor W/L ratio were analyzed according to age and gender. All comparative data were statistically analyzed with one-sample t-tests, one-way ANOVAs with Tukey tests, and independent t-tests. No significant differences in maxillary anterior teeth ratios were found among the age groups. The maxillary central incisor W/L ratios in Group III were the greatest and were significantly higher than those in the other groups. The central incisor W/L ratio of men was higher than that of women in Group II. Maxillary anterior teeth width ratios were similar in all age groups in the Korean population. The maxillary central incisor was observed as worn teeth in the group over 60 years of age, and a significant difference between genders was found in 40 to 50 year olds.

Effect of the transpalatal arch during extraction treatment.

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Zablocki, Heather L; McNamara, James A; Franchi, Lorenzo; Baccetti, Tiziano

2008-06-01

The transpalatal arch (TPA) can be used as an adjunct during orthodontic treatment to help control the movement of the maxillary first molars in 3 dimensions, including producing molar rotation and uprighting, maintaining transverse dimensions posteriorly during treatment, and maintaining leeway spaces during the transition of the dentition. The purpose of this retrospective cephalometric study was to test an additional function of the TPA: its ability to enhance orthodontic anchorage during extraction treatment. Records consisting of pretreatment and posttreatment cephalograms were gathered from several orthodontic practices that used an .018 x .025-in preangulated appliance. All patients were white and had 4 first premolars extracted as part of their treatment protocol. Patients were treated either with or without a TPA of the soldered Goshgarian design. Patients were excluded if headgear or any other auxiliary anchorage device beside the TPA was used during treatment. Matched samples of 30 patients were identified based on sex, age at the start of treatment, treatment duration, and cervical vertebral maturation stage. Statistical comparisons were made with nonparametric statistical tests. Analysis of the changes from pretreatment to posttreatment for the TPA and the no-TPA groups showed no statistically significant differences in any of the variables examined. The net difference for both vertical and mesial movement of the maxillary first molar in relation to the maxilla between the 2 groups was 0.4 mm, with the no-TPA group in a more downward and forward position. Although the usefulness of the TPA for the abovementioned functions is not negated, it does not provide a significant effect on either the anteroposterior or the vertical position of the maxillary first molars during extraction treatment.

Rapid maxillary expansion effects: An alternative assessment method by means of cone-beam tomography

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Camilo Aquino Melgaço

2014-10-01

Full Text Available INTRODUCTION: This study aims to develop a method to assess the changes in palatal and lingual cross-sectional areas in patients submitted to rapid maxillary expansion (RME. METHODS: The sample comprised 31 Class I malocclusion individuals submitted to RME and divided into two groups treated with Haas (17 patients and Hyrax (14 patients expanders. Cone-beam computed tomography scans were acquired at T0 (before expansion and T1 (six months after screw stabilization. Maxillary and mandibular cross-sectional areas were assessed at first permanent molars and first premolars regions and compared at T0 and T1. Mandibular occlusal area was also analyzed. RESULTS: Maxillary cross-sectional areas increased in 56.18 mm2 and 44.32 mm2 for the posterior and anterior regions. These values were smaller for the mandible, representing augmentation of 40.32 mm2 and 39.91 mm2 for posterior and anterior sections. No differences were found when comparing both expanders. Mandibular occlusal area increased 43.99mm2 and mandibular incisors proclined. Increments of 1.74 mm and 1.7 mm occurred in mandibular intermolar and interpremolar distances. These same distances presented increments of 5.5 mm and 5.57 mm for the maxillary arch. CONCLUSION: Occlusal and cross-sectional areas increased significantly after RME. The method described seems to be reliable and precise to assess intraoral area changes.

The use of spiral computed tomography in the localization of impacted maxillary canines

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Preda, L.; La Fianza, A.; Di Maggio, E. [Pavia Univ. (Italy)

1998-02-01

The purpose was to compare spiral CT with conventional radiography in planning the orthodontic treatment of impacted permanent maxillary canines. In conclusion, CT facilitates the treatment of impacted canines especially when the teeth are very oblique to the arch. Root resorption is better demonstrated especially on the palatal and buccal surfaces of the adjacent incisors. Spiral CT reduces examination time and risks of accidental movement, thus optimizing multiplanar quality. Examination at 2:1 pitch enables a significant reduction in radiation exposure without loss of image quality. (N.C.)

The use of spiral computed tomography in the localization of impacted maxillary canines

International Nuclear Information System (INIS)

Preda, L.; La Fianza, A.; Di Maggio, E.

1998-01-01

The purpose was to compare spiral CT with conventional radiography in planning the orthodontic treatment of impacted permanent maxillary canines. In conclusion, CT facilitates the treatment of impacted canines especially when the teeth are very oblique to the arch. Root resorption is better demonstrated especially on the palatal and buccal surfaces of the adjacent incisors. Spiral CT reduces examination time and risks of accidental movement, thus optimizing multiplanar quality. Examination at 2:1 pitch enables a significant reduction in radiation exposure without loss of image quality. (N.C.)

Maxillary distraction osteogenesis using Le Fort I osteotomy without intraoperative down-fracture.

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Yamauchi, K; Mitsugi, M; Takahashi, T

2006-06-01

The aim of this study is to present a technique for maxillary distraction osteogenesis using Le Fort I osteotomy without down-fracture. Six cleft-related patients suffering from severe midfacial deficiency were treated with maxillary distraction osteogenesis. The RED II system was chosen as the extraoral device and the Leipzig retention plate system to anchor the maxillary segment. Maxillary distraction osteogenesis was successful in all cases. Cephalometric and clinical evaluation after an average follow-up period of 1 year showed stable results with respect to skeletal and dental relationships. The SNA angle increased from 72.3 degrees to 81.4 degrees and the ANB angle increased by 11.0 degrees immediately after removing the distraction device. After 1 year, the sagittal bone gain remained and the SNA angle had decreased by 0.8 degrees . This technique seems to minimize the risk of the surgical procedure and shorten the operation time. It may become an alternative method for the treatment of patients with severe midfacial hypoplasia.

Arch reconstruction with autologous pulmonary artery patch in interrupted aortic arch.

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Lee, Won-Young; Park, Jeong-Jun

2014-04-01

Various surgical techniques have been developed for the repair of an interrupted aortic arch. However, tension and Gothic arch formation at the anastomotic site have remained major problems for these techniques: Excessive tension causes arch stenosis and left main bronchus compression, and Gothic arch configuration is related to cardiovascular complications. To resolve these problems, we adopted a modified surgical technique of distal aortic arch augmentation using an autologous main pulmonary artery patch. The descending aorta was then anastomosed to the augmented aortic arch in an end-to-side manner. Here, we report two cases of interrupted aortic arch that were repaired using this technique.

Ectopic eruption of the maxillary first permanent molar: characteristics and occurrence in growing children.

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Barberia-Leache, Elena; Suarez-Clúa, María Cruz; Saavedra-Ontiveros, Dolores

2005-07-01

The purpose of this study was to determine the characteristics and occurrence of the ectopic eruption of the maxillary first permanent molar in a sample of growing Spanish children. A descriptive, observational, retrospective study was done using the radiographs of 509 consecutive patients, who were in the first phase of mixed dentition. A method was designed to evaluate the amount of pathologic resorption of the second maxillary primary molar and the impaction of the first permanent molar measured in millimeters. Statistical analysis of the studied variables was done using chi-square, analysis of variance, and Pearson correlation coefficient. The frequency of occurrence was 4.3% with no differences in both sexes. Of these, 36.4% were unilateral and 63.6% bilateral with a right:left relation of 3:1. Of the 36 ectopic molars, 69.4% self-corrected spontaneously. In such cases, the pathological resorption of the root of the second maxillary primary molar and its adverse clinical implications were persistent. The relation between self-correction and impaction was 2.27:1. The average impaction on the right side was 2.91 mm and 1.6 mm on the left side. Correlation between the magnitude of resorption and grade of impaction was not observed. Although resorption was found on grades I and II, spontaneous self-correction could occur without arch length loss. However, on grade III or more, therapeutic intervention has to be done. The benefit of early diagnosis and treatment of the maxillary first permanent molar is the prevention of the premature loss of second maxillary deciduous molar and the resulting malocclusion.

Upper full arch rehabilitation with sinus by-pass with tilted implants via tapered-threaded expanders in low density bone: a clinical trial.

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Andreasi Bassi, M; Andrisani, C; Lico, S; Ormanier, Z; Arcuri, C

2016-01-01

In the present paper the use of tapered-screw bone expanders (TSBEs) is proposed, in combination with the placement of tilted implants, in close proximity to the anterior sinus wall, solving the problem of the reduced height of the alveolar bone in the sub-antral area. The Authors present a case series of full-arch rehabilitations performed with this procedure named: Tilted Implant Expansion Osteotomy (TIEO). 12 patients (5 males and 7 females, average age 58.5 ± 8.1 years) with totally or partially edentulous maxilla were enrolled in this study. For each patient 4 implants were placed, the anterior implants in the area of lateral incisors or canines while, the posterior implants, immediately in front of the maxillary sinus, with an inclined position. Adopting the aforesaid procedure, 48 cylindrical two-piece implants were placed, 24 of which were placed in tilted position, in order to by-pass the maxillary sinus. After a healing period of 6 months, the second stage surgery was performed. The cases were finalized by means of a hybrid metal-acrylic prosthesis. The post finalization follow-up was at 12 months. Survival rate was 100% since none fixtures were lost. At the one-year follow up the clinical and radiological appearance of the soft and hard tissues was optimal and no pathological signs were recorded. TIEO is a promising surgical procedure for full-arch rehabilitation of maxillary edentulous sites and represents a therapeutic alternative to sinus lift techniques.

Reconstruction of the premaxilla by segmental distraction osteogenesis for maxillary retrusion in cleft lip and palate.

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Kim, Bong Chul; Lee, Sang-Hwy; Park, Kyung-Ran; Jung, Young-Soo; Yi, Choong-Kook

2014-03-01

We present a strategy to target one of the main areas causing retruded maxilla, the premaxillary region for patients with cleft lip and palate (CLP). Advancement of the premaxilla by distraction osteogenesis is attempted, and the retruded anterior maxilla, the collapsed dental space, and the arch shape are sufficiently improved. This strategy also prevents deterioration of the velopharyngeal incompetency function. The procedure seems to be a good option for the treatment of maxillary retrusion and malocclusion for CLP.

IBO Case Report: Management of Skeletal Class III Malocclusion with Combined Rapid Maxillary Expansion: Facemask Therapy and 5-Year Follow-up

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Ashok Surana

2012-01-01

Full Text Available This case report describes the management of skeletal Class III malocclusion with maxillary deficiency in an adolescent girl, using combined rapid maxillary expansion-facemask approach, followed by comprehensive fixed appliance mechanotherapy. Excellent long-term stability is demonstrated up to 5 years post-treatment.

Special distraction osteogenesis before bone grafting for alveolar cleft defects to correct maxillary deformities in patients with bilateral cleft lips and palates: distraction osteogenesis performed separately for each bone segment.

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Mitsukawa, Nobuyuki; Saiga, Atsuomi; Morishita, Tadashi; Satoh, Kaneshige

2014-07-01

Patients with bilateral cleft lips and palates have premaxillary protrusion and characteristic jaw deformities involving three-dimensional malposition of the premaxilla and bilateral maxillary bone segments. This study examined patients with bilateral cleft lips and palates who had deviation and hypoplasia of the premaxillas and bilateral maxillary segments. Before bone grafting, the patients were treated with special distraction performed separately for each bone segment using a halo-type external device. This report describes this novel treatment method which produced good results. The subjects were five patients with severe jaw deformities due to bilateral cleft lip and palate. They were treated with maxillary Le Fort I osteotomy and subsequent distraction performed separately for each bone segment using a halo device. In three of five patients, premaxillary osteotomy was not performed, and osteotomy and distraction were performed only for the right and left lateral segments with severe hypoplasia. All patients achieved distraction close to the desired amount. The widths of the alveolar clefts were narrowed, and satisfactory occlusion and maxillary arch form were achieved. After the surgery, three of five patients underwent bone grafting for bilateral alveolar cleft defects and the bone graft survival was satisfactory. This method had many benefits, including narrowing of alveolar clefts, improvement of maxillary hypoplasia, and achievement of a good maxillary arch form. In addition, subsequent bone grafting for alveolar cleft defects was beneficial, dental prostheses were unnecessary, and frequency of surgery and surgical invasiveness were reduced. This method is a good surgical procedure that should be considered for patients with bilateral cleft lips and palates who have premaxillary protrusion and hypoplasia of the right and left lateral segments. Copyright © 2013 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights

Rapid maxillary distraction protocol utilizing the halo distraction system and rigid internal fixation.

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Baker, Stephen B; Reid, Russell R; Burkey, Brooke; Bartlett, Scott P

2007-09-01

To shorten head frame wear time associated with external halo distraction (HD), we have adapted a protocol for maxillary distraction with the halo system that integrates plate fixation. All patients had a history of cleft lip and/or palate and maxillary retrusion > or = 8 mm. Five patients treated with this protocol and followed for at least 1 year were included in this study. The protocol included a 3-day latency period, variable maxillary distraction, and removal of the halo device with simultaneous rigid internal fixation. Two patients had a variable period of maxillomandibular fixation (MMF), which maintained the maxillary advancement and idealized intercuspal position while permitting further callus maturation. Cephalographs were obtained preoperatively, immediately following distractor removal, and 1 year after rigid internal fixation. The mean age at time of surgery was 18.7 years. The maxillary deficiency ranged from 8 to 15 mm (mean = 10.6 mm). All five patients demonstrated excellent occlusion. Cephalometric analysis 1-year post rigid internal fixation revealed minimal (maxillary distraction followed by MMF to maintain maxillary advancement may reduce halo device wear to 1 to 2 weeks. MMF optimizes occlusion by forcing the maxillary teeth into maximal intercuspal position. Rigid fixation is not only associated with less long-term relapse compared to nonrigid forms of fixation, but also minimizes the incidence of nonunion. This treatment protocol provides the advancement possible with distraction osteogenesis and the accuracy of orthognathic surgery, thereby minimizing external head frame wear.

Ribbon-wise customized lingual appliance and orthodontic anchor screw for the treatment of skeletal high-angle maxillary protrusion without bowing effect.

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Inami, Toru; Ito, Goshi; Miyazawa, Ken; Tabuchi, Masako; Goto, Shigemi

2018-05-02

This case report demonstrates the treatment of a skeletal Class II high-angle adult patient with bimaxillary protrusion, angle Class I occlusion, and crowded anterior teeth. A ribbon-wise arch wire and a customized lingual appliance with anterior vertical slots were used to achieve proper torque control of the maxillary anterior teeth. An orthodontic anchor screw and a palatal bar were used for vertical control to avoid increasing the Frankfort-mandibular plane angle (FMA) by maxillary molar extrusion. Through the combined use of the ribbon-wise customized lingual appliance, palatal bar, and orthodontic anchor screw, vertical control and an excellent treatment result were achieved without the vertical and horizontal bowing effects peculiar to conventional lingual treatment.

Recurrent Pneumonia due to Double Aortic Arch

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I. Sedighi

2012-04-01

Full Text Available Introduction: Pneumonia is one of the most common infections during childhood. In children with recurrent bacterial pneumonia complete evaluation for underlying factors is necessary. The most common underlying diseases include: antibody deficiencies , cystic fibrosis , tracheoesophageal fistula and increased pulmonary blood flow. Vascular ring and its pressure effect is a less common cause of stridor and recurrent pneumonia. Congenital abnormalities in aortic arch and main branches which form vascular ring around esophagus and trachea with variable pressure effect cause respiratory symptoms such as stridor , wheezing and recurrent pneumoniaCase Report: A 2 year old boy was admitted in our hospital with respiratory distress and cough . Chest x-Ray demonstrated right lobar pneumonia. He had history of stridor and wheezing from neonatal period and hospitalization due to pneumonia for four times. The patient received appropriate antibiotics. Despite fever and respiratory distress improvement, wheezing continued. Review of his medical documents showed fixed pressure effect on posterior aspect of esophagus in barium swallow. In CT angiography we confirmed double aortic arch.Conclusion: Double aortic arch is one of the causes of persistant respiratory symptom and recurrent pneumonia in children for which fluoroscopic barium swallow is the first non-invasive diagnostic method.(Sci J Hamadan Univ Med Sci 2012;19(1:70-74

Influence of Palatal Coverage and Implant Distribution on Implant Strain in Maxillary Implant Overdentures.

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Takahashi, Toshihito; Gonda, Tomoya; Mizuno, Yoko; Fujinami, Yozo; Maeda, Yoshinobu

2016-01-01

Maxillary implant overdentures are often used in clinical practice. However, there is no agreement or established guidelines regarding prosthetic design or optimal implant placement configuration. The purpose of this study was to examine the influence of palatal coverage and implant number and distribution in relation to impact strain under maxillary implant overdentures. A maxillary edentulous model with implants and experimental overdentures with and without palatal coverage was fabricated. Four strain gauges were attached to each implant, and they were positioned in the anterior, premolar, and molar areas. A vertical occlusal load of 98 N was applied through a mandibular complete denture, and the implant strains were compared using one-way analysis of variance (P = .05). The palatolabial strain was much higher on anterior implants than on other implants in both denture types. Although there was no significant difference between the strain under dentures with and without palatal coverage, palateless dentures tended to result in higher implant strain than dentures with palatal coverage. Dentures supported by only two implants registered higher strain than those supported by four or six implants. Implants under palateless dentures registered higher strain than those under dentures with palatal coverage. Anterior implants exhibited higher palatolabial strain than other implants regardless of palatal coverage and implant configuration; it is therefore recommended that maxillary implant overdentures should be supported by six implants with support extending to the distal end of the arch.

Tooth-Borne Anterior Maxillary Distraction for Cleft Maxillary Hypoplasia: Our Experience With 147 Patients.

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Richardson, Sunil; Selvaraj, Dhivakar; Khandeparker, Rakshit V; Seelan, Nikkie S; Richardson, Shweta

2016-12-01

 = 35) in velopharyngeal insufficiency, resonance, nasal air emission, articulation, and intelligibility, respectively, were observed, with worsening of all parameters in 1 patient (2%). An overall complication rate of 25.17% (n = 37) was noted, with bleeding being the most common intra- and postoperative complication noted in 15 patients (10.2%). No serious consequences related to any complication were noted. Anterior maxillary distraction can be considered a suitable treatment option for the management of mild to moderate cleft maxillary hypoplasia because the anteroposterior deficiency can be addressed at a young age, immediately after the eruption of the maxillary second premolars. Stable long-term results with negligible skeletal relapse are possible with this technique, with an added advantage of unhampered or even improved velopharyngeal function. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

[The reliability of dento-maxillary models created by cone-beam CT and rapid prototyping:a comparative study].

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Lv, Yan; Yan, Bin; Wang, Lin; Lou, Dong-hua

2012-04-01

To analyze the reliability of the dento-maxillary models created by cone-beam CT and rapid prototyping (RP). Plaster models were obtained from 20 orthodontic patients who had been scanned by cone-beam CT and 3-D models were formed after the calculation and reconstruction of software. Then, computerized composite models (RP models) were produced by rapid prototyping technique. The crown widths, dental arch widths and dental arch lengths on each plaster model, 3-D model and RP model were measured, followed by statistical analysis with SPSS17.0 software package. For crown widths, dental arch lengths and crowding, there were significant differences(Pmodels, but the dental arch widths were on the contrary. Measurements on 3-D models were significantly smaller than those on other two models(Pmodels, RP models had more numbers which were not significantly different from those on plaster models(P>0.05). The regression coefficient among three models were significantly different(Pmodels was bigger than that between 3-D and plaster models. There is high consistency within 3 models, while some differences were accepted in clinic. Therefore, it is possible to substitute 3-D and RP models for plaster models in order to save storage space and improve efficiency.

Speech evaluation and dental arch shape following pushback palatoplasty in cleft palate patients: Supraperiosteal flap technique versus mucoperiosteal flap technique.

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Ito, Shizuyo; Noguchi, Makoto; Suda, Yoshiyuki; Yamaguchi, Akira; Kohama, Geniku; Yamamoto, Etsuhide

2006-04-01

The aim of this study was to evaluate and compare the maxillary dental arch shape and speech of cleft palate patients following pushback palatoplasty using either the supraperiosteal flap technique or the mucoperiosteal flap technique. Sixty-two patients (29, cleft palate only; 33, unilateral cleft lip, alveolus and palate) operated on by the supraperiosteal technique and 47 patients (23, cleft palate only; 24 unilateral cleft lip, alveolus and palate) by the mucoperiosteal technique were reviewed in this study. Dental arch shape and speech proficiency at preschool and school age were evaluated in all patients. Dental arch shapes were classified as U type (good dental arch shape) and V type (narrow dental arch shape). In cleft palate only patients, U type was observed in 90% of the supraperiosteal group and 83% of the mucoperiosteal group. In unilateral cleft lip, alveolus and palate patients, U type was observed in 85% of the supraperiosteal group, while only in 33% of the mucoperiosteal group. In cleft palate only patients, normal speech at school age was observed 100% of the supraperiosteal group and 83% of the mucoperiosteal group. In unilateral cleft lip, alveolus and palate patients, normal speech at school age was observed in 97% of the supraperiosteal group and 75% of the mucoperiosteal group. Misarticulation was frequently found in patients with the V type of dental arch shape. It is suggested that pushback palatoplasty using the supraperiosteal technique is more advantageous for speech development compared with the mucoperiosteal technique.

Treatment of skeletal class III malocclusion using face mask therapy with alternate rapid maxillary expansion and constriction (Alt-RAMEC protocol

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Anand Ramchandra Rathi

2015-01-01

Full Text Available Class III malocclusion is very common malocclusion and can be due to maxillary retrusion, mandibular prognathism, or combination. Ellis and McNamara found a combination of maxillary retrusion and mandibular protrusion to be the most common skeletal relationship (30%. The treatment should be carried out as early as possible for permitting normal growth of the skeletal bases. Reverse pull head gear combined with maxillary expansion can effectively correct skeletal Class III malocclusion due to maxillary deficiency in growing patient. An eight-year-old female patient with chief complaint of prognathic mandible and anterior crossbite was successfully treated in duration of 5 months with facemask and expansion therapy based on Alternate Rapid Maxillary Expansion and Constriction (Alt-RAMEC protocol.

Comparison of rate of maxillary canine movement with or without modified corticotomy facilitated orthodontic treatment: A prospective clinical trial

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Harshal N Suryavanshi

2015-01-01

Full Text Available Background and Objectives: The average orthodontic treatment time for extraction therapy is 31 months. One of the main disadvantages of orthodontic treatment is time. Alveolar corticotomies have been used in conjunction with orthodontics to reduce the treatment time by increasing the rate of tooth movement. Concerns about the possible risks of corticotomy procedure have led to the modification of this technique. Germeη et al. reported a case treated by their modified corticotomy technique and noted reduced treatment time without any adverse effects on the periodontium and the vitality of teeth with their new conservative corticotomy technique. This study was undertaken to clinically evaluate the efficacy of the aforesaid technique. Materials and Methods: A split-mouth study design was carried out to compare the rate of maxillary canine movement with and without modified corticotomy facilitated orthodontic treatment in 10 patients requiring maxillary first premolar extractions. The modified corticotomy procedure was performed on the maxillary arch unilaterally. The upper arch was immediately activated bilaterally after surgical procedure using equal orthodontic forces for retraction of the maxillary canines. The amount of tooth movement was recorded at an interval of every month till the completion of canine retraction. The rate of canine movement on experimental and control site was compared. The patients were followed for 6 months to check the occurrence of undesired effects such as root resorption, periodontal damage and loss of vitality of teeth on the experimental side. Results: Higher mean velocity was observed in canines with modified corticotomy facilitated retraction compared to conventionally retracted canines; with the difference in mean velocity between the two groups was found to be clinically significant as well as statistically significant (P < 0.001. Interpretation and Conclusion: The results suggested that modified corticotomy

Bilateral en-masse distalization of maxillary posterior teeth with skeletal anchorage: a case report

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Saeed Noorollahian

Full Text Available ABSTRACT Objective: The aim of this study was to introduce a new method for bilateral distal movement of the entire maxillary posterior segment. Case report: A 17-year-old girl with Class I skeletal malocclusion (end-to-end molar relationships, deviated midline and space deficiency for left maxillary canine was referred for orthodontic treatment. She did not accept maxillary first premolars extraction. A modified Hyrax appliance (Dentaurum Ispringen, Germany was used for bilateral distalization of maxillary posterior teeth simultaneously. Expansion vector was set anteroposteriorly. Posterior legs of Hyrax were welded to first maxillary molar bands. All posterior teeth on each side consolidated with a segment of 0.017 × 0.025-in stainless steel wire from the buccal side. Anterior legs of Hyrax were bent into eyelet form and attached to the anterior palate with two mini-screws (2 × 10 mm (Jeil Medical Corporation Seoul, South Korea. Hyrax opening rate was 0.8 mm per month. Lateral cephalometric radiographs were used to evaluate the extent of distal movement. 3.5-mm distalization of posterior maxillary teeth was achieved in five months. Results: A nearly bodily distal movement without anchorage loss was obtained. Conclusion: The mini-screw-supported modified Hyrax appliance was found to be helpful for achieving en-masse distal movement of maxillary posterior teeth.

A clinical study to evaluate the correlation between maxillary central incisor tooth form and face form in an Indian population.

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Koralakunte, Pavankumar R; Budihal, Dhanyakumar H

2012-09-01

A study was performed to examine the correlation between maxillary central incisor tooth form and face form in males and females in an Indian population. The selection of prosthetic teeth for edentulous patients is a primary issue in denture esthetics, especially in the case of maxillary central incisors, which are the most prominent teeth in the arch. Two hundred dental students of Indian origin comprising 79 males and 121 females aged 18-28 years studying at Bapuji Dental College and Hospital were randomly selected as the study subjects. A standardized photographic procedure was used to obtain images of the face and the maxillary central incisors. The outline forms of the face and the maxillary right central incisor tooth were determined using a standardized method. The outline forms obtained were used to classify both face form and tooth form on the basis of visual and William's methods. The means were considered after evaluation by five prosthodontists, and the results were tabulated. Statistical analysis was performed using the chi-squared test for association and Z-test for equality of proportions. A correlation greater than 50% was observed between tooth form and face form by the visual method, compared with one of 31.5% by William's method. There was no highly defined correlation between maxillary central incisor tooth form and face form among the male and female Indian subjects studied.

Skeletal response to maxillary protraction with and without maxillary expansion: a finite element study.

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Gautam, Pawan; Valiathan, Ashima; Adhikari, Raviraj

2009-06-01

The purpose of this finite element study was to evaluate biomechanically 2 treatment modalities-maxillary protraction alone and in combination with maxillary expansion-by comparing the displacement of various craniofacial structures. Two 3-dimensional analytical models were developed from sequential computed tomography scan images taken at 2.5-mm intervals of a dry young skull. AutoCAD software (2004 version, Autodesk, San Rafael, Calif) and ANSYS software (version 10, Belcan Engineering Group, Cincinnati, Ohio) were used. The model consisted of 108,799 solid 10 node 92 elements, 193,633 nodes, and 580,899 degrees of freedom. In the first model, maxillary protraction forces were simulated by applying 1 kg of anterior force 30 degrees downward to the palatal plane. In the second model, a 4-mm midpalatal suture opening and maxillary protraction were simulated. Forward displacement of the nasomaxillary complex with upward and forward rotation was observed with maxillary protraction alone. No rotational tendency was noted when protraction was carried out with 4 mm of transverse expansion. A tendency for anterior maxillary constriction after maxillary protraction was evident. The amounts of displacement in the frontal, vertical, and lateral directions with midpalatal suture opening were greater compared with no opening of the midpalatal suture. The forward and downward displacements of the nasomaxillary complex with maxillary protraction and maxillary expansion more closely approximated the natural growth direction of the maxilla. Displacements of craniofacial structures were more favorable for the treatment of skeletal Class III maxillary retrognathia when maxillary protraction was used with maxillary expansion. Hence, biomechanically, maxillary protraction combined with maxillary expansion appears to be a superior treatment modality for the treatment of maxillary retrognathia than maxillary protraction alone.

Management of an Unusual Ectopic Eruption of Maxillary Canine.

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Aileni, Kaladhar Reddy; Rachala, Madhukar Reddy; Prathima, Chintakunta Reddy; Naveen, Pitalla Kumar; Soujanya, Donthula

2017-05-01

Transposition of teeth is a rare condition, with a prevalence of 0.3-0.4% in general population. They are more commonly observed in females, and may occur unilaterally/bilaterally with greater frequency of left side occurrence in unilateral transposition cases. A 17-year-old female patient reported with the chief complaint of unaesthetic smile. On clinical examination the patient was diagnosed with Angle's class I malocclusion with an ectopically erupted maxillary left canine labial to the left central incisor with retained deciduous canine. The treatment plan decided was to extract the retained deciduous canine, level and align the ectopic canine using an R-loop. The treatment for the patient was finished in 14 months and was retained using a fixed lingual retainer in the upper and lower arches.

Effects of maxillary sinus floor elevation surgery on maxillary sinus physiology

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Timmenga, NM; Raghoebar, GM; Liem, RSB; van Weissenbruch, R; Manson, WL; Vissink, A

In a prospective study, the effects of elevation surgery of the maxillary sinus floor on maxillary sinus physiology were assessed. Seventeen consecutive patients without preoperative anamnestic, clinical and radiological signs of maxillary sinusitis underwent sinus floor elevation surgery with iliac

Implant-Supported PMMA Monolithic Full-Arch Rehabilitation with Surgical Computer-Planned Guide and Immediate Provisional: A Case Report with One Year Follow-Up

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Vincenzo Luca Zizzari

2018-01-01

Full Text Available The aim of this case report is to describe the surgical and prosthetic procedures to achieve maxillary and mandibular implant-supported PMMA monolithic full-arch rehabilitation (PMFR with surgical computer-planned guide and immediate provisional. In such cases, the correct planning of dental implants’ position, length, and diameter and the prosthetic phases via computer-aided design are very important to achieve good aesthetic and functional long-lasting results.

Implant-Supported PMMA Monolithic Full-Arch Rehabilitation with Surgical Computer-Planned Guide and Immediate Provisional: A Case Report with One Year Follow-Up

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Zizzari, Vincenzo Luca; Tacconelli, Gianmarco

2018-01-01

The aim of this case report is to describe the surgical and prosthetic procedures to achieve maxillary and mandibular implant-supported PMMA monolithic full-arch rehabilitation (PMFR) with surgical computer-planned guide and immediate provisional. In such cases, the correct planning of dental implants’ position, length, and diameter and the prosthetic phases via computer-aided design are very important to achieve good aesthetic and functional long-lasting results.

One-stage closure of isolated cleft palate with the Veau-Wardill-Kilner V to Y pushback procedure or the Cronin modification. II. Height, weight and comparison of dental arches.

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Heliövaara, A; Pere, A; Ranta, R

1994-03-01

The body height and weight, and sizes of dental arches in 116 patients with isolated cleft palate were evaluated at 16.9-20.6 years of age. One-stage closure of the soft and hard palate had been done at a mean age of 1.8 years using the Veau-Wardill-Kilner or the Cronin mucoperiosteal palatal V-Y pushback technique. The height attained in both the boys (177.6 cm) and the girls (165.7 cm) was similar to that in the general adult population, even though half of the boys had not reached their final height. The median relative weight for height and sex was 6%. There were no significant differences in dental arch measurements depending on the method of operation but the more palatal operations done the shorter the maxillary and mandibular dental arch widths. The extent of cleft made a significant difference, larger clefts having narrower palatal intercanine widths. Dental arch dimensions were consistently larger in boys than in girls.

Stress distribution and displacement of maxillary anterior teeth during en-masse intrusion and retraction: A FEM study

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Parag Bohara

2017-01-01

Full Text Available Background: Space closure by en masse intrusion and retraction in orthodontics is of particular interest. Aim: The aim of this study was to evaluate the stress distribution and displacement of maxillary anterior teeth. Materials and Methods: Four different finite element models of maxillary arch were constructed to understand the nature of stresses and displacement patterns of anterior teeth during en masse intrusion and retraction on force application with different combinations of mini-implants and retraction hooks. Results: In this study, tensile stresses were seen in the cervical region and various movements of teeth such as lingual crown tipping, bodily movement, lingual root tipping, intrusion, and extrusion were observed. Conclusion: Nature of stresses changes from tensile to compressive from cervical area to apical area. Various tooth displacements suggest that different combinations of mini-implants and retraction hooks affect the direction of the tooth movement.

Space closure in the maxillary posterior area through the maxillary sinus.

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Park, Jae Hyun; Tai, Kiyoshi; Kanao, Akira; Takagi, Masato

2014-01-01

A common dilemma in adult orthodontic treatment is deciding how best to treat missing posterior teeth. One treatment option is to orthodontically close the space. But closure can be difficult, especially if the open space is in the maxillary posterior area, because tooth movement through the maxillary sinus is limited. The increased difficulty of moving teeth in the maxillary sinus is similar to moving a tooth in the atrophic posterior mandibular ridge. If space closure is selected as a treatment method, proper mechanics and light forces should be applied. In this article, we report movement of teeth through the maxillary sinus and discuss various implications related to orthodontic treatment in the maxillary sinus. Copyright © 2014 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Rehabilitation of large maxillary defect with two-piece maxillary obturators

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Kanchan P Dholam

2015-01-01

Full Text Available The insertion and removal of an obturator in large maxillary defects with or without trismus is difficult. Fabrication of a two-piece obturator in such cases overcomes this problem. This article describes rehabilitation of large maxillary defects with two piece maxillary obturator of three types. All these obturators have a maxillary plate and a bulb component, which are approximated together by various techniques namely, silicone cover, embedded magnets, and press studs. Prosthetic rehabilitation of large maxillary defects with two-piece obturators offers the possibility of adequate oral rehabilitation by fabricating light weight prosthesis, which is easy to use. The bulb covers the undercut areas of the defect enhancing the facial contour and retention. It facilitates easy examination of underlying tissues, recreation of the anatomic barrier between the oral and nasal cavities and restoration of the function and esthetics. Thus, it adds to the quality of life.

Dysplasia of the temporo-maxillary joint of mouse embryos due to x-ray irradiation

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Shibata, Shigeo

1974-01-01

On the 9-13 pregnant days of ddN mice 200-300 R of X-ray was daily irradiated, and observations were made on the formation of micro-mandible and changes in the temporo-maxillary joint in the embryos on the 18th pregnant day using skeletal and H-E stain specimens. Gross observation revealed the emergence of observable micro-mandible in groups exposed to 200 R on the 10th and 11th pregnant days and in groups exposed to 300 R on the 11th and 12th pregnant days. By skeletal specimens also, micro-mandible was observed in groups exposed on and after the 10th pregnant day, and anomaly of the malar arch was frequently associated with anomaly of the mandibular branches and growth inhibition of the anterior region of the mandible. Histologically, there were observed embryos totally lacking the temporo-maxillary joint composing elements, resulting in fusion with the temporal bone, or embryos lacking the elements partially or complicated by anomaly of cartilagious tissue of the mandibular head. (Mukohata, S.)

Genetics Home Reference: cerebral folate transport deficiency

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... R. Cerebral folate deficiency syndromes in childhood: clinical, analytical, and etiologic aspects. Arch Neurol. 2011 May;68( ... 2009.08.005. Citation on PubMed or Free article on PubMed Central Toelle SP, Wille D, Schmitt ...

Maxillary arch width and buccal corridor changes with Damon and conventional brackets: A retrospective analysis.

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Shook, Corey; Kim, Sohyon Michelle; Burnheimer, John

2016-07-01

To evaluate the effect of Damon self-ligating and conventional bracket systems on buccal corridor widths and areas. A retrospective sample of consecutively treated patients using either conventional (CG, n  =  45) or Damon self-ligating (SL, n  =  39) brackets was analyzed to determine any differences in buccal corridor widths and areas both within and between groups. Pretreatment and posttreatment frontal photographs were transferred to Photoshop CC, standardized using intercanthal width, and linear and area measurements were performed with tools in Photoshop CC. Ratios were then calculated for statistical analysis. Relationships between arch widths and buccal corridors were also examined. There were no significant differences in the posttreatment intercanine or intermolar widths either within or between the CG and SL groups. There were no significant differences in any buccal corridor width or area measurement either within or between the CG and SL groups. There were strong correlations with the intercanine width and the corresponding buccal corridor smile width measurements. There was an inverse correlation with the buccal corridor area in relation to the canine and the total smile width. It is likely that posttreatment increases in arch width can be seen in patients treated with either a conventional bracket system or the Damon system. It is highly unlikely that there is any significant difference in buccal corridor width or area in patients treated with the Damon self-ligating system or a conventional bracket system.

Evolution Characteristic Analysis of Pressure-arch of a Double-arch Tunnel in Water-rich Strata

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C. L. Li

2016-03-01

Full Text Available It is of importance to analyze the morphological characterization, the evolution process and the skewed effect of pressure-arch of a double-arch tunnel in the water-rich strata. Taking a buried depth 80 m double-arch tunnel as an example, a computational model of the double-arch tunnel was built by using FLAC3D technique. Then considering some aspects including groundwater conditions, tunnel depth, construction sequences and permeability coefficients, the coupling effect of stress field and seepage field in the pressure-arch of the double-arch tunnel was analyzed. The results show that the thickness of the pressure-arch induced by step-by-step excavation and display a step-descent skewed distribution from the left to the right of the double-arch tunnel. The permeability coefficient has a significant influence on the shape and the skewed effect of the pressure arch. The excavation of the bench method has a better arching condition than that of the expanding method. The abtained results provide a basic reference for the rock reinforcement design and safety construction of double-arch tunnels in the water-rich strata.

Maxillary Hypoplasia With Congenital Oligodontia Treated by Maxillary Distraction Osteogenesis.

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Mishima, Sayaka; Yamaguchi, Takako; Watanabe, Takuma; Komatani, Toru; Nakao, Kazumasa; Takahashi, Katsu; Bessho, Kazuhisa

2018-02-27

It is known that congenitally missing teeth can often cause differences in craniofacial morphology; however, there are few reported cases of orthognathic surgical treatment for these patients. Herein, the authors report a rare case of maxillary hypoplasia with congenital oligodontia treated by maxillary distraction osteogenesis with internal device. A 17-year-old male presenting with multiple tooth agenesis and maxillary recession was referred to our hospital for orthognathic surgical treatment. Preoperative simulation surgery was performed using Full-Color 3-dimensional salt model. After surgery, improvement in maxillary recession and occlusal stability was observed. This report demonstrates the advantages of the method used herein, which includes reduction in operating time with increase in the safety of the procedure.

Root Length and Anatomy of Impacted Maxillary Canines in Patients with Unilateral Maxillary Canine Impaction

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Mostfa Shahabi

2017-09-01

Full Text Available Introduction: Canine impaction is a common occurrence. In this study, we sought to investigate the root anatomy and length of impacted canines and lateral incisor adjacent to impacted maxillary canine. Materials and Methods: In this retrospective study, three-dimensional tomographic imaging was performed on 26 patients with unilateral maxillary canine impaction. In this study, we evaluated root length and anatomy of impacted canines, in terms of resorption intensity and curvature, with Planmeca Romexis Viewer 4.0. Furthermore, crown shape as well as root length and anatomy of the lateral incisors adjacent to impacted canines were investigated and compared with the other side on the dental arch, where canine eruption was normal. Results: Root length of impacted canines was significantly lower than that of normal canines (P=0.011. There were no significant differences between root length of lateral incisors adjacent to impacted canines and root length of lateral incisors adjacent to normal canines (P=0.221. Moreover, the resorption intensity of the adjacent lateral incisors was higher than that of the impacted canines. No significant differences were noted in root resorption intensity between the lateral incisors adjacent to the imacted canines and the lateral incisors adjacent to normal canines (P=0.36. In addition, resorption intensity was significantly higher in impacted canines than in normal canines (P=0.024. Root anatomy of impacted canines was not significantly different from that of normal canines (P=0.055. The crown shape of the lateral incisors adjacent to impacted canines was not significantly different from that of the lateral incisors adjacent to normal canines (P=0.052. Conclusion: Impaction can probably affect root length and canine resorption severity. However, root and crown shape of lateral incisors cannot always be associated with canine impaction.

Impacted maxillary canines and root resorption of adjacent teeth: A retrospective observational study.

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Guarnieri, R; Cavallini, C; Vernucci, R; Vichi, M; Leonardi, R; Barbato, E

2016-11-01

The prevalence of impacted maxillary canine is reported to be between 1% and 3%. The lack of monitoring and the delay in the treatment of the impacted canine can cause different complications such as: displacement of adjacent teeth, loss of vitality of neighbouring teeth, shortening of the dental arch, follicular cysts, canine ankylosis, recurrent infections, recurrent pain, internal resorption of the canine and the adjacent teeth, external resorption of the canine and the adjacent teeth, combination of these factors. An appropriate diagnosis, accurate predictive analysis and early intervention are likely to prevent such undesirable effects. The objective is to evaluate, by means of a retrospective observational study, the possibility of carrying out a predictive analysis of root resorption adjacent to the impacted canines by means of orthopantomographs, so as to limit the prescription of additional 3D radiography. 120 subjects with unilateral or bilateral maxillary impacted canine were examined and 50 patients with 69 impacted maxillary canine (22 male, 28 female; mean age: 11.7 years) satisfied the inclusion criteria of the study. These patients were subjected to a basic clinical and radiographic investigation (orthopantomographs and computerized tomography). All panoramic films were viewed under standardized conditions for the evaluation of two main variables: maxillary canine angulations (a, b, g angles) and the overlapping between the impacted teeth and the lateral incisor (Analysis of Lindauer). Binary logistic regression was used to estimate the likelihood of resorbed lateral incisors depending on sector location and angle measurements. Results indicated that b angle has the greatest influence on the prediction of root resorption (predictive value of b angle = 76%). If β angle <18° and Lindauer = I, the probability of resorption is 0.06. Evaluation of b angle and superimposition lateral incisor/impacted canine analysed on orthopantomographs could be one of

Clinical and radiographic evaluation of maxillary central incisors exposure in patients undergoing maxillary advancement

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Guilherme dos Santos Trento

2015-12-01

Full Text Available Abstract Introduction: Patients with dentofacial deformities may undergo orthodontic or orthodontic-surgical treatment. Both modalities can affect esthetics. Objective: This study aims to evaluate clinical and radiographic changes in exposure of maxillary central incisors occurring after orthognathic surgery for maxillary advancement. Methods: A total of 17 patients who underwent orthognathic surgery for maxillary advancement between September, 2010 and July, 2011 were selected. Exposure of maxillary central incisors was evaluated clinically and by lateral cephalograms. Measurements were taken one week before and three months after surgery. Data were paired in terms of sex, age, nasolabial angle, height and thickness of the upper lip, the amount of maxillary advancement, clinical exposure and inclination of maxillary central incisor by statistical tests (CI 95%. Results: After maxillary advancement, incisor clinical exposure had increased even with relaxed lips and under forced smile. Moreover, there was a mean increase of 23.33% revealed by lateral cephalograms. There was an inverse correlation between upper lip thickness and incisors postsurgical exposure revealed by radiographic images (p = 0.002. Conclusions: Significant changes in the exposure of maxillary central incisors occur after maxillary advancement, under the influence of some factors, especially lip thickness.

Generation and evaluation of 3D digital casts of maxillary defects based on multisource data registration: A pilot clinical study.

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Ye, Hongqiang; Ma, Qijun; Hou, Yuezhong; Li, Man; Zhou, Yongsheng

2017-12-01

Digital techniques are not clinically applied for 1-piece maxillary prostheses containing an obturator and removable partial denture retained by the remaining teeth because of the difficulty in obtaining sufficiently accurate 3-dimensional (3D) images. The purpose of this pilot clinical study was to generate 3D digital casts of maxillary defects, including the defective region and the maxillary dentition, based on multisource data registration and to evaluate their effectiveness. Twelve participants with maxillary defects were selected. The maxillofacial region was scanned with spiral computer tomography (CT), and the maxillary arch and palate were scanned using an intraoral optical scanner. The 3D images from the CT and intraoral scanner were registered and merged to form a 3D digital cast of the maxillary defect containing the anatomic structures needed for the maxillary prosthesis. This included the defect cavity, maxillary dentition, and palate. Traditional silicone impressions were also made, and stone casts were poured. The accuracy of the digital cast in comparison with that of the stone cast was evaluated by measuring the distance between 4 anatomic landmarks. Differences and consistencies were assessed using paired Student t tests and the intraclass correlation coefficient (ICC). In 3 participants, physical resin casts were produced by rapid prototyping from digital casts. Based on the resin casts, maxillary prostheses were fabricated by using conventional methods and then evaluated in the participants to assess the clinical applicability of the digital casts. Digital casts of the maxillary defects were generated and contained all the anatomic details needed for the maxillary prosthesis. Comparing the digital and stone casts, a paired Student t test indicated that differences in the linear distances between landmarks were not statistically significant (P>.05). High ICC values (0.977 to 0.998) for the interlandmark distances further indicated the high

Transition from failing dentition to complete-arch implant rehabilitation with a staged approach: a 3-year clinical report.

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Papaspyridakos, Panos; Chronopoulos, Vasilios

2014-09-01

The transition of patients from failing dentition to complete-arch implant rehabilitation often means that the patient is rendered edentulous and has to wear a removable complete denture for a time. Many patients find this objectionable. A staged treatment approach provides a fixed interim prosthesis for use throughout the rehabilitation process, allowing patient comfort and prosthodontic control. This clinical report describes a staged approach protocol with a new type of interim prosthesis. The prosthesis is supported by hopeless teeth and the soft tissues of the maxillary tuberosities and mandibular retromolar pads for the complete-arch implant rehabilitation of a patient with failing dentition. This protocol allows for a fixed interim prosthesis with combined tooth and mucosa or implant support during the entire rehabilitation process, thus avoiding the use of complete dentures. The implants and prostheses were functioning successfully after 3 years of clinical service. Copyright © 2014 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Comparison of Total Arch and Partial Arch Transposition During Hybrid Endovascular Repair for Aortic Arch Disease.

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Kang, W C; Ko, Y-G; Oh, P C; Shin, E K; Park, C-H; Choi, D; Youn, Y N; Lee, D Y

2016-08-01

Total arch transposition (TAT) during hybrid endovascular repair for aortic arch disease is believed to allow a better landing zone, but also to be associated with higher peri-operative mortality than partial arch transposition (PAT). Information on this issue is limited. This study was a retrospective analysis. All 53 consecutive patients with aortic arch disease (41 males, mean age 65.0 years) who underwent hybrid endovascular repair with TAT (zone 0, n=20) or PAT (zone 1 or 2, n=33) from 2008 to 2014 were analyzed retrospectively. The peri-operative and late outcomes of these two groups were compared. Baseline characteristics, including EuroSCORE II results, were similar in the two groups. After procedures, peri-operative mortalities and stroke rates were similar in the two groups (5.0% vs. 9.1%, p=1.000, and 10.0% vs. 6.1%, p=.627). Interestingly, all four strokes occurred in patients with a type III aortic arch irrespective of transposition type. Primary success rates (80.0% vs. 69.7%, p=.527) and type I endoleak incidences (20.0% vs. 27.3%, p=.744) were not significantly different. During follow up (mean duration 36.9 months), overall survival (89.7% vs. 87.4% at 1 year and 89.7% vs. 79.3% at 3 years; p=.375) and re-intervention free survival rates (78.6% vs. 92.0% at 1 year; 72.0% vs. 62.2% at 3 years, p=.872) were similar in the two groups. Morbidity and mortality were high within the first year of hybrid endovascular therapy for aortic arch disease, implying that candidates for hybrid procedures need to be selected carefully. Hybrid endovascular repair with TAT was found to have peri-operative mortality, stroke, and long-term survival rates comparable with PAT, so hybrid endovascular repair may be considered, irrespective of type of arch reconstruction, when clinically indicated. Copyright © 2016 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

Persistent fifth arch anomalies - broadening the spectrum to include a variation of double aortic arch vascular ring

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Newman, Beverley; Chan, Frandics [Stanford Children' s Hospital and Stanford University, Department of Radiology, Stanford, CA (United States); Hanneman, Kate [University of Toronto, Department of Medical Imaging, Toronto, ON (Canada)

2016-12-15

Fifth arch anomalies are rare and complex and frequently misdiagnosed or mistaken for other entities. We report a double arch vascular ring that is thought to consist of right fourth arch and left fifth arch components, a previously undescribed persistent fifth arch variant. The currently recognized spectrum and classification of fifth arch vascular anomalies are expanded along with illustrative images to justify the proposed changes. Reviewing and expanding the classification of fifth arch anomalies to include a double arch ring variant will promote recognition, correct diagnosis and appropriate management of these anomalies. (orig.)

Extraction of maxillary canines: Esthetic perceptions of patient smiles among dental professionals and laypeople.

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Thiruvenkatachari, Badri; Javidi, Hanieh; Griffiths, Sarah Elizabeth; Shah, Anwar A; Sandler, Jonathan

2017-10-01

Maxillary canines are generally considered important both cosmetically and functionally. Most claims on the importance of maxillary canines, however, have been based on expert opinions and clinician-based studies. There are no scientific studies in the literature reporting on their cosmetic importance or how laypeople perceive a smile treated by maxillary canine extractions. Our objective was to investigate whether there is any difference in the perceptions of patients' smiles treated by extracting either maxillary canines or first premolars, as judged by orthodontists, dentists, and laypeople. This retrospective study included 24 participants who had unilateral or bilateral extraction of maxillary permanent canines and fixed appliances in the maxillary and mandibular arches to comprehensively correct the malocclusion, selected from orthodontic patients treated at Chesterfield Royal Hospital NHS trust in the United Kingdom over the last 20 years. The control group of patients had extraction of maxillary first premolars followed by fixed appliances and finished to an extremely high standard judged by the requirement that they had been submitted for the Membership in Orthodontics examination. The finished Peer Assessment Rating scores for this group were less than 5. The end-of-treatment frontal extraoral smiling and frontal intraoral views were presented for both groups. The photographs were blinded for extraction choice and standardized for size and brightness using computer software (Adobe Photoshop CC version 14.0; Adobe Systems, San Jose, Calif). The work file was converted to an editable pdf file and e-mailed to the assessors. The assessor panel consisted of 30 members (10 orthodontists, 10 dentists, and 10 laypeople), who were purposely selected. The measures were rated on a 10-point Likert scale. The attractiveness ratings were not statistically significantly different between the canine extraction and premolar extraction groups, with a mean difference of 0

Truncal anaesthesia of the maxillary nerve for outpatient surgically assisted rapid maxillary expansion.

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Robiony, M; Demitri, V; Costa, F; Politi, M; Cugini, U

1998-10-01

We present our experience of transcutaneous truncal anaesthesia of the maxillary nerve in association with transmucosal anaesthesia of the sphenopalatine ganglion in surgically assisted rapid maxillary expansion. Twelve patients with a skeletal transverse discrepancy of the maxilla were treated in our department from 1994 to 1995. Maxillary transcutaneous nerve block was done with a Quincke 8 cm spinal needle together with transmucosal anaesthesia of the sphenopalatine ganglion. Mepivacaine without adrenaline and sodium bicarbonate 1/10 was used for truncal anaesthesia and lidocaine-prilocaine cream for transmucosal anaesthesia. A Le Fort I osteotomy, lateral nasal wall osteotomy, pterygomaxillary osteotomy, and a palatal osteotomy were done for all patients before the maxillary expansion. Total anaesthesia of the maxillary area facilitated the operations and appreciably reduced the amount of postoperative pain. The ease of achieving effective anaesthesia before and after operation and the absence of side-effects make this form of anaesthetic particularly useful in surgically assisted rapid maxillary expansion.

Maxillary hematocele

International Nuclear Information System (INIS)

Inaba, Tsuyoshi; Fujimura, Takeyuki; Udaka, Tsuyoshi; Siomori, Teruo; Kadokawa, Yohei; Suzuki, Hideaki

2007-01-01

Hematocele is a benign hemorrhagic pseudotumor that preferably arises in the sinonasal tract, particularly in the maxillary sinus. The occurrence of maxillary hematocele has sporadically been documented, but its nature is not dearly understood. We herein report four cases of maxillary hematocele. The patients were 3 men and one woman, 30-62 years of age with an average of 49.8 years. Major symptoms were nasal obstruction (2 cases), nasal bleeding (2 cases), and toothache (1 case). Computed tomography demonstrated well-defined expansive soft tissue shadows with bone erosion. The lesions showed intermingled high/intermediate/low intensity in both T1- and T2-weighted magnetic resonance imaging. Endoscopic sinus surgery was performed in 3 cases, and the other patient underwent Caldwell-Luc procedure. Surgical specimens microscopically exhibited inflammatory changes with hematoma and fibrin deposition. The postoperative clinical course was uneventful in all cases, and all the patients are currently free from disease 4-25 months after surgery. Clinical, histopathological and radiological characteristics of maxillary hematocele are reviewed. (author)

Speech intelligibility enhancement after maxillary denture treatment and its impact on quality of life.

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Knipfer, Christian; Riemann, Max; Bocklet, Tobias; Noeth, Elmar; Schuster, Maria; Sokol, Biljana; Eitner, Stephan; Nkenke, Emeka; Stelzle, Florian

2014-01-01

Tooth loss and its prosthetic rehabilitation significantly affect speech intelligibility. However, little is known about the influence of speech deficiencies on oral health-related quality of life (OHRQoL). The aim of this study was to investigate whether speech intelligibility enhancement through prosthetic rehabilitation significantly influences OHRQoL in patients wearing complete maxillary dentures. Speech intelligibility by means of an automatic speech recognition system (ASR) was prospectively evaluated and compared with subjectively assessed Oral Health Impact Profile (OHIP) scores. Speech was recorded in 28 edentulous patients 1 week prior to the fabrication of new complete maxillary dentures and 6 months thereafter. Speech intelligibility was computed based on the word accuracy (WA) by means of an ASR and compared with a matched control group. One week before and 6 months after rehabilitation, patients assessed themselves for OHRQoL. Speech intelligibility improved significantly after 6 months. Subjects reported a significantly higher OHRQoL after maxillary rehabilitation with complete dentures. No significant correlation was found between the OHIP sum score or its subscales to the WA. Speech intelligibility enhancement achieved through the fabrication of new complete maxillary dentures might not be in the forefront of the patients' perception of their quality of life. For the improvement of OHRQoL in patients wearing complete maxillary dentures, food intake and mastication as well as freedom from pain play a more prominent role.

Orthodontic considerations for maxillary distraction osteogenesis in growing patients with cleft lip and palate using internal distractors.

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Silveira, Adriana da; Moura, Pollyana Marques de; Harshbarger, Raymond J

2014-11-01

The orthodontist plays a key role in the selection of the optimal treatment for patients followed by a craniofacial team. For patients with cleft lip and palate, the need for multidisciplinary treatment planning and sequentially staged treatment is essential for successful patient outcomes. The technique of Le Fort I distraction osteogenesis of the maxilla using an internal device is potentially a predictable, stable, and convenient option for the correction of severe maxillary hypoplasia. It is an alternative option for treatment of maxillary hypoplasia in growing patients. In this article, the authors describe the orthodontist's approach to the management of cleft patients with severe maxillary deficiency with the use of an internal distraction device. The information is presented with a focus on the clinical aspects of treatment, using case illustrations and appropriate literature.

Neonatal aortic arch reconstruction avoiding circulatory arrest and direct arch vessel cannulation.

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Tchervenkov, C I; Korkola, S J; Shum-Tim, D; Calaritis, C; Laliberté, E; Reyes, T U; Lavoie, J

2001-11-01

Aortic arch reconstruction in neonates routinely requires deep hypothermic circulatory arrest. We reviewed our experience with techniques of continuous low-flow cerebral perfusion (LFCP) avoiding direct arch vessel cannulation. Eighteen patients, with a median age of 11 days (range 1 to 85 days) and a mean weight of 3.2 +/- 0.8 kg, underwent aortic arch reconstruction with LFCP. Seven had biventricular repairs with arch reconstruction, 9 underwent the Norwood operation and 2 had isolated arch repairs. In 1 Norwood and 7 biventricular repair patients, LFCP was maintained by advancing the cannula from the distal ascending aorta into the innominate artery. In 8 of 9 Norwood patients, LFCP was maintained by directing the arterial cannula into the pulmonary artery confluence and perfusing the innominate artery through the right modified Blalock-Taussig shunt fully constructed before cannulation for cardiopulmonary bypass. In 2 patients requiring isolated arch reconstruction, the ascending aorta was cannulated and the cross-clamp was applied just distal to the innominate artery. LFCP was maintained at 0.6 +/- 0.2 L x min(-1) x m(-2) for 41.0 +/- 13.9 minutes at 18.5 degrees C +/- 1.1 degrees C. In 10 of the 18 patients, blood pressure during LFCP was 15 +/- 8 mm Hg remote from the innominate artery (left radial, umbilical or femoral arteries). In 8 of the 18 patients, right radial pressure during LFCP was 24 +/- 10 mm Hg. The mean mixed-venous saturation was 79.8% +/- 10% during LFCP. Two patients had preoperative seizures, whereas none had seizures postoperatively. One patient died. Neonatal aortic arch reconstruction is possible without circulatory arrest or direct arch vessel cannulation. These techniques maintained adequate mixed-venous oxygen saturations with no associated adverse neurologic outcomes.

Soft Tissue Changes in Cleft Lip and Palate Patients: Anterior Maxillary Distraction versus Conventional Le-Fort I Osteotomy.

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Markose, Eldho; Paulose, Joby; Paul, Eldho T

2013-12-01

The purpose of the study was to compare the soft tissue changes after maxillary advancement in patients with maxillary deficiency associated with cleft lip and palate (CLP) by two approaches-anterior maxillary distraction (AMD) and advancement LeFort I osteotomy (ALO). Twenty patients with maxillary hypoplasia associated with cleft lip and palate who had undergone either LeFort I osteotomy or distraction osteogenesis with maxillary advancement were included in this study. Lateral cephalogram taken at various intervals of time were used to evaluate soft tissue and hard tissue changes over time. In both groups, vertical as well as horizontal changes in pronasale was well observed. A substantial increase in nasal parameters was noted in case of AMD group in comparison to ALO. Though maxillary advancement was evident in both the groups, a significant and consistent change was observed in AMD. Significant vertical and horizontal changes were seen with respect to subnasale and labrale superius in AMD group. Soft tissue as well as hard tissue relapse was greater in ALO group than AMD group. Significant soft tissue and hard tissue changes were clearly observed in both the groups, but the treatment results were more consistent in cases treated with AMD. Hence AMD could be considered as a better treatment of choice in cases of maxillary hypoplasia associated with cleft lip and palate.

One-stage tooth-borne distraction versus two stage bone-borne distraction in surgically assisted maxillary expansion (SARME).

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Seeberger, Robin; Abe-Nickler, Dorothee; Hoffmann, Jürgen; Kunzmann, Kevin; Zingler, Sebastian

2015-12-01

To evaluate and compare the effects of tooth-borne and bone-borne distraction devices in surgically assisted maxillary expansion (SARME) on dental and skeletal structures. A sample of 33 skeletally mature patients with transverse maxillary deficiencies was examined with cone beam computed tomography (CBCT) before and 3 months after surgery. Fourteen patients were treated with tooth-borne devices and 19 patients with bone-borne devices. Dental crown expansion in the first premolars did not differ significantly between the two groups, and median expansion was 5.55 mm (interquartile range [IQR] 5.23) in the tooth-borne device group and 4.6 mm (IQR 3.4) in the bone-borne device group. In the first molars, crown expansion and lateral tipping were significantly greater in the tooth-borne device group (P ≤ .02). The median skeletal nasal isthmus increase was significantly more in the bone-borne device group at 3.0 mm than in the tooth-borne device group at 0.98 mm (P ≤ .02). Both tooth-borne and bone-borne devices are effective treatment modalities to correct maxillary transverse deficiencies. Bone-borne devices produced greater widening of the skeletal nasal floor and fewer dental side effects in the first molars. Copyright © 2015 Elsevier Inc. All rights reserved.

Surgical modification for preventing a gothic arch after aortic arch repair without the use of foreign material.

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Seo, Dong-Man; Park, Jiyoung; Goo, Hyun Woo; Kim, Young Hwue; Ko, Jae-Kon; Jhang, Won Kyoung

2015-04-01

Systemic hypertension is the main late complication after arch reconstruction in patients with arch obstruction. Gothic arch geometry is suspected to be one of its possible causes. Accordingly, we evaluated here if a modified arch repair technique using an autologous pulmonary patch is effective in preventing gothic arch development. Fifty infants who underwent arch repair with either a modified (n = 17) or conventional (n = 33) technique between January 2006 and August 2012 by a single surgeon were retrospectively reviewed. Arch geometry was compared using three categories (gothic, crenel or roman), classified by the height/width (H/W) ratio and the arch angle measured in computed tomography. No gothic arch geometry was observed in the modified group, whereas it was observed in 9 cases in the conventional group (P = 0.005). Moreover, reintervention for arch restenosis was performed only in the conventional group (n = 4; P = 0.29). No associated complications were observed, although the selective cerebral perfusion time was longer in the modified group than in the conventional group (28.5 ± 6.2 vs 17.1 ± 9.9 min; P gothic arch geometry, but also as equally safe in terms of early clinical outcomes as conventional arch reconstruction techniques. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

[Piezosurgery for surgically assisted rapid maxillary expansion under local anesthesia].

Science.gov (United States)

Sun, Hao; Li, Biao; Sun, Hao; Liu, Zhixu; Wang, Xudong

2014-08-01

This study evaluates piezosurgery for surgically assisted rapid maxillary expansion (SARME) under local anesthesia. SARME was performed on adults with maxillary transverse deficiency under local anesthesia with a piezosurgical device. Fourteen patients (six males and eight females) underwent lateral maxillary osteotomies, midpalatal osteotomies, and bilateral pterygomaxillary disjunction. The feelings of patients during the operation were determined through questionnaires. All patients underwent SARME in the out-patient operating room. The surgical procedures were completed under local anesthesia. All patients exhibited satisfactory tolerance. Ultrasonic bone-cutting surgery was recently introduced as a feasible alternative to the conventional tools of cranio-maxillofacial surgery for its technical characteristics of precision and safety. The device used was unique in that cutting action occurred when the tool was employed on mineralized tissues, but stoped on soft tissues. The results of the questionnaires showed that eight (57.14%) patients felt a mild sensation of ultrasonic vibration, tweleve (85.7 1%) felt mild tolerable pain and tooth soreness during surgery, and eleven (78.57%) felt little fear and hardly heard the ultrasonic sound. Preoperative and postoperative six months later measurements showed an evident effect of expansion. Piezosurgery enabled patients to undergo all the steps of SARME under local anesthesia, but more cases and longer follow-up are needed to verif ' the results.

Transantral distraction devices in correction of severe maxillary deformity in cleft patients.

Science.gov (United States)

Shokirov, Shokhruh; Wangerin, Konrad

2011-01-01

Maxillary advancement by Le Fort I osteotomy in cleft patients has an average relapse of about 40-60 percent. With extraoral distraction devices it is possible to obtain an almost unlimited advancement of the upper jaw. Due to the social problems the retention period is normally reduced to some monthes. A relapse of 10-25 % can be seen in these cases. Le Fort I internal distraction osteogenesis offers an alternative to one-step orthognathic advancement, with advantages of gradual lengthening through scar and earlier treatment in growing patients. The objective of this study was to present our experience in the treatment of maxillary deficiency in cleft patients using transantral internal distraction devices. The distraction procedure was successfully accomplished in seventeen patients. For all the seventeen patients maxillary distraction device designed by Konrad Wangerin was used. The distraction distances were 8 to 24 mm. Preoperative, postoperative, and follow-up (12 and 24 months) lateral cephalogram measurements were compared including angular and linear changes. A good new bone was found that was formed in distraction pitch between lines of osteotomy. After distraction of median facial zone, occlusion and profile of soft tissues were considerably improved. All patients after postoperative time required final orthodontic treatment and their final occlusal relationships were satisfactory. The transantral distraction device is a new option for the treatment of severe maxillary hypoplasia in cleft patients.

RARE BRANCHIAL ARCH ANOMALIES

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Jayanta Kumar

2016-03-01

Full Text Available AIM Amongst the branchial arch anomalies third arch anomaly occurs rarely and more so the fourth arch anomalies. We present our experience with cases of rare branchial arch anomalies. PATIENTS AND METHODS From June 2006 to January 2016, cases having their external opening in the lower third of sternocleidomastoid muscle with the tract going through thyroid gland and directing to pyriform sinus (PFS or cysts with internal opening in the PFS were studied. RESULTS No fourth arch anomaly was encountered. One cyst with internal opening which later on formed a fistula, three fistulae from beginning and two sinuses were encountered. The main stay of diagnosis was the fistula in the PFS and the tract lying posterior to the internal carotid artery. Simple excision technique with a small incision around the external opening was done. There was no recurrence. CONCLUSION Third arch fistula is not very rare as it was thought. Internal fistula is found in most of the cases. Though radiological investigations are helpful, fistulae can be diagnosed clinically and during operation. Extensive operation of the neck, mediastinum and pharynx is not required.

Bilateral cross-bite treated by repeated rapid maxillary expansions: a 17-year follow-up case.

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Cozzani, M; Mazzotta, L; Caprioglio, A

2014-07-01

The objective of this paper is to show the clinical results after the repeated application of a Haas expander for rapid maxillary expansion (RME) anchored onto deciduous teeth in a 7-year-old patient that presented bilateral cross-bite, superior crowding and no space for permanent lateral incisors eruption. A first Haas expander was applied to the patient. She was told to activate it once a day, each activation was equal to 0.20 mm. After the first RME, the bilateral cross-bite was solved but still there was not enough space for lateral incisor eruption. A second and then a third Haas expander were applied, with the same activation protocol as the first one, in order to gain space in the anterior region and to achieve proper eruption of the lateral incisors. The patient was then treated with fixed appliances. At debonding the patient presented well aligned arch-forms: space for lateral incisor eruption was gained and superior crowding was solved. Bilateral cross-bite was also corrected. She was seen again 10 years and 17 years after expansions: she showed no relapse and presented a good functional occlusion that had remained stable, and an aesthetically pleasant smile, however she exhibited gingival recessions. Repeated rapid maxillary expansion, anchored onto deciduous teeth, performed in early mixed dentition represents a safe and successful treatment to correct severe bilateral cross- bites and to create space for maxillary incisor eruption.

Cable strengthened arches

NARCIS (Netherlands)

Kamerling, M.W.

2013-01-01

The structural efficiency of arches, subjected to several variable loads, can be increased by strengthening these arches with cables. For these structures it can be necessary, especially in case the permanent load is small, to post-tension the cables to avoid any compression acting on the cables. A

Management of Cleft Maxillary Hypoplasia with Anterior Maxillary Distraction: Our Experience.

Science.gov (United States)

Chacko, Tojan; Vinod, Sankar; Mani, Varghese; George, Arun; Sivaprasad, K K

2014-12-01

Maxillary hypoplasia is a common developmental problem in cleft lip and palate deformities. Since 1970s these deformities have traditionally been corrected by means of orthognathic surgery. Management of skeletal deformities in the maxillofacial region has been an important challenge for maxillofacial surgeons and orthodontists. Distraction osteogenesis is a surgical technique that uses body's own repairing mechanisms for optimal reconstruction of the tissues. We present four cases of anterior maxillary distraction osteogenesis with tooth borne distraction device-Hyrax, which were analyzed retrospectively for the efficacy of the tooth borne device-Hyrax and skeletal stability of distracted anterior maxillary segment.

Right circumflex retro-oesophageal aortic arch with coarctation of a high-positioned right arch

International Nuclear Information System (INIS)

Ahn, Kyung-Sik; Yong, Hwan Seok; Woo, Ok Hee; Kang, Eun-Young; Lee, Joo-Won

2007-01-01

We present a rare case of right circumflex retro-oesophageal aortic arch with coarctation of a high-positioned right arch. A 7-month-old boy presented with a cardiac murmur. Cardiac situs was normal and there was no evidence of an intracardiac shunt or patent ductus arteriosus. MR aortography revealed a right aortic arch that was high-positioned, tortuous and narrowed. This right aortic arch crossed the midline behind the oesophagus and continued as a left-sided descending aorta. The left common carotid and subclavian arteries arose from a large branching vascular structure that derived from the top of the left-sided descending aorta. The right common carotid artery arose from the ascending aorta. The proximal portion of the right common carotid artery showed very severe stenosis and poststenotic dilatation. The right subclavian artery originated distal to the narrowed and tortuous segment of the aortic arch. (orig.)

Interceptive orthopedics for the correction of maxillary transverse and sagittal deficiency in the early mixed dentition period

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Ashok Kumar Talapaneni

2011-01-01

Full Text Available Dentofacial Orthopedics directed to a hypoplastic maxilla in the prepubertal period redirects growth of the maxilla in the vertical, transverse and sagittal planes of space. The orthopedic correction of maxillary hypoplasia in the early mixed dentition period thus intercepts the establishment of permanent structural asymmetry in the mandible and helps in the achievement of optimal dentofacial esthetics. This paper presents the growth redirection in a hypoplastic maxilla of an 8-year-old girl with simultaneous rapid maxillary expansion and protraction headgear therapy for a period of 11 months which corrected the posterior unilateral cross-bite, the positional asymmetry of the mandible and established an orthognathic profile in the individual.

Positional relationship between the maxillary sinus floor and the apex of the maxillary first molar using cone beam computed tomograph

International Nuclear Information System (INIS)

Kim, Kyung Hwa; Koh, Kwang Joon

2008-01-01

To assess the positional relationship between the maxillary sinus floor and the apex of the maxillary first molar using cone beam computed tomograph (CBCT). CBCTs from 127 subjects were analysed. A total of 134 maxillary first molars were classified according to their vertical and horizontal positional relationship to the maxillary sinus floor and measured according to the distance between the maxillary sinus floor and the maxillary first molar. Type III (The root projected laterally on the sinus cavity but its apex is outside the sinus boundaries) was dominated between 10 and 19 years and type I (The root apex was not in contact with the cortical borders of the sinus) was dominated (P<0.05) between 20 and 72 years on the vertical relationship between the maxillary sinus floor and the apex of the maxillary first molar. The maxillary sinus floor was located more at the apex (78.2%) than at the furcation (21.3%) for the palatal root. The distance from the root apex to the maxillary sinus floor confined to type I was increased according to the ages (P<0.05). Type M (The maxillary sinus floor was located between the buccal and the palatal root) was most common (72.4%) on the horizontal relationship between the maxillary sinus floor and the apex of the maxillary first molar. CBCT can provide highly qualified images for the maxillary sinus floor and the root apex of the maxillary first molar.

Aortic arch malformations

Energy Technology Data Exchange (ETDEWEB)

Kellenberger, Christian J. [University Children' s Hospital, Department of Diagnostic Imaging, Zuerich (Switzerland)

2010-06-15

Although anomalies of the aortic arch and its branches are relatively uncommon malformations, they are often associated with congenital heart disease. Isolated lesions may be clinically significant when the airways are compromised by a vascular ring. In this article, the development and imaging appearance of the aortic arch system and its various malformations are reviewed. (orig.)

Aortic arch malformations

International Nuclear Information System (INIS)

Kellenberger, Christian J.

2010-01-01

Although anomalies of the aortic arch and its branches are relatively uncommon malformations, they are often associated with congenital heart disease. Isolated lesions may be clinically significant when the airways are compromised by a vascular ring. In this article, the development and imaging appearance of the aortic arch system and its various malformations are reviewed. (orig.)

Bone-anchored maxillary expansion and bilateral interoral mandibular distraction osteogenesis in adult with severe obstructive sleep apnea syndrome.

Science.gov (United States)

Nie, Ping; Zhu, Min; Lu, Xiao-Feng; Fang, Bing

2013-05-01

Severe obstructive sleep apnea syndrome (OSAS) threatens patients' lives. To solve ventilation problem, snoring, and avoid another orthognathic surgery for mandibular advancement, bone-anchored rapid maxillary expansion and bilateral interoral mandibular distraction osteogenesis were tried on a 20-year-old Chinese male patient with severe skeletal class II malocclusion and OSAS.The patient had polysomnography (apnea-hypopnea index 54.2), body mass index measurement (19.7 kg/m), and cephalometry before the treatment. Bone-anchored rapid maxillary expansion was performed for the correction of maxillary transverse and minor sagittal deficiency and the improvement of nasal airflow by decreasing nasal resistance. Bilateral interoral mandibular distraction osteogenesis was operated to lengthen the small, retruded mandible by 15 mm. Orthodontic treatment after the maxillary expansion and mandibular distraction osteogenesis can help obtain stable occlusion.The Epworth Sleepiness Scale, a questionnaire for temporomandibular joint, cephalometric analysis, polysomnography, acoustic rhinometry, and multislice spiral computed tomography were performed to evaluate changes from the treatment. All the results showed that the patient had a significantly alleviated OSAS. In addition, an acceptable occlusion was also obtained.

Occlusal stability in shortened dental arches.

Science.gov (United States)

Witter, D J; Creugers, N H; Kreulen, C M; de Haan, A F

2001-02-01

Shortened dental arches consisting of anterior and premolar teeth have been shown to meet oral functional demands. However, the occlusal stability may be at risk as a result of tooth migration. The aim of this nine-year study was to investigate occlusal stability in shortened dental arches as a function over time. Occlusal stability indicators were: 'interdental spacing', 'occlusal contacts of anterior teeth in Intercuspal Position', 'overbite', 'occlusal tooth wear', and 'alveolar bone support'. Subjects with shortened dental arches (n = 74) were compared with subjects with complete dental arches (controls, n = 72). Repeated-measurement regression analyses were applied to assess age-dependent variables in the controls and to relate the occlusal changes to the period of time since the treatment that led to the shortened dental arches. Compared with complete dental arches, shortened dental arches had similar overbite and occlusal tooth wear. They showed more interdental spacing in the premolar regions, more anterior teeth in occlusal contact, and lower alveolar bone scores. Since the differences remained constant over time, we conclude that shortened dental arches can provide long-term occlusal stability. Occlusal changes were self-limiting, indicating a new occlusal equilibrium.

Dimensions of Velopharyngeal Space following Maxillary Advancement with Le Fort I Osteotomy Compared to Zisser Segmental Osteotomy: A Cephalometric Study

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Furkan Erol Karabekmez

2015-01-01

Full Text Available The objectives of this study are to assess the velopharyngeal dimensions using cephalometric variables of the nasopharynx and oropharynx as well as to compare the Le Fort I osteotomy technique to Zisser’s anterior maxillary osteotomy technique based on patients’ outcomes within early and late postoperative follow-ups. 15 patients with severe maxillary deficiency treated with Le Fort I osteotomy and maxillary segmental osteotomy were assessed. Preoperative, early postoperative, and late postoperative follow-up lateral cephalograms, patient histories, and operative reports are reviewed with a focus on defined cephalometric landmarks for assessing velopharyngeal space dimension and maxillary movement (measured for three different tracing points. A significant change was found between preoperative and postoperative lateral cephalometric measurements regarding the distance between the posterior nasal spine and the posterior pharyngeal wall in Le Fort I osteotomy cases. However, no significant difference was found between preoperative and postoperative measurements in maxillary segmental osteotomy cases regarding the same measurements. The velopharyngeal area calculated for the Le Fort I osteotomy group showed a significant difference between the preoperative and postoperative measurements. Le Fort I osteotomy for advancement of upper jaw increases velopharyngeal space. On the other hand, Zisser’s anterior maxillary segmental osteotomy does not alter the dimension of the velopharyngeal space significantly.

Maxillary molar distalization with aligners in adult patients: a multicenter retrospective study

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Serena Ravera

2016-04-01

Full Text Available Abstract Background The aim of the present study was to test the hypothesis that bodily maxillary molar distalization was not achievable in aligner orthodontics. Methods Forty lateral cephalograms obtained from 20 non-growing subjects (9 male, 11 female; average age 29.73 years (group S, who underwent bilateral distalization of their maxillary dentition with Invisalign aligners (Align Technology, Inc., San José, CA, USA, were considered for the study. Skeletal class I or class II malocclusion and a bilateral end-to-end class II molar relationship were the main inclusion criteria. Cephalograms were taken at two time points: (T0 pretreatment and (T2 post-treatment. Treatment changes were evaluated between the time points using 39 variables by means of paired t test. The level of significance was set at P < 0.05. Reproducibility of measurements was assessed by the intraclass correlation coefficient (ICC. Results The mean treatment time was 24.3 ± 4.2 months. At the post-treatment point, the first molar moved distally 2.25 mm without significant tipping (P = 0.27 and vertical movements (P = 0.43. The second molar distalization was 2.52 mm without significant tipping (P = 0.056 and vertical movements (P = 0.25. No significant movements were detected on the lower arch. SN^GoGn and SPP^GoGn angles showed no significant differences between pre- and post-treatment cephalograms (P = 0.22 and P = 0.85, respectively. Conclusions Aligner therapy in association with composite attachments and class II elastics can distalize maxillary first molars by 2.25 mm without significant tipping and vertical movements of the crown. No changes to the facial height were revealed.

Perceptual Speech Assessment after Maxillary Advancement Osteotomy in Patients with a Repaired Cleft Lip and Palate

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Seok-Kwun Kim

2012-05-01

Full Text Available BackgroundMaxillary hypoplasia refers to a deficiency in the growth of the maxilla commonly seen in patients with a repaired cleft palate. Those who develop maxillary hypoplasia can be offered a repositioning of the maxilla to a functional and esthetic position. Velopharyngeal dysfunction is one of the important problems affecting speech after maxillary advancement surgery. The aim of this study was to investigate the impact of maxillary advancement on repaired cleft palate patients without preoperative deterioration in speech compared with non-cleft palate patients.MethodsEighteen patients underwent Le Fort I osteotomy between 2005 and 2011. One patient was excluded due to preoperative deterioration in speech. Eight repaired cleft palate patients belonged to group A, and 9 non-cleft palate patients belonged to group B. Speech assessments were performed preoperatively and postoperatively by using a speech screening protocol that consisted of a list of single words designed by Ok-Ran Jung. Wilcoxon signed rank test was used to determine if there were significant differences between the preoperative and postoperative outcomes in each group A and B. And Mann-Whitney U test was used to determine if there were significant differences in the change of score between groups A and B.ResultsNo patients had any noticeable change in speech production on perceptual assessment after maxillary advancement in our study. Furthermore, there were no significant differences between groups A and B.ConclusionsRepaired cleft palate patients without preoperative velopharyngeal dysfunction would not have greater risk of deterioration of velopharyngeal function after maxillary advancement compared to non-cleft palate patients.

Perceptual speech assessment after maxillary advancement osteotomy in patients with a repaired cleft lip and palate.

Science.gov (United States)

Kim, Seok-Kwun; Kim, Ju-Chan; Moon, Ju-Bong; Lee, Keun-Cheol

2012-05-01

Maxillary hypoplasia refers to a deficiency in the growth of the maxilla commonly seen in patients with a repaired cleft palate. Those who develop maxillary hypoplasia can be offered a repositioning of the maxilla to a functional and esthetic position. Velopharyngeal dysfunction is one of the important problems affecting speech after maxillary advancement surgery. The aim of this study was to investigate the impact of maxillary advancement on repaired cleft palate patients without preoperative deterioration in speech compared with non-cleft palate patients. Eighteen patients underwent Le Fort I osteotomy between 2005 and 2011. One patient was excluded due to preoperative deterioration in speech. Eight repaired cleft palate patients belonged to group A, and 9 non-cleft palate patients belonged to group B. Speech assessments were performed preoperatively and postoperatively by using a speech screening protocol that consisted of a list of single words designed by Ok-Ran Jung. Wilcoxon signed rank test was used to determine if there were significant differences between the preoperative and postoperative outcomes in each group A and B. And Mann-Whitney U test was used to determine if there were significant differences in the change of score between groups A and B. No patients had any noticeable change in speech production on perceptual assessment after maxillary advancement in our study. Furthermore, there were no significant differences between groups A and B. Repaired cleft palate patients without preoperative velopharyngeal dysfunction would not have greater risk of deterioration of velopharyngeal function after maxillary advancement compared to non-cleft palate patients.

Transition from failing dentition to full-arch fixed implant-supported prosthesis with a staged approach using removable partial dentures: a case series.

Science.gov (United States)

Cortes, Arthur Rodriguez Gonzalez; Cortes, Djalma Nogueira; No-Cortes, Juliana; Arita, Emiko Saito

2014-06-01

The present retrospective case series is aimed at evaluating a staged approach using a removable partial denture (RPD) as an interim prosthesis in treatment to correct a failing dentition until such time as a full-arch fixed implant-supported prosthesis may be inserted. Eight patients, who had undergone maxillary full-arch rehabilitation with dental implants due to poor prognosis of their dentitions, were analyzed. All treatment included initial periodontal therapy and a strategic order of extraction of hopeless teeth. An RPD supported by selected teeth rehabilitated the compromised arch during implant osseointegration. These remaining teeth were extracted prior to definitive prosthesis delivery. Advantages and drawbacks of this technique were also recorded for the cases presented. Among the advantages provided by the staged approach are simplicity of fabrication, low cost, and ease of insertion. Additionally, RPD tooth support prevented contact between the interim prosthesis and healing abutments, promoting implant osseointegration. The main drawbacks were interference with speech and limited esthetic results. Implant survival rate was 100% within a follow-up of at least 1 year. The use of RPDs as interim prostheses allowed for the accomplishment of the analyzed rehabilitation treatments. It is a simple treatment alternative for patients with a low smile line. © 2013 by the American College of Prosthodontists.

Rapid palatal expansion effects on mandibular transverse dimensions in unilateral posterior crossbite patients: a three-dimensional digital imaging study

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Alessandro Ugolini

2016-01-01

Full Text Available Abstract Background The purpose of this controlled study was to investigate indirect effects on mandibular arch dimensions, 1 year after rapid palatal expansion (RPE therapy. Methods Thirty-three patients in mixed dentition (mean age 8.8 years showing unilateral posterior crossbite and maxillary deficiency were treated with a RPE (Haas type cemented on the first permanent molars. Treatment protocol consisted of two turns per day until slight overcorrection of the molar transverse relationship occurred. The Haas expander was kept on the teeth as a passive retainer for an average of 6 months. Study models were taken prior (T1 and 15 months on average (T2 after expansion. A control group of 15 untreated subjects with maxillary deficiency (mean age 8.3 years was also recorded with a 12-month interval. Stone casts were digitized with a 3D scanner (3Shape, DK. Results In the treated group, both mandibular intermolar distance (+1.9 mm and mandibular molar angulation (+9° increased. Mandibular incisor angulation showed an increase of 1.9°. There was little effect on intercanine distance and canine angulation. Controls showed a reduction in transverse arch dimension and a decrease in molar and canine angulation values. Conclusions RPE protocol has indirect widening effects on the mandibular incisors and first molars.

Islamic Architecture and Arch

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Mohammed Mahbubur Rahman

2015-01-01

Full Text Available The arch, an essential architectural element since the early civilizations, permitted the construction of lighter walls and vaults, often covering a large span. Visually it was an important decorative feature that was trans-mitted from architectural decoration to other forms of art worldwide. In early Islamic period, Muslims were receiving from many civilizations, which they improved and re-introduced to bring about the Renaissance. Arches appeared in Mesopotamia, Indus, Egyptian, Babylonian, Greek and Assyrian civilizations; but the Romans applied the technique to a wide range of structures. The Muslims mastered the use and design of the arch, employed for structural and functional purposes, progressively meeting decorative and symbolic pur-poses. Islamic architecture is characterized by arches employed in all types of buildings; most common uses being in arcades. This paper discusses the process of assimilation and charts how they contributed to other civilizations.

Maxillary Sinus Floor Augmentation

DEFF Research Database (Denmark)

Starch-Jensen, Thomas; Jensen, Janek Dalsgaard

2017-01-01

, radiological and histomorphometric outcome as well as complications are presented after maxillary sinus floor augmentation applying the lateral window technique with a graft material, maxillary sinus membrane elevation without a graft material and osteotome-mediated sinus floor elevation with or without...

Changes in nasorespiratory function in association with maxillary distraction osteogenesis in subjects with cleft lip and palate.

Science.gov (United States)

Saito, Kiyo; Ono, Takashi; Mochida, Masumi; Ohyama, Kimie

2006-01-01

The current study aimed to determine how nasorespiratory function changes in association with maxillary distraction osteogenesis (DO). Furthermore, with regard to impaired nasorespiratory function, the possibility of a relationship between the cleft side and laterality and any effect of maxillary distraction osteogenesis was investigated. In this descriptive, prospective clinical report, subjective and objective data regarding nasorespiratory function before and after maxillary distraction osteogenesis were compared. Data from 13 subjects with cleft lip and palate were used. Subjects had a severe maxillary deficiency and underwent distraction osteogenesis using a rigid external device system. The subjective measure was the score on a questionnaire regarding nasorespiratory function using a visual analog scale. The objective measure was nasal resistance. The visual analog scale score for two items significantly decreased just after distraction osteogenesis. Nasal resistance also significantly decreased 1 year after distraction osteogenesis. Moreover, nasal resistance on the cleft side was significantly greater than that on the noncleft side just before and 1 year after distraction osteogenesis. There was a significant positive correlation between changes in the visual analog scale score and nasal resistance. These results suggest that nasorespiratory function changes in association with maxillary distraction osteogenesis in subjects with cleft lip and palate. Moreover, it appears that nasal obstruction on the cleft side does not change in subjects with unilateral cleft lip and palate.

Patients’ general satisfaction with the appearance of anterior maxillary teeth

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Lajnert Vlatka

2017-01-01

Full Text Available Background/Aim. Dental appearance plays an important role in practically all personal social interactions. The main factors that define the dental appearance are tooth colour, shape and position, quality of restoration, and the general position of the teeth in arch, especially in the anterior region. The aim of this study was to evaluate the impact of dental status (tooth shape, fracture, dental and prosthetic restorations and presence of plaque on patient''s satisfaction with the dental appearance, controlling for the age and gender. Methods. A total of 700 Caucasian subjects (439 women aged 18–86 (median 45 years participated in the cross-sectional study. Study included clinical examination and self-administrated questionnaire based on selfperceived aesthetics and satisfaction with the appearance of their maxillary anterior teeth. Results. A regression analysis demonstrated that presence of dental plaque, tooth fracture, composite fillings and crowns had significant independent contribution and were negative predictors of satisfaction with teeth appearance. Participants with presence of plaque on upper teeth (p < 0.001, fractures (p = 0.005, composite fillings (p < 0.001 and crowns (p = 0.032 were less satisfied than those without it. Model explains 12% or variance of general satisfaction with the appearance of maxillary frontal teeth (p < 0.001 and the major contributors are composite fillings (5.3% and plaque (3.2%. Tooth shape, age and gender were not significant predictors of satisfaction. Conclusion. Satisfaction with the teeth appearance is under the influence of many factors with significant negative influence of presence of dental plaque, fractures, composite restorations, and crowns.

Electrostatically Tunable Nanomechanical Shallow Arches

KAUST Repository

Kazmi, Syed N. R.

2017-11-03

We report an analytical and experimental study on the tunability of in-plane doubly-clamped nanomechanical arches under varied DC bias conditions at room temperature. For this purpose, silicon based shallow arches are fabricated using standard e-beam lithography and surface nanomachining of a highly conductive device layer on a silicon-on-insulator (SOI) wafer. The experimental results show good agreement with the analytical results with a maximum tunability of 108.14% for 180 nm thick arch with a transduction gap of 1 μm between the beam and the driving/sensing electrodes. The high tunability of shallow arches paves the ways for highly tunable band pass filtering applications in high frequency range.

Comparison of marginal bone loss and implant success between axial and tilted implants in maxillary All-on-4 treatment concept rehabilitations after 5 years of follow-up.

Science.gov (United States)

Hopp, Milena; de Araújo Nobre, Miguel; Maló, Paulo

2017-10-01

There is need for more scientific and clinical information on longer-term outcomes of tilted implants compared to implants inserted in an axial position. Comparison of marginal bone loss and implant success after a 5-year follow-up between axial and tilted implants inserted for full-arch maxillary rehabilitation. The retrospective clinical study included 891 patients with 3564 maxillary implants rehabilitated according to the All-on-4 treatment concept. The follow-up time was 5 years. Linear mixed-effect models were performed to analyze the influence of implant orientation (axial/tilted) on marginal bone loss and binary logistic regression to assess the effect of patient characteristics on occurrence of marginal bone loss >2.8 mm. Only those patients with measurements of at least one axial and one tilted implant available were analyzed. This resulted in a data set of 2379 implants (1201 axial, 1178 tilted) in 626 patients (=reduced data set). Axial and tilted implants showed comparable mean marginal bone losses of 1.14 ± 0.71 and 1.19 ± 0.82 mm, respectively. Mixed model analysis indicated that marginal bone loss levels at 5 years follow up was not significantly affected by the orientation (axial/tilted) of the implants in the maxillary bone. Smoking and female gender were associated with marginal bone loss >2.8 mm in a logistic regression analysis. Five-year implant success rates were 96%. The occurrence of implant failure showed to be statistically independent from orientation. Within the limitations of this study and considering a follow-up time of 5 years, it can be concluded that tilted implants behave similarly with regards to marginal bone loss and implant success in comparison to axial implants in full-arch rehabilitation of the maxilla. Longer-term outcomes (10 years +) are needed to verify this result. © 2017 Wiley Periodicals, Inc.

Intraoral gothic arch tracing.

Science.gov (United States)

Rubel, Barry; Hill, Edward E

2011-01-01

In order to create optimum esthetics, function and phonetics in complete denture fabrication, it is necessary to record accurate maxillo-mandibular determinants of occlusion. This requires clinical skill to establish an accurate, verifiable and reproducible vertical dimension of occlusion (VDO) and centric relation (CR). Correct vertical relation depends upon a consideration of several factors, including muscle tone, inter-dental arch space and parallelism of the ridges. Any errors made while taking maxillo-mandibular jaw relation records will result in dentures that are uncomfortable and, possibly, unwearable. The application of a tracing mechanism such as the Gothic arch tracer (a central bearing device) is a demonstrable method of determining centric relation. Intraoral Gothic arch tracers provide the advantage of capturing VDO and CR in an easy-to-use technique for practitioners. Intraoral tracing (Gothic arch tracing) is a preferred method of obtaining consistent positions of the mandible in motion (retrusive, protrusive and lateral) at a comfortable VDO.

Precast Pearl-Chain concrete arch bridges

DEFF Research Database (Denmark)

Halding, Philip Skov; Hertz, Kristian Dahl; Schmidt, Jacob Wittrup

2015-01-01

A Pearl-Chain Bridge is a closed-spandrel arch bridge consisting of a number of straight pre-fabricated so called Super-Light Deck elements put together in an arch shape by post-tensioning cables. Several Pearl-Chain arches can be positioned adjacent to each other by a crane to achieve a bridge...... of a desired width. On top of the arch is a filling material to level out the surface of the above road. The filling only transfers vertical loads to the arch. The geometry and material properties of Super-Light Decks are presented, and we refer to several fullscale tests of Pearl-Chain arches where...... the technology was used. We also study other important components and details in the Pearl-Chain Bridge concept and review the effects of different types of loads. A theoretical case study of a circular 30 m span Pearl-Chain Bridge is presented showing the influence of a number of parameters: The number of post...

Three-Dimensional Reconstruction of Post-Traumatic Deficient Anterior Maxilla.

Science.gov (United States)

Rachmiel, Adi; Shilo, Dekel; Aizenbud, Dror; Pen, Mark; Rachmiel, Dana; Emodi, Omri

2017-12-01

Maxillary retrognathism appears in 14.3% of patients exhibiting malocclusion after trauma treatment. This report describes the application of alveolar distraction osteogenesis (ADO) for treating the severely deficient anterior maxilla after trauma injuries in the vertical and anteroposterior planes. This is a retrospective study of patients exhibiting severe vertical and anteroposterior maxillary bone deficiency after trauma injuries and treated by ADO as a first stage with additional Le Fort I advancement when required. Predictor variables included ADO for alveolar augmentation and Le Fort I advancement for anteroposterior discrepancy after ADO. Outcome variables included dental implant failure and anteroposterior maxillary relations. Twelve patients with severe atrophic anterior maxilla secondary to trauma injuries were included and treated using ADO. In accordance to the size of the horizontal deficiency, 1 or 2 distractors were used. Vertical alveolar distraction was performed and the transported segments were elongated at a rate of 0.5 mm/day to a mean total of 13.9 mm (12 to 15 mm). In 4 of 12 cases, there was a severe anteroposterior discrepancy larger than 8 mm that could not be fully corrected using an anterior inclination during the vertical elongation. Therefore, a second stage of conventional Le Fort I advancement was performed. Thirty-eight dental implants were inserted, with a survival rate of 97.37% (median follow-up, 6.2 yr). This report describes treatment of the deficient anterior maxilla after trauma injuries in the vertical and anteroposterior planes, including implant-based dental rehabilitation. The main advantages include simultaneous bone and mucosa augmentation, no donor site morbidity, considerably higher vertical augmentation compared with other methods, and minimal relapse. Using an additional Le Fort I advancement in severe cases permits a useful method for proper repositioning of the maxilla, thus resulting in superior

Assessment of the dental and skeletal effects of fan-type rapid maxillary expansion screw and Hyrax screw on craniofacial structures

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Umarevathi Gopalakrishnan

2017-01-01

Full Text Available Aims and Objectives: The purpose of the study was to assess the skeletal and dental effects of fan-type rapid maxillary expansion (RME appliance and Hyrax RME appliance on the craniofacial structures. Materials and Methods: The sample of the study included 12 patients with constricted maxillary arches. Acrylic bonded type of attachment was used for both groups. Changes in sagittal, vertical, and transverse relationship were assessed with lateral and frontal cephalograms, respectively. Intercanine and intermolar widths were measured with stone models. Pre- and immediate post-treatment records were statistically analyzed with Wilcoxon signed-rank test. The differences between the groups were evaluated using Mann–Whitney U-test. Since the data pertaining to intercanine width and intermolar width were normally distributed, parametric test of signifi cance (unpaired t-test was used to compare them. Results: Results showed that Hyrax presented with signifi cantly greater increments for both nasal cavity width and maxillary width when compared to fan-type RME. Both groups had retroclination of incisors. The increase in the intercanine width was almost similar in both groups. Conclusion: Fan-type RME caused only minimal expansion of the intermolar width when compared to the Hyrax. The ratio between the intercanine and intermolar width expansion was nearly 4:1 in the fan-type RME and 0.75:1 in Hyrax.

Imaging findings in the right aortic arch with mirror image branching of arch vessels: An unusual cause of dysphagia

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Guneet Singh

2015-01-01

Full Text Available We report a case of a 72-year-old female with a right aortic arch with mirror-image branching of arch vessels presenting with dysphagia, and characteristic images on barium esophagogram, contrast-enhanced computed tomography scan, and magnetic resonance aortography. Right-sided thoracic aortic arch with mirror-image branching of the brachiocephalic vessels causing dysphagia without associated congenital cardiac anomalies is extremely uncommon. Right-sided aortic arch is a rare congenital abnormality with incidence of 0.05-0.1% in the normal population. Anomalies of great vessels are usually incidental findings, because they are asymptomatic. Right aortic arch infrequently presents with a vascular ring that can cause complete or partial obstruction of the trachea and/or esophagus. The understanding of this arch anomaly is based on Edward′s hypothesis about the double arch system during embryonic developmental.

Footprint parameters as a measure of arch height.

Science.gov (United States)

Hawes, M R; Nachbauer, W; Sovak, D; Nigg, B M

1992-01-01

The human foot has frequently been categorized into arch height groups based upon analysis of footprint parameters. This study investigates the relationship between directly measured arch height and many of the footprint parameters that have been assumed to represent arch height. A total of 115 male subjects were measured and footprint parameters were calculated from digitized outlines. Correlation and regression analyses were used to determine the relationship between footprint measures and arch height. It may be concluded from the results that footprint parameters proposed in the literature (arch angle, footprint index, and arch index) and two further parameters suggested in this study (arch length index and truncated arch index) are invalid as a basis for prediction or categorization of arch height. The categorization of the human foot according to the footprint measures evaluated in this paper represent no more than indices and angles of the plantar surface of the foot itself.

Concrete-Filled Steel Tube Arch Bridges in China

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Jielian Zheng

2018-02-01

Full Text Available In the past 20 years, great progress has been achieved in China in the construction of concrete-filled steel tube (CFST arch bridges and concrete arch bridges with a CFST skeleton. The span of these bridges has been increasing rapidly, which is rare in the history of bridge development. The large-scale construction of expressways and high-speed railways demands the development of long-span arch bridges, and advances in design and construction techniques have made it possible to construct such bridges. In the present study, the current status, development, and major innovative technologies of CFST arch bridges and concrete arch bridges with a CFST skeleton in China are elaborated. This paper covers the key construction technologies of CFST arch bridges, such as the design, manufacture, and installation of steel tube arch trusses, the preparation and pouring of in-tube concrete, and the construction of the world’s longest CFST arch bridge—the First Hejiang Yangtze River Bridge. The main construction technologies of reinforced concrete arch bridges are also presented, which include cable-stayed fastening-hanging cantilever assembly, adjusting the load by means of stay cables, surrounding the concrete for arch rib pouring, and so forth. In addition, the construction of two CFST skeleton concrete arch bridges—the Guangxi Yongning Yong River Bridge and the Yunnan–Guangxi Railway Nanpan River Bridge—is discussed. CFST arch bridges in China have already gained a world-leading position; with the continuous innovation of key technologies, China will become the new leader in promoting the development of arch bridges. Keywords: Concrete-filled steel tube (CFST arch bridge, Steel-reinforced concrete arch bridge, Cable-stayed fastening-hanging cantilever assembly, Vacuum-assisted pouring in-tube concrete, Adjusting load by stay cables

Thin-plate spline analysis of the short- and long-term effects of rapid maxillary expansion.

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Franchi, Lorenzo; Baccetti, Tiziano; Cameron, Christopher G; Kutcipal, Elizabeth A; McNamara, James A

2002-04-01

The aim of this study was to investigate the short- and long-term effects induced by rapid maxillary expansion (RME) on the shape of the maxillary and circummaxillary structures by means of thin-plate spline (TPS) analysis. The sample consisted of 42 patients who were compared with a control sample of 20 subjects. The treated subjects underwent Haas-type RME, followed by fixed appliance therapy. Postero-anterior (PA) cephalograms were analysed for each treated subject at T1 (pre-treatment), T2 (immediate post-expansion), and T3 (long-term observation), and were available at T1 and T3 for the control group (CG). The mean age at T1 was 11 years and 10 months for both groups. The mean chronological ages at T3 were 20 years, 6 months for the treated group (TG) and 17 years, 8 months for the control group. The study focused on shape changes in the maxillary, nasal, zygomatic, and orbital regions. TPS analysis revealed significant shape changes in the TG. They consisted of an upward and lateral displacement of the two halves of the naso-maxillary complex as a result of active expansion in the short-term, and normalization of maxillary shape in the transverse dimension in the long-term (the initial transverse deficiency of the maxilla in the treated group was eliminated by RME therapy both in the short- and long-term). At the end of the observation period, the nasal cavities were larger when compared with both their pre-expansion configuration and the final configuration in the controls. RME with the Haas appliance appears to be an efficient therapeutic means to induce permanent favourable changes in the shape of the naso-maxillary complex.

Vector alignment in maxillary distraction osteogenesis.

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Uckan, Sina; Arman, Ayca; Bayram, Burak; Celik, Erkan

2006-09-01

Maxillary distraction osteogenesis is an alternative treatment of cleft patients with severe maxillary hypoplasia. The aim of this paper is to present the combined surgical/orthodontic treatment of a cleft lip and palate patient and to evaluate the maxillary distraction procedure and the distraction vector in high Le Fort I osteotomy.

[An adjustable distractor for transverse maxillary distraction osteogenesis].

Science.gov (United States)

Leyder, P; Wycisk, G; Quilichini, J

2013-06-01

The posterior skeletal widening in conventional distractions (Surgical Assisted Rapid Maxillary Expansion) is often modest, in contrast with a predominant anterior expansion. Until recently, it was not possible to consider transverse palatal distraction osteogenesis and Le Fort I impaction or advancement in the same procedure, as the osteosynthesis plates impeded maxillary anterior opening. We developed new sliding osteosynthesis plates allowing to perform an advancement or impaction Le Fort I osteotomy associated with a low-resistance bipartite palatal distraction osteogenesis. We had for aim to describe the device and to determine its clinical applications. This new palatal distractor is made up of two independent stainless steel jacks allowing for an adjustable distraction in the anterior or posterior area as needed. Bone-borne and tooth-borne versions are available. This new distractor can be adjusted sagittally. The distraction can be angular or parallel, and the distraction mode can be modified during post-operative distraction. This device should be adapted to all clinical presentations. It can be used in combination with sliding osteosynthesis to perform a Le Fort 1 osteotomy and at the same time a complete correction of vertical, horizontal, and sagittal deficiencies. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

Orthopantomographic study of the maxillary sinus

Energy Technology Data Exchange (ETDEWEB)

Kim, Hyun Joo; Yu, Dong Su [School of Dentistry, Seoul National University, Seoul (Korea, Republic of)

1971-11-15

The author has observed the orthopantomograms of the maxillary sinus which were taken by special exposure method to study mesiodistal dimension, shape, symmetrical relationship, bony septum of the maxillary sinus and relationship between upper lst molar and the maxillary sinus, that were selected 56 cases of 23 to 27 years old male, who have good systemic conditions and no missing teeth on upper posterior molar in normal occlusion, and obtained following conclusions: 1. Mesiodistal dimensions of the maxillary sinus are shown as follows; The mean of left dimension is 50.94 {+-} 8.34 mm and of right dimension is 49.50 {+-} 9.87 mm. 2. To the shape of the maxillary sinus, V or U shape are 33 cases(29.5%) and W shape are 77 cases (70.5%). 3. In the ralationship between upper lst molar and floor of the maxllary sinus, superimposition are 62 cases (55.36%) a nd approach are 50 cases (44.64%). 4. In the right and left symmetrical relationship of the maxillary sinus, symmetry are 37 cases (66.07%) and asymmetry are 19 cases (33.93%). 5. The bony septums in the maxillary sinuses revealed that presence of bony septums are 29 cases (25.8%) and absence ar e 83 cases (74.11%).

Conventional bone-anchored palatal distractor using an orthodontic palatal expander for the transverse maxillary distraction osteogenesis: technical note.

Science.gov (United States)

Iida, Seiji; Haraguchi, Seiji; Aikawa, Tomonao; Yashiro, Kohtaro; Okura, Masaya; Kogo, Mikihiko

2008-02-01

Surgical-assisted rapid palatal expansion includes various treatment procedures for solving transverse maxillary deficiencies, especially in cases with a matured palatal suture. Recent introduction of the concept of distraction osteogenesis has contributed to generalize this useful treatment and to develop some bone-borne devices that will not cause the problems found in cases treated by tooth-supported palatal expander. This report shows a conventional bone-borne distractor using commercially available orthodontic palatal expansion screws. The distractor consists of 2 parts: one is a commercially available orthodontic palatal expansion screw (Hyrax type, Fan style) and another is a screw-ring, which is one of the attached parts of the mandibular distraction system. The bone screws are inserted transmucosally to the palatal bone via the screw-rings. The palatal distractor can be applied to varied palatal shapes and can expand the palate without any trouble. This conventional palatal distractor may contribute to generalize the transpalatal maxillary distraction osteogenesis for cases with maxillary teeth problems.

Keratocystic odontogenic tumor with impacted maxillary third molar involving the right maxillary antrum:An unusual case report

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Abhishek Gupta

2011-01-01

Full Text Available The odontogenic keratocyst (OKC, first described by Phillipsen in 1956, has metamorphosized as a keratocystic odontogenic tumor (KCOT as reported in WHO classification of head and neck tumors in 2005. KCOT is a benign intraosseous neoplasm of the jaw and its occurrence in maxilla is unusual and its appearance in maxillary antrum along with maxillary impacted third molar is very uncommon. This article reports a case of KCOT associated with impacted maxillary third molar in right maxillary antrum and describes its rare site of occurrence.

Photometric Evaluation of Soft Tissue Changes in CLP Patients: Le Fort I Advancement Osteotomy (ALO) Versus Anterior Maxillary Distraction (AMD).

Science.gov (United States)

Paulose, Joby; Markose, Eldho

2014-12-01

This paper is a comparative photometric evaluation of soft tissue changes in patients with CLP associated with maxillary deficiency treated with conventional Le Fort I advancement osteotomy (ALO) and anterior maxillary distraction (AMD). Twenty patients with maxillary hypoplasia associated with cleft lip and palate who had undergone either LeFort I osteotomy or distraction osteogenesis with maxillary advancement were included in this study. Frontal and profile photographs were used to ascertain the changes post-surgically. Photographs were obtained before treatment and 1 year after surgical correction in both groups. Vertical as well as horizontal changes in pronasale was well observed in both groups. A substantial increase in nasal parameters was noted in case of AMD group in comparison to ALO group. Though maxillary advancement was quite evident in AMD and ALO groups, a significant and consistent change was observed in AMD group. Significant vertical and horizontal changes were seen with respect to subnasale and labrale superius in AMD group. The hard and soft tissue changes produced by AMD by intra oral distractors were being evaluated so far. The results of the above studies have proved the excellence of AMD over conventional osteotomies. The present study goes hand in hand with the research outcomes till date.

Methodical Design of Software Architecture Using an Architecture Design Assistant (ArchE)

Science.gov (United States)

2005-04-01

PA 15213-3890 Methodical Design of Software Architecture Using an Architecture Design Assistant (ArchE) Felix Bachmann and Mark Klein Software...DATES COVERED 00-00-2005 to 00-00-2005 4. TITLE AND SUBTITLE Methodical Design of Software Architecture Using an Architecture Design Assistant...important for architecture design – quality requirements and constraints are most important Here’s some evidence: If the only concern is

Maxillary advancement using distraction osteogenesis with intraoral device.

Science.gov (United States)

Takigawa, Yoko; Uematsu, Setsuko; Takada, Kenji

2010-11-01

This article describes the surgical orthodontic treatment of maxillary hypoplasia in a patient with cleft lip and palate using maxillary distraction osteogenesis with internal maxillary distractors. Maxillary advancement was performed to correct the retrusive maxillary facial profile and Class III malocclusion. Rotational movement of the distraction segment was made to correct the upper dental midline. Although maxillary advancement was insufficient because of unexpected breakage of the intraoral distractor after completion of the distraction, skeletal traction with a face mask compensated for the shortage. Successful esthetic improvement and posttreatment occlusal stability were achieved with no discernible relapse after 2 years of retention.

Highly Tunable Electrothermally Actuated Arch Resonator

KAUST Repository

Hajjaj, Amal Z.

2016-12-05

This paper demonstrates experimentally, theoretically, and numerically a wide-range tunability of electrothermally actuated MEMS arch beams. The beams are made of silicon and are intentionally fabricated with some curvature as in-plane shallow arches. Analytical results based on the Galerkin discretization of the Euler Bernoulli beam theory are generated and compared to the experimental data and results of a multi-physics finite-element model. A good agreement is found among all the results. The electrothermal voltage is applied between the anchors of the clamped-clamped MEMS arch beam, generating a current that passes through the MEMS arch beam and controls its axial stress caused by thermal expansion. When the electrothermal voltage increases, the compressive stress increases inside the arch beam. This leads to increase in its curvature, thereby increases the resonance frequencies of the structure. We show here that the first resonance frequency can increase up to twice its initial value. We show also that after some electro-thermal voltage load, the third resonance frequency starts to become more sensitive to the axial thermal stress, while the first resonance frequency becomes less sensitive. These results can be used as guidelines to utilize arches as wide-range tunable resonators.

Evaluation of the fit of preformed nickel titanium arch wires on normal occlusion dental arches

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Rakhn G. Al-Barakati

2016-01-01

Conclusions: Using an archwire form with the best fit to the dental arch should produce minimal changes in the dental arch form when NiTi wires are used and require less customization when stainless-steel wires are used.

A Radiologic Study of the Relationship of the Maxillary Sinus Floor and Apex of the Maxillary Molar

International Nuclear Information System (INIS)

Yoon, Hae Rym; Park, Chang Seo

1998-01-01

In this study, radiographic evaluation was made using panoramic radiography and cross-sectional tomography of SCANORA in male and female adults in their 20 s on the relationship between the maxillary sinus floor and the apex of the maxillary molar, to test the accuracy and effectiveness of the cross-sectional tomography, and to use this information in the assessment of preop, and postop, root canal treatment, apical surgery, extraction and implantology. Forty-one adults with an average age of 24.4 years were studied panoramic radiography and cross-sectional tomography. In panoramic view and cross-sectional view, the position of the apices of maxillary molars were classified as separated, contacted, or protruded type; the general shape of the maxillary sinus floor was evaluated horizontally and vertically from cross-sectional tomography. The accuracy of each radiography was tested using maxilla from 5 fresh cadavers from the Anatomy Lab at Yonsei University Dental College, and panoramic view and cross-sectional tomography were taken in the same condition as with the patients. The results were as follows ; 1. Panoramic view and cross-sectional view were taken in the maxilla specimen, and the actual distance between the maxillary sinus floor and the tooth apices were measured in the specimen; the median values of the distance from the tooth apices to the maxillary sinus floor in the panoramic view, cross-sectional view and in the accrual maxilla specimen were 2.83 mm, 4.51 mm, and 4.15 mm, respectively. In the cross-sectional view, the measured distance was close to the actual distance but in the panoramic view, the measured distance was far from the actual distance. 2. When the results of the panoramic view and cross-sectional view were compared, 40.5% of the results agreed with each other in the two radiographic methods and buccal roots of the 2nd molar were the closest to the maxillary sinus floor in the cross-sectional tomography.3. In cross-sectional view, when

Comparison of Bone Resorption Rates after Intraoral Block Bone and Guided Bone Regeneration Augmentation for the Reconstruction of Horizontally Deficient Maxillary Alveolar Ridges

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B. Alper Gultekin

2016-01-01

Full Text Available Purpose. Bone atrophy after tooth loss may leave insufficient bone for implant placement. We compared volumetric changes after autogenous ramus block bone grafting (RBG or guided bone regeneration (GBR in horizontally deficient maxilla before implant placement. Materials and Methods. In this retrospective study, volumetric changes at RBG or GBR graft sites were evaluated using cone-beam computed tomography. The primary outcome variable was the volumetric resorption rate. Secondary outcomes were bone gain, graft success, and implant insertion torque. Results. Twenty-four patients (28 grafted sites were included (GBR, 15; RBG, 13. One patient (RBG suffered mucosal dehiscence at the recipient site 6 weeks after surgery, which healed spontaneously. Mean volume reduction in the GBR and RBG groups was 12.48 ± 2.67% and 7.20 ± 1.40%, respectively. GBR resulted in significantly more bone resorption than RBG (P0.05. Conclusions. Both RBG and GBR hard-tissue augmentation techniques provide adequate bone graft volume and stability for implant insertion. However, GBR causes greater resorption at maxillary augmented sites than RBG, which clinicians should consider during treatment planning.

Electrothermally Tunable Arch Resonator

KAUST Repository

Hajjaj, Amal Z.

2017-03-18

This paper demonstrates experimentally, theoretically, and numerically a wide-range tunability of electrothermally actuated microelectromechanical arch beams. The beams are made of silicon and are intentionally fabricated with some curvature as in-plane shallow arches. An electrothermal voltage is applied between the anchors of the beam generating a current that controls the axial stress caused by thermal expansion. When the electrothermal voltage increases, the compressive stress increases inside the arch beam. This leads to an increase in its curvature, thereby increasing its resonance frequencies. We show here that the first resonance frequency can increase monotonically up to twice its initial value. We show also that after some electrothermal voltage load, the third resonance frequency starts to become more sensitive to the axial thermal stress, while the first resonance frequency becomes less sensitive. These results can be used as guidelines to utilize arches as wide-range tunable resonators. Analytical results based on the nonlinear Euler Bernoulli beam theory are generated and compared with the experimental data and the results of a multi-physics finite-element model. A good agreement is found among all the results. [2016-0291

Standardizing foot-type classification using arch index values.

Science.gov (United States)

Wong, Christopher Kevin; Weil, Rich; de Boer, Emily

2012-01-01

The lack of a reliable classification standard for foot type makes drawing conclusions from existing research and clinical decisions difficult, since different foot types may move and respond to treatment differently. The purpose of this study was to determine interrater agreement for foot-type classification based on photo-box-derived arch index values. For this correlational study with two raters, a sample of 11 healthy volunteers with normal to obese body mass indices was recruited from both a community weight-loss programme and a programme in physical therapy. Arch index was calculated using AutoCAD software from footprint photographs obtained via mirrored photo-box. Classification as high-arched, normal, or low-arched foot type was based on arch index values. Reliability of the arch index was determined with intra-class correlations; agreement on foot-type classification was determined using quadratic weighted kappa (κw). Average arch index was 0.215 for one tester and 0.219 for the second tester, with an overall range of 0.017 to 0.370. Both testers classified 6 feet as low-arched, 9 feet as normal, and 7 feet as high-arched. Interrater reliability for the arch index was ICC=0.90; interrater agreement for foot-type classification was κw=0.923. Classification of foot type based on arch index values derived from plantar footprint photographs obtained via mirrored photo-box showed excellent reliability in people with varying BMI. Foot-type classification may help clinicians and researchers subdivide sample populations to better differentiate mobility, gait, or treatment effects among foot types.

Standardizing Foot-Type Classification Using Arch Index Values

Science.gov (United States)

Weil, Rich; de Boer, Emily

2012-01-01

ABSTRACT Purpose: The lack of a reliable classification standard for foot type makes drawing conclusions from existing research and clinical decisions difficult, since different foot types may move and respond to treatment differently. The purpose of this study was to determine interrater agreement for foot-type classification based on photo-box-derived arch index values. Method: For this correlational study with two raters, a sample of 11 healthy volunteers with normal to obese body mass indices was recruited from both a community weight-loss programme and a programme in physical therapy. Arch index was calculated using AutoCAD software from footprint photographs obtained via mirrored photo-box. Classification as high-arched, normal, or low-arched foot type was based on arch index values. Reliability of the arch index was determined with intra-class correlations; agreement on foot-type classification was determined using quadratic weighted kappa (κw). Results: Average arch index was 0.215 for one tester and 0.219 for the second tester, with an overall range of 0.017 to 0.370. Both testers classified 6 feet as low-arched, 9 feet as normal, and 7 feet as high-arched. Interrater reliability for the arch index was ICC=0.90; interrater agreement for foot-type classification was κw=0.923. Conclusions: Classification of foot type based on arch index values derived from plantar footprint photographs obtained via mirrored photo-box showed excellent reliability in people with varying BMI. Foot-type classification may help clinicians and researchers subdivide sample populations to better differentiate mobility, gait, or treatment effects among foot types. PMID:23729964

Changes in speech following maxillary distraction osteogenesis.

Science.gov (United States)

Guyette, T W; Polley, J W; Figueroa, A; Smith, B E

2001-05-01

The purpose of this study was to describe changes in articulation and velopharyngeal function following maxillary distraction osteogenesis. This is a descriptive, post hoc clinical report comparing the performance of patients before and after maxillary distraction. The independent variable was maxillary distraction while the dependent variables were resonance, articulation errors, and velopharyngeal function. The data were collected at a tertiary health care center in Chicago. The data from pre- and postoperative evaluations of 18 maxillary distraction patients were used. The outcome measures were severity of hypernasality and hyponasality, velopharyngeal orifice size as estimated using the pressure-flow technique, and number and type of articulation errors. At the long-term follow-up, 16.7% exhibited a significant increase in hypernasality. Seventy-five percent of patients with preoperative hyponasality experienced improved nasal resonance. Articulation improved in 67% of patients by the 1-year follow-up. In a predominately cleft palate population, the risk for velopharyngeal insufficiency following maxillary distraction is similar to the risk observed in Le Fort I maxillary advancement. Patients being considered for maxillary distraction surgery should receive pre- and postoperative speech evaluations and be counseled about risks for changes in their speech.

Maxillary Distraction Osteogenesis in Unilateral Cleft Lip and Palate Patients with Rigid External Distraction System.

Science.gov (United States)

Alkhouri, Shadi; Waite, Peter D; Davis, Matthew B; Lamani, Ejvis; Kau, Chung How

2017-01-01

Distraction osteogenesis (DO) is a treatment option for patients with maxillary hypoplasia secondary to cleft lip and palate (CLP). The aim of this study is to present a technique for maxillary DO using Le Fort I osteotomy with rigid external distraction (RED) system. The patient presented in this paper was an Asian female with CLP aged 13 years and 6 months. She presented with severe midfacial deficiency with a Class III dental malocclusion with a negative overjet and concave facial profile. Cone-beam computed tomography images were recorded preoperatively and the operation performed involved a high Le Fort I osteotomy. The appliance fabricated was banded to upper first molars used for anchorage of the RED system. Distraction of the maxilla was initiated after 7-day latency period. Postoperative cephalometric analysis showed maxillary advancement anteriorly and superiorly, the total distraction treatment period was 10 days. The maxillary advancement was 10.5 mm and the SNA angle increased from 67.5° to 77.9°. Furthermore, the ANB angle changed from -9.8° to 1.6° and the occlusion changed from Class III to Class I. The profile of the face changed from concave to convex and a much better esthetic result was achieved. The study suggests RED system to be a reliable alternative procedure for the treatment of midfacial hypoplasia with or without cleft. Furthermore, it minimizes the risk of the surgical procedure and shortens the operating time.

Assembly and lifting of Pearl-Chain arches

DEFF Research Database (Denmark)

Halding, Philip Skov; Hertz, Kristian Dahl; Viebæk, N.E.

2015-01-01

Pearl-Chain arches were invented at the Technical University of Denmark in cooporation with the company Abeo A/S. The system uses specially designed, pre-fabricated concrete elements that are post-tensioned together into an arch shape, which is then lifted into place. The arches can be used both ...

Blood-flow change and recovery of sensibility in the maxillary dental pulp during and after maxillary distraction: a pilot study.

Science.gov (United States)

Harada, Kiyoshi; Sato, Masaru; Omura, Ken

2004-11-01

To examine the change in blood flow and recovery of sensibility in the maxillary dental pulp during and after maxillary distraction. The subjects included 5 patients undergoing high Le Fort I osteotomy and maxillary distraction (D-group) and a reference group of 14 patients who underwent a common single-segment Le Fort I osteotomy, 1-stage maxillary advancement, and mandibular setback surgery (C-group). Eleven (D-group) and 54 (C-group) maxillary incisors were assessed preoperatively and at 1-7 days, 14 days, and 3 months postoperatively. Pulpal blood flow (PBF) was measured by laser Doppler flowmetry, and pulpal sensibility (PS) was investigated by electrodiagnostics. From postoperative days 1 to 5 (the latency period), the PBF tended to be higher in the D-group than in the C-group. From day 6 to 3 months postoperatively (during and after maxillary distraction), the PBF values of the 2 groups were similar. The PS remained negative up to 14 days postoperatively in both groups. However, at 3 months after the operation, a higher proportion (90.9%) of teeth in the D-group was positive for PS. These results suggest that maxillary distraction is a favorable technique for maintenance of PBF and recovery of PS in the maxillary teeth after surgery.

CT-MPR invaluable in diagnosing odontogenic maxillary sinusitis

International Nuclear Information System (INIS)

Aoki, Hideaki; Shimazu, Kaoru; Kamada, Morito; Shiroyama, Akihiro; Mouri, Daisuke; Yamashita, Masashi; Kawasaki, Yasunori; Koseki, Takakazu; Mouri, Manabu

2001-01-01

In everyday examination, it is usual to encounter odontogenic maxillary sinusitis patients. Odontogenic maxillary sinusitis is generally best diagnosed by dental X-ray imaging. Many medical facilities not having a dental X-ray unit use coronal computed tomography (CT) images to diagnose odontogenic maxillary sinusitis. Coronal CT imaging causes artifacts, however due to dental prosthesises. Computed tomography-Multiplanar reformation (CT-MPR) imaging has proved useful in evaluating the paranasal sinus because it is not influenced by dental prosthesises. We evaluated the usefulness of CT-MPR for diagnosing odontogenic maxillary sinusitis by retrospectively analyzing 16 patients, with the following results. We couldn't diagnose all cases of odontogenic maxillary sinusitis in posteroanterior and Waters projection images. Panoramic radiography is needed to diagnose odontogenic maxillary sinusitis. Dental X-ray imaging missed some cases, but all cases were diagnosed by CT-MPR imaging, giving a 100% diagnosestic rate. CT-MPR imaging is thus at least as valuable or better than dental X-ray imaging in diagnosing odontogenic maxillary sinusitis. (author)

Anterior maxillary distraction using a tooth-borne device for hypoplastic cleft maxillas-a pilot study.

Science.gov (United States)

Richardson, Sunil; Agni, Nisheet A; Selvaraj, Dhivakar

2011-12-01

The management of maxillary retrusion in a patient with cleft lip and palate is performed using Le Fort I advancement or distraction osteogenesis using an external or an internal device. Distraction mostly involves movement of the entire maxilla at the Le Fort I level and is characterized by a higher relapse rate and a hampering of speech. Hence, distraction of the anterior maxilla was performed using a tooth-borne palatal distractor similar to the one proposed by Gunaseelan et al (J Oral Maxillofac Surg 65:1044, 2007). However, the technique was modified by placing the distractor preoperatively before performing the osteotomy cut. The main advantage of this modification is that more control over the vector can be achieved and chances of cement failure caused by contamination and an inability to achieve isolation is drastically decreased. This study investigated the efficacy and stability of anterior maxillary distraction in the management of cleft maxillary retrognathia and any resulting complications. Fourteen patients older than 12 years with cleft maxillary retrognathia were included in the study irrespective of gender, type of cleft lip and palate, and the amount of advancement needed. The patients were evaluated using Orthopantomogram and lateral cephalograms preoperatively and at 3 months postoperatively (ie, before appliance removal) and at 6 months postoperatively. The distractor was fabricated extraorally on a cast and cemented into the patient's mouth the day before surgery. The initial deficiency, amount of advancement achieved, and relapses at 6 months, if any, were studied. The data were tabulated and analyzed. Only 1 of the 14 patients showed a relapse, of 2 mm, because this patient was lost to follow-up and thus delayed tooth replacement. Anterior maxillary distraction with a tooth-borne device is a feasible modality for the management of cleft maxillary retrognathia, with stable results. Copyright © 2011 American Association of Oral and

[Radiologic picture of maxillary sinus aspergilloma].

Science.gov (United States)

Kaczmarek, I; Bilska, J; Osmola, K; Nowaczyk, M T

2010-06-01

Mycotic infection of paranasal sinus could be the etiological factor of chronic sinusitis. The increase in number of fungal sinusitis cases have been reported recently among nonimmunocompromised patient after endodontic treatment of maxillary teeth. Nonspecific clinical signs and incorrect radiologic pictures interpretation as well as loss of therapeutic standards seems to be the cause of false negative diagnosis and difficulties in treatment of fungal sinusitis. Clinical and radiological picture of maxillary sinus aspergillosis was described in this paper. In the period of 2006-2009 in the Department of Maxillo-Facial Surgery 19 patient with fungal maxillary sinusitis was treated. The endodontic treatment of maxillary teeth of the related side was performed previously in 80% examined cases. In 2 cases there were immunocompromised patients with immunosuppressive treatment. In 16 cases patients were referred to our Department due to metallic foreign body of the maxillary sinus. Routine diagnostic radiological imaging was performed in each case: paranasal sinus view--Water's view and panoramic radiograph (orthopantomograph). In 4 cases imaging was extended with computer tomography (CT) visualization. The surgical treatment was performed in each case. The final diagnosis was puted on histopathological examination and fungal culture. In 16 cases of analysed group histopathological examination and fungal culture revealed aspergilosis. In 2 cases fungal culture was negative, but histopathology slices confirm presence of hyphae of Aspergillus. In 1 case the root canal sealer was found in the maxillary sinus. In none case invasive form of aspergillosis was confirmed. In all cases Water's view of paranasal sinuses and ortopantomograph showed partially or totally clouded sinus with well-defined, single or multifocal radiopaque object similar to metallic foreign body. Characteristic finding in CT imaging was well-defined radiodence concretions that have been attributed to

Occlusal plane change after intrusion of maxillary posterior teeth by microimplants to avoid maxillary surgery with skeletal Class III orthognathic surgery.

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Park, Hyo-Sang; Kim, Ji-Yeun; Kwon, Tae-Geon

2010-11-01

To increase stability and mandibular setback movement, surgical maxillary impaction is normally performed with mandibular setback surgery in treating adult skeletal Class III patients. This article demonstrates the use of microimplants for anchorage to intrude molars and the resultant rotation of the maxillary occlusal plane clockwise to increase the surgical mandibular setback and reduce the posterior vertical dimension instead of maxillary surgical impaction. A 21-year-old man with mandibular prognathism was treated with mandibular setback surgery that included orthodontic treatment for decompensation. Microimplants placed into the palatal alveolar bone between the maxillary first and second molars were used to intrude the maxillary posterior teeth and change the occlusal plane clockwise. This produced 4 mm more of distal movement of the chin during mandibular setback surgery compared with the surgical prediction with no change in the occlusal plane. These results were similar to those of 2-jaw surgery with maxillary posterior impaction. The intrusion of the maxillary posterior teeth with microimplants might prevent the need for maxillary surgery in adult skeletal Class III patients. Copyright © 2010 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Semi-parametric estimation for ARCH models

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Raed Alzghool

2018-03-01

Full Text Available In this paper, we conduct semi-parametric estimation for autoregressive conditional heteroscedasticity (ARCH model with Quasi likelihood (QL and Asymptotic Quasi-likelihood (AQL estimation methods. The QL approach relaxes the distributional assumptions of ARCH processes. The AQL technique is obtained from the QL method when the process conditional variance is unknown. We present an application of the methods to a daily exchange rate series. Keywords: ARCH model, Quasi likelihood (QL, Asymptotic Quasi-likelihood (AQL, Martingale difference, Kernel estimator

Botulinum Toxin Type A as Preoperative Treatment for Immediately Loaded Dental Implants Placed in Fresh Extraction Sockets for Full-Arch Restoration of Patients With Bruxism.

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Mijiritsky, Eitan; Mortellaro, Carmen; Rudberg, Omri; Fahn, Miri; Basegmez, Cansu; Levin, Liran

2016-05-01

The aim of the present report was to describe the use of Botulinum toxin type A as preoperative treatment for immediately loaded dental implants placed in fresh extraction sockets for full-arch restoration of patients with bruxism. Patients with bruxism who were scheduled to receive immediately loaded full-arch implant supported fixed restorations were included in this retrospective clinical report. To reduce the occlusal forces applied in patients with bruxism, Botulinum toxin type A was introduced prior to the implant placement procedure. Patients were followed and implant survival as well as peri-implant bone level was assessed in each periodic follow-up visit. Adverse effects were also recorded. A control group with no use of Botulinum toxin was evaluated as well. A total of 26 patients (13 test and 13 control), with bruxism, aged 59.15 ± 11.43 years on average were included in this retrospective report and received immediately loaded dental implants placed in fresh extraction sockets for full-arch restoration. The test group treatment preceded by Botulinum toxin type A injection. Maxillary arches were supported by 8 to 10 implants while the mandibular arch was supported by 6 implants. All surgeries went uneventfully and no adverse effects were observed. The average follow-up time was 32.5 ± 10.4 months (range, 18-51). In the test group, no implant failures were recorded. One patient presented with 1 to 2 mm bone loss around 4 of the implants; the other implants presented with stable bone level. In the control group 1 patient lost 2 implants and another demonstrated 2 mm bone loss around 3 of the implants. The preoperative use of Botulinum toxin in patients with bruxism undergoing full-arch rehabilitation using immediately loaded dental implants placed in fresh extraction sockets seems to be a technique that deserves attention. Further long-term, large-scale randomized clinical trials will help to determine the additional benefit of this suggested

Nonlinear Dynamics of Electrostatically Actuated MEMS Arches

KAUST Repository

Al Hennawi, Qais M.

2015-05-01

In this thesis, we present theoretical and experimental investigation into the nonlinear statics and dynamics of clamped-clamped in-plane MEMS arches when excited by an electrostatic force. Theoretically, we first solve the equation of motion using a multi- mode Galarkin Reduced Order Model (ROM). We investigate the static response of the arch experimentally where we show several jumps due to the snap-through instability. Experimentally, a case study of in-plane silicon micromachined arch is studied and its mechanical behavior is measured using optical techniques. We develop an algorithm to extract various parameters that are needed to model the arch, such as the induced axial force, the modulus of elasticity, and the initially induced initial rise. After that, we excite the arch by a DC electrostatic force superimposed to an AC harmonic load. A softening spring behavior is observed when the excitation is close to the first resonance frequency due to the quadratic nonlinearity coming from the arch geometry and the electrostatic force. Also, a hardening spring behavior is observed when the excitation is close to the third (second symmetric) resonance frequency due to the cubic nonlinearity coming from mid-plane stretching. Then, we excite the arch by an electric load of two AC frequency components, where we report a combination resonance of the summed type. Agreement is reported among the theoretical and experimental work.

A study on occlusal stability in shortened dental arches.

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Sarita, Paulo T N; Kreulen, Cees M; Witter, Dick J; van't Hof, Martin; Creugers, Nico H J

2003-01-01

The aim of this study was to verify the hypothesis that shortened dental arches constitute a risk to occlusal stability. Using cluster samples, 725 subjects with shortened dental arches comprising intact anterior regions and zero to eight occluding pairs of posterior teeth and 125 subjects with complete dental arches were selected. Subjects with shortened dental arches were classified into eight categories according to arch length and symmetry. Parameters for occlusal stability were interdental spacing, occlusal tooth wear, occlusal contact of incisors in intercuspal position, and vertical and horizontal overlap. Additionally, tooth mobility and overeruption of unopposed teeth were assessed. Influence of independent variables (dental arch category, age, gender, and residence) on the parameters for occlusal stability was assessed by one-way ANOVA and Tukey's multiple range tests. Extreme shortened dental arches (zero to two pairs of occluding premolars) had significantly more interdental spacing, occlusal contact of incisors, and vertical overlap compared to complete dental arches. Occlusal wear and prevalence of mobile teeth were highest in these categories. The category with three to four occluding premolars had significantly more interdental spacing and, for the older age group, more anterior teeth in occlusal contact compared to complete dental arches. Age was consistently associated with increased changes in occlusal integrity. Signs of increased risk to occlusal stability seemed to occur in extreme shortened dental arches, whereas no such evidence was found for intermediate categories of shortened dental arches.

Maxillary sinus augmentation

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A B Tarun Kumar

2015-01-01

Full Text Available Placing dental implants in the maxillary posterior region can be both challenging and un-nerving for a regular implant dentist who is not well versed with advanced surgical procedures. It is vital for a general dentist to understand the fundamentals of bone grafting the maxillary sinus if he/she is really committed to providing the best health care for their patients. The dental practice is seeing an increasing group of patients who are living longer, and this group of older baby boomers often has an edentulous posterior maxilla either unilateral or bilateral. When edentulous, the posterior maxilla more likely has diminished bone height, which does not allow for the placement of dental implants without creating additional bone. Through grafting the maxillary sinus, bone of ideal quality can be created (allowing for placement of dental implants, which offer many advantages over other tooth replacement modalities. The sinus graft offers the dental patient a predictable procedure of regenerating lost osseous structure in the posterior maxilla. This offers the patient many advantages for long-term success. If dentists understand these concepts, they can better educate their patients and guide them to have the procedure performed. This article outlines bone grafting of the maxillary sinus for the purpose of placing dental implants. This review will help the readers to understand the intricacies of sinus augmentation. They can relate their patient's condition with the available literature and chalk out the best treatment plan for the patient, especially by using indirect sinus augmentation procedures which are less invasive and highly successful if done using prescribed technique.

Radiodiagnostics of maxillary osteomyelitis

International Nuclear Information System (INIS)

Klemova, J.; Jenca, A.; Hanusinova, V.; Danko, J.; Ondrasovicova, J.

2006-01-01

Osteomyelitis is defined as an inflammation or infection in bone tissues - cancellous bone, bone marrow, bone compacta and periosteum due to invasion of infection from surrounding tissues. Maxillary osteomyelitis is less common disease than osteomyelitis of mandible. This can be explained by anatomical structure of maxilla which is mainly composed of sinuses and thin bone lamellae. Such a structure allows rapid propagation of the infection to the surface. There have been examined and treated 70 patients with osteomyelitis of facial bones within past 15 years at Department of stomatology and maxillo-facial surgery of P.J. Safarik University in Kosice. Only four cases were diagnosed as maxillary osteomyelitis. The aim of this study was to mention the differences in anatomy and symptoms of acute and chronic stage of maxillary osteomyelitis and to give a detailed radiographic picture of this affliction. (authors)

Postoperative Maxillary Cyst: A Case Report

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Asiye Şafak Bulut

2010-01-01

Full Text Available Postoperative maxillary cyst is a quite rare delayed complication of surgical intervention associated with maxillary sinuses. It occurs many years after surgery. This paper describes a 54-year-old woman presenting with swelling of left cheek for seven-years duration. The orthopantomograph revealed a unilocular cystic radiolucency with well-defined margins in left maxillary sinus. In the computerized tomography, the cyst had a sclerotic wall with bony condensations. Aspiration cytology revealed many neutrophil leukocytes. Cyst was drained and enucleated. Histopathologically, it had a fibrous wall with inflammation and focal reactive bone formation and lined by a respiratory-type epithelium. In the clinical history, it is learned that she had a maxillary sinus surgery 8 years ago and the diagnosis was made considering the clinical and histopathological findings.

Highly tunable NEMS shallow arches

KAUST Repository

Kazmi, Syed N. R.

2017-11-30

We report highly tunable nanoelectromechanical systems NEMS shallow arches under dc excitation voltages. Silicon based in-plane doubly clamped bridges, slightly curved as shallow arches, are fabricated using standard electron beam lithography and surface nanomachining of a highly conductive device layer on a silicon-on-insulator wafer. By designing the structures to have gap to thickness ratio of more than four, the mid-plane stretching of the nano arches is maximized such that an increase in the dc bias voltage will result into continuous increase in the resonance frequency of the resonators to wide ranges. This is confirmed analytically based on a nonlinear beam model. The experimental results are found to be in good agreement with that of the results from developed analytical model. A maximum tunability of 108.14% for a 180 nm thick arch with an initially designed gap of 1 μm between the beam and the driving/sensing electrodes is achieved. Furthermore, a tunable narrow bandpass filter is demonstrated, which opens up opportunities for designing such structures as filtering elements in high frequency ranges.

[Stimulation and evaluation on maxillary distraction osteogenesis using CASSOS 2001].

Science.gov (United States)

Zhu, Min; Qiu, Wei-liu; Tang, You-sheng; Li, Qing-yun

2002-09-01

To simulate maxillary distraction osteogenesis and evaluate the change of soft and hard tissue before and after treatment, using Computer-Assisted Simulation System for Orthognathic Surgery( CASSOS 2001). A fourteen-year-old boy with severe maxillary hypoplasia, due to unilateral cleft lip and palate, was analysed by cephalometric analysis. The simulations of maxillary distraction osteogenesis (Le Fort I osteotomy and Le Fort II osteotomy) were re-analysed. After the treatment, cephalometric analysis was preformed again. The data were compared. The maxillary hypoplasia was well treated using maxillary distraction osteogenesis; Compared with Le fort I osteotomy, more satisfactory results can be obtained by Le fort I distraction osteogenesis. Maxillary distraction osteogenesis is a better way to treat severe maxillary hypoplasia with operated CLP than maxillary osteotomy. CASSOS 2001 can help surgeons and patients on simulation and evaluation of maxillary distraction osteogenesis, and on decision of treatment plan.

Incisor and molar overjet, arch contraction, and molar relationship in the mixed dentition in repaired complete unilateral cleft lip and palate: A qualitative and quantitative appraisal.

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Disthaporn, Suteeta; Suri, Sunjay; Ross, Bruce; Tompson, Bryan; Baena, Diogenes; Fisher, David; Lou, Wendy

2017-07-01

To compare the mixed dentition incisor and molar overjet, severity of contraction of the dental arch, and the sagittal molar relationship on the cleft side vs the noncleft side in children with repaired complete unilateral cleft of the lip and palate (UCLP). Orthodontic records taken prior to orthodontic preparation for alveolar bone grafting were screened to select study casts from patients with nonsyndromic repaired complete UCLP who did not have mandibular skeletal or dental asymmetry. The study sample comprised dental casts from 74 children aged 8.9 ± 1 years. Standardized digital photographs were acquired at 1:1 magnification. A coordinate system was developed using digital image-processing software (Photoshop CS4 and Adobe Illustrator). Incisor and molar overjet, Angle's classification, and arch contraction were recorded. Descriptive statistics, paired t-tests, and kappa statistics were used to compare the cleft and noncleft sides. A negative overjet of -1 to -5 mm was often present at the incisors, with greater frequency and magnitude on the cleft side. Class II molar relation was more frequent on the cleft side (61.1%) than on the noncleft side (47.2%). Significantly greater contraction of the cleft side deciduous canine and deciduous first molar was noted, while the difference was very minor at the first permanent molar. Cleft side maxillary arch contraction was most severe in the deciduous canine and first deciduous molar region and progressively less severe in the posterior region of the arch. A greater frequency and severity of negative overjet and Class II molar relationship was seen on the cleft side.

Mycotic Aneurysm of the Aortic Arch

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Ji Hye Seo

2014-08-01

Full Text Available A mycotic aneurysm of the thoracic aorta is rare. We report a case of mycotic aneurysm that developed in the aortic arch. An 86-year-old man was admitted with fever and general weakness. Blood culture yielded methicillin-resistant Staphylococcus aureus. Chest X-ray showed an enlarged aortic arch, and computed tomography scan revealed an aneurysm in the aortic arch. The patient was treated only with antibiotics and not surgically. The size of the aneurysm increased rapidly, resulting in bronchial obstruction and superimposed pneumonia. The patient died of respiratory failure.

An alternative clinical approach to achieve greater anterior than posterior maxillary expansion in cleft lip and palate patients.

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Oliveira, Dauro Douglas; Bartolomeo, Flávia Uchôa Costa; Cardinal, Lucas; Figueiredo, Daniel Santos Fonseca; Palomo, Juan Martin; Andrade, Ildeu

2014-11-01

Cleft lip and palate patients commonly present maxillary constriction, particularly in the anterior region. The aim of this case report was to describe an alternative clinical approach that used a smaller Hyrax screw unconventionally positioned to achieve greater anterior than posterior expansion in patients with complete unilateral cleft lip and palate. The idea presented here is to take advantage of a reduced dimension screw to position it anteriorly. When only anterior expansion was needed (patient 1), the appliance was soldered to the first premolar bands and associated to a transpalatal arch cemented to the first molars. However, when overall expansion was required (patient 2), the screw was positioned anteriorly, but soldered to the first molar bands. Intercanine, premolar, and first molar widths were measured on dental casts with a digital caliper. Pre-expansion and postexpansion radiographs and tomographies were also evaluated. A significant anterior expansion and no intermolar width increase were registered in the first patient. Although patient 2 also presented a greater anterior than posterior expansion, a noteworthy expansion occurred at the molar region. The alternative approach to expand the maxilla in cleft patients reported here caused greater anterior than posterior expansion when the Mini-Hyrax was associated to a transpalatal arch, and its reduced dimension also minimized discomfort and facilitated hygiene.

Aspergillus in endodontic infection near the maxillary sinus

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Cinthya Cristina Gomes

2015-10-01

Full Text Available ABSTRACT INTRODUCTION: Diseases of the maxillary sinus have been associated with dental roots near the maxillary sinus that have undergone endodontic treatment. OBJECTIVE: To investigate the presence of filamentous fungi in patients with dental roots near the maxillary sinus who had apical periodontitis treated endodontically, and to alert practitioners that this could be a possible avenue of contamination of the sinus in patients who develop maxillary sinus infection. METHODS: Cross-sectional study in 60 palatal roots of the first maxillary molars near the maxillary sinus, that underwent endodontic treatment for apical periodontitis. After removal of the filling material, dentin shavings were collected and placed in test tubes containing Sabouraud dextrose agar and chloramphenicol. The phenotype was determined by macroscopic and microscopic examination of the colonies. For polymerase chain reaction, the primers ITS-5 and ITS-4 were used. The sequences obtained were compared with those deposited at GenBank using the Basic Local Alignment Search Tool program. RESULTS: Filamentous fungi were isolated from 6 of 60 canals (10%:Aspergillus niger (6.7%, Aspergillus versicolor (1.6%, and Aspergillus fumigatus(1.6%. CONCLUSION: Root canals near the maxillary sinus with endodontic treatment and apical periodontitis may exhibit positive cultures for filamentous fungi. Interested professionals should be alert, because these microorganisms have pathogenic characteristics that can cause disease of odontogenic origin in the maxillary sinus.

Comparison of two protocols for maxillary protraction: bone anchors versus face mask with rapid maxillary expansion

Science.gov (United States)

Cevidanes, Lucia; Baccetti, Tiziano; Franchi, Lorenzo; McNamara, James A.; De Clerck, Hugo

2010-01-01

Objective To test the hypothesis that there is no difference in the active treatment effects for maxillary advancement induced by bone-anchored maxillary protraction (BAMP) and the active treatment effects for face mask in association with rapid maxillary expansion (RME/FM). Materials and Methods This is a study on consecutively treated patients. The changes in dentoskeletal cephalometric variables from start of treatment (T1) to end of active treatment (T2) with an average T1–T2 interval of about 1 year were contrasted in a BAMP sample of 21 subjects with a RME/FM sample of 34 patients. All subjects were prepubertal at T1. Statistical comparison was performed with t-tests for independent samples. Results The BAMP protocol produced significantly larger maxillary advancement than the RME/FM therapy (with a difference of 2 mm to 3 mm). Mandibular sagittal changes were similar, while vertical changes were better controlled with BAMP. The sagittal intermaxillary relationships improved 2.5 mm more in the BAMP patients. Additional favorable outcomes of BAMP treatment were the lack of clockwise rotation of the mandible as well as a lack of retroclination of the lower incisors. Conclusions The hypothesis is rejected. The BAMP protocol produced significantly larger maxillary advancement than the RME/FM therapy. PMID:20578848

CBVT analysis of canal configuration of the mesio-buccal root of maxillary first permanent molar teeth: An in vitro study.

Science.gov (United States)

Shenoi, R Pratima; Ghule, Hrishikesh M

2012-07-01

For successful endodontic treatment, it's imperative to locate and obturate all root canals. As concluded by Ingle, the major cause for failure of root canal therapy is in ability to recognize all theexisting canals and subsequent failure in their obturation. To analyze the canal configuration of the mesio-buccal root of maxillary first permanent molar teeth. A total of 30 recently extracted human permanent maxillary first molars were collected and stored in a container with 5% Sodium Chloride solution for four days. Teeth with open apices, external resorption, improperly formed roots and teeth with previous restorations were excluded. Using the dental modeling wax, teeth were arranged in a 'U' shaped arch with roots embedded inside the wax and occlusal surface remaining free. 10 teeth were arranged in each arch and three such sample plates were prepared. Flat surface of the base encasing enabled the plate to be mounted on flat plastic bite plate. With bite plate roughly centered in the focal trough area Axial, Coronal and Sagittal section Cone-Beam Computed Tomography (CBCT) images were taken with Kodak 9000 Extra-oral Imaging System. Images displayed on a monitor were inspected by two endodontists using Kodak Dental Imaging Software 3D Module V2.2. When the data was observed, it was found that 24 teeth out of total 30 teeth examined showed some variation (i.e. possible additional canal) along the length of the mesio-buccal root canal. Out of these 24 teeth, 13 showed presence of additional canal at coronal third, 7 showed presence of additional canal at middle third and four showed presence of additional canal in apical third level. Percentage analysis was done as there was no group comparison to be done. Cone-Beam Volumetric Tomography (CBVT) evaluation positively identified the variations in mesio-buccal canal in 80% of samples. Out of these, 54.16% were in coronal 3(rd), 29.16% in middle 3(rd) and 16.66% were in apical 3(rd). Within the limitations of this

CBVT analysis of canal configuration of the mesio-buccal root of maxillary first permanent molar teeth: An in vitro study

Directory of Open Access Journals (Sweden)

R Pratima Shenoi

2012-01-01

Full Text Available Context: For successful endodontic treatment, it′s imperative to locate and obturate all root canals. As concluded by Ingle, the major cause for failure of root canal therapy is in ability to recognize all theexisting canals and subsequent failure in their obturation. Aim: To analyze the canal configuration of the mesio-buccal root of maxillary first permanent molar teeth. Materials and Methods: A total of 30 recently extracted human permanent maxillary first molars were collected and stored in a container with 5% Sodium Chloride solution for four days. Teeth with open apices, external resorption, improperly formed roots and teeth with previous restorations were excluded. Using the dental modeling wax, teeth were arranged in a ′U′ shaped arch with roots embedded inside the wax and occlusal surface remaining free. 10 teeth were arranged in each arch and three such sample plates were prepared. Flat surface of the base encasing enabled the plate to be mounted on flat plastic bite plate. With bite plate roughly centered in the focal trough area Axial, Coronal and Sagittal section Cone-Beam Computed Tomography (CBCT images were taken with Kodak 9000 Extra-oral Imaging System. Images displayed on a monitor were inspected by two endodontists using Kodak Dental Imaging Software 3D Module V2.2. Statistical Analysis: When the data was observed, it was found that 24 teeth out of total 30 teeth examined showed some variation (i.e. possible additional canal along the length of the mesio-buccal root canal. Out of these 24 teeth, 13 showed presence of additional canal at coronal third, 7 showed presence of additional canal at middle third and four showed presence of additional canal in apical third level. Percentage analysis was done as there was no group comparison to be done. Results: Cone-Beam Volumetric Tomography (CBVT evaluation positively identified the variations in mesio-buccal canal in 80% of samples. Out of these, 54.16% were in coronal 3 rd

Occlusal plane location in edentulous patients: a review.

Science.gov (United States)

Shetty, Sanath; Zargar, Nazia Majeed; Shenoy, Kamalakanth; Rekha, V

2013-09-01

Occlusal plane orientation is an important factor in the construction of a complete denture. Occlusal plane could be oriented using landmarks in the mandibular arch as well as in the maxillary arch. In the mandibular arch there are few landmarks which could be used to orient the occlusal plane like the retromolar pad, corner of the lips (lower lip length) whereas the maxillary arch has a number of landmarks, of which the ala-tragal line is the most commonly used and the same being the most controversial. In the following article different landmarks and its accuracy for orientating the occlusal plane in an edentulous subject as studied by various authors has been discussed.

Surgically assisted rapid maxillary expansion in adults.

Science.gov (United States)

Pogrel, M A; Kaban, L B; Vargervik, K; Baumrind, S

1992-01-01

Twelve adults with maxillary width discrepancy of greater than 5 mm were treated by surgically assisted rapid maxillary expansion. The procedure consisted of bilateral zygomatic buttress and midpalatal osteotomies combined with the use of a tooth-borne orthopedic device postoperatively. Mean palatal expansion of 7.5 mm (range of 6 to 13 mm), measured in the first molar region, was achieved within 3 weeks in all patients. Expansion remained stable during the 12-month study period, with a mean relapse for the entire group of 0.88 +/- 0.48 mm. Morbidity was limited to mild postoperative discomfort. The results of this preliminary study indicated that surgically assisted rapid maxillary expansion is a safe, simple, and reliable procedure for achieving a permanent increase in skeletal maxillary width in adults. Further study is necessary to document the three-dimensional movements of the maxillary segments and long-term stability of the skeletal and dental changes.

A case report of mucoid retention cyst in maxillary sinus

Energy Technology Data Exchange (ETDEWEB)

Kim, Han Pyoung [College of Dentistry, Seoul National University, Seoul (Korea, Republic of)

1973-11-15

The author have observed mucoid retention cyst in the right maxillary sinus of the patient, 41 year old woman, complained discharging of purulent exudate on the right maxillary molar area, and obtained the following conclusions; 1. The mucoid retention cyst in maxillary sinus casts a faint dome shaped shadow into the radiolucent image of maxillary sinus. 2. The mucoid retention cyst in maxillary sinus may occurred without the history of trauma. 3. Intraoral standard films are also valuable for the interpretation of the lesions in maxillary sinus but only extraoral roentgenograms.

Aspergillus in endodontic infection near the maxillary sinus.

Science.gov (United States)

Gomes, Cinthya Cristina; Pinto, Larissa Christina Costa; Victor, Fernanda Loretti; Silva, Erlange Andrade Borges da; Ribeiro, Apoena de Aguiar; Sarquis, Maria Inês de Moura; Camões, Isabel Coelho Gomes

2015-01-01

Diseases of the maxillary sinus have been associated with dental roots near the maxillary sinus that have undergone endodontic treatment. To investigate the presence of filamentous fungi in patients with dental roots near the maxillary sinus who had apical periodontitis treated endodontically, and to alert practitioners that this could be a possible avenue of contamination of the sinus in patients who develop maxillary sinus infection. Cross-sectional study in 60 palatal roots of the first maxillary molars near the maxillary sinus, that underwent endodontic treatment for apical periodontitis. After removal of the filling material, dentin shavings were collected and placed in test tubes containing Sabouraud dextrose agar and chloramphenicol. The phenotype was determined by macroscopic and microscopic examination of the colonies. For polymerase chain reaction, the primers ITS-5 and ITS-4 were used. The sequences obtained were compared with those deposited at GenBank using the Basic Local Alignment Search Tool program. Filamentous fungi were isolated from 6 of 60 canals (10%): Aspergillus niger (6.7%), Aspergillus versicolor (1.6%), and Aspergillus fumigatus (1.6%). Root canals near the maxillary sinus with endodontic treatment and apical periodontitis may exhibit positive cultures for filamentous fungi. Interested professionals should be alert, because these microorganisms have pathogenic characteristics that can cause disease of odontogenic origin in the maxillary sinus. Copyright © 2015 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Mechanism Research of Arch Dam Abutment Forces during Overload

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Yu Xia

2015-01-01

Full Text Available This paper presents research on the abutment forces of a double-curvature arch dam during overload based on numerical calculation results obtained through finite element method by Ansys. Results show that, with an increase in elevation, the abutment forces and bending moment of the arch dam increase first and then decrease from the bottom to the top of the dam. Abutment forces and bending moment reach their maximum at the middle or middle-down portion of the dam. The distributions of abutment forces and moment do not change during overload. The magnitude of each arch layer’s forces and moment increases linearly during overload. This result indicates that each arch layer transmits bearing loads to the rocks of the left and right banks steadily. This research explains the operating mechanism of an arch dam under normal and overload conditions. It provides a simple method to calculate the distribution of forces Fx and Fy and a new method to calculate the overload factor of an arch dam through the estimation of arch layers based on the redistribution characteristic of arch abutment forces.

Breakage of internal maxillary distractor: considerable complication of maxillary distraction osteogenesis.

Science.gov (United States)

Aikawa, Tomonao; Iida, Seiji; Isomura, Emiko T; Namikawa, Mari; Matsuoka, Yudai; Yamada, Chiaki; Yamamoto, Taku; Takigawa, Yoko

2008-07-01

Maxillary distraction osteogenesis using intraoral distractors is now one of the standard treatments of maxillary retrusion. This report shows 2 cases of breakage of this internal maxillary distractor in patients with cleft lip and palate; one was observed during the distraction period and the other was during the retention period. The first case required a rotational movement of the distraction segment, and this movement caused the laterally dislocation of the posterior part of the distractor, where the distractor suffered some mechanical forces by mouth opening. In the latter case, breakage of distractor was observed on the radiographs taken 3 months after distraction and this complication may have been caused by mechanical force by occlusion and mastication. Both breakages were found at the joint of the anchorage plate and the extension rod, which has some flexibility for adjusting the plate to the bone surface. Therefore, surgeons should pay special attention for this mechanical weak area in this distractor not only during the advancement period, but also during the retention period and should avoid unnecessary frequent bending for adopting the bone surface, which directly weakens the joint.

[Outcomes of endovascular repairing aortic arch disease hybrid with supra-arch debranching procedures].

Science.gov (United States)

Wang, Mian; Chang, Guangqi; Yin, Henghui; Yao, Chen; Wang, Jinsong; Wang, Shenming

2015-11-01

To summarize the experience of endovascular repairing aortic arch disease hybrid with supra-arch debranching procedures. It was a retrospective study. From January 2002 to December 2014, 42 high risk patients with aortic arch disease were treated by supra-arch debranching hybrid with subsequent endovascular repair in the First Affiliated Hospital of Sun Yat-sen University. There were 39 male and 3 female patients with a mean age of (53±13) years (ranging from 34 to 80 years). Of the 42 patients, 7 were thoracic aortic aneurysm, 20 were Stanford type B aortic dissection and 15 were Stanford type A aortic dissection. After the supra-aortic debranching technique, simultaneous (n=16) or staged (n=26, mean interval (7±3) days) endovascular repair were performed. Fisher exact test was used to compare the in-hospital mortality of ascending aorta based debranching and non-ascending aorta based debranching. Technical success rate was 81.0% (34/42). The overall 30-day complication rate was 31.0% (13/42), including 3 cerebral stroke (7.1%), 8 endoleak (19.0%, including 6 type I endoleak and 2 type II endoleak), 1 circulatory failure, 1 aorto-tracheal fistula. The 30-day mortality was 9.5% (4/42), 2 died of cerebral stroke, 1 died of circulatory failure, 1 died of aorto-tracheal fistula. The in-hospital mortality of ascending aorta based debranching group was obviously higher than that of the non-ascending aorta based debranching group (4/16 vs. 0, P=0.02). The median time of follow-up was 64.8 (2 to 156.9) months. CT scanning was performed at 1, 3 months after surgery and annually thereafter. The overall survival rate was 76.6%. During the follow-up period, there was 4 deaths, and 2 of them were aortic artery related (5.3%). There were 4 de novo complications during the follow-up period, 1 stroke attributed to bypass occlusion was cured by medical treatment, 2 pseudoaneurysm was successfully treated with open surgery, 1 stent-graft induced new distal entry tear was

Volumetric measurement of the maxillary sinus by coronal CT scan

International Nuclear Information System (INIS)

Ikeda, Atsuko

1996-01-01

The volume of the maxillary sinus was estimated by coronal CT scan. The purpose of this study was to compare the estimated volume of the normal maxillary sinus with that of the inflamed maxillary sinus. Patients were classified following evaluation by CT scan of the paranasal sinuses into 3 categories. Group A (n=12): Patients suffered from headache, facial pain and epistaxis, but CT scans of their nasal cavity and paranasal sinus were within normal limits without inflammatory change. Group B (n=69): Patients with bilateral chronic maxillary sinusitis, CT scans of whom showed inflammatory changes in both maxillary sinuses. All of the patients in this group underwent sinus surgery after coronal CT scans. Group C (n=14): Patients with unilateral chronic maxillary sinusitis, CT scans of whom showed inflammatory change in unilateral maxillary sinuses. CT scans of these patients were measured by Plannimeter to take the area of each image of the maxillary sinus. Consecutively imaged areas were summated by integral calculus to obtain an estimate of the sinus volume. The mean maxillary sinus volume in the affected sinuses was significantly smaller than those in the contralateral normal sinuses (p<0.05, Wilcoxon-test). The various volumes of the maxillary sinuses and the developmental cause were discussed. Comparison of groups A with B suggested three distinct patterns; the maxillary sinus volume has decreased due to inflammatory changes in the bone. The small sinuses have a tendency to develop chronic inflammatory change. The aeration in the maxillary sinus may be decreased when anatomic variations that may obstruct the ethmoid infundibulum exist. (K.H.)

Volumetric measurement of the maxillary sinus by coronal CT scan

Energy Technology Data Exchange (ETDEWEB)

Ikeda, Atsuko [Tokyo Medical and Dental Univ. (Japan). School of Medicine

1996-08-01

The volume of the maxillary sinus was estimated by coronal CT scan. The purpose of this study was to compare the estimated volume of the normal maxillary sinus with that of the inflamed maxillary sinus. Patients were classified following evaluation by CT scan of the paranasal sinuses into 3 categories. Group A (n=12): Patients suffered from headache, facial pain and epistaxis, but CT scans of their nasal cavity and paranasal sinus were within normal limits without inflammatory change. Group B (n=69): Patients with bilateral chronic maxillary sinusitis, CT scans of whom showed inflammatory changes in both maxillary sinuses. All of the patients in this group underwent sinus surgery after coronal CT scans. Group C (n=14): Patients with unilateral chronic maxillary sinusitis, CT scans of whom showed inflammatory change in unilateral maxillary sinuses. CT scans of these patients were measured by Plannimeter to take the area of each image of the maxillary sinus. Consecutively imaged areas were summated by integral calculus to obtain an estimate of the sinus volume. The mean maxillary sinus volume in the affected sinuses was significantly smaller than those in the contralateral normal sinuses (p<0.05, Wilcoxon-test). The various volumes of the maxillary sinuses and the developmental cause were discussed. Comparison of groups A with B suggested three distinct patterns; the maxillary sinus volume has decreased due to inflammatory changes in the bone. The small sinuses have a tendency to develop chronic inflammatory change. The aeration in the maxillary sinus may be decreased when anatomic variations that may obstruct the ethmoid infundibulum exist. (K.H.)

endodontic treatment of unusually long discolored maxillary central ...

African Journals Online (AJOL)

a few cases of dual–rooted maxillary central incisor have been reported in literature1-5. Maxillary central incisors vary in root ... The following case report describes the endodontic management of a patient with an unusually long maxillary central incisor in our environment. CASE PROFILE. A 31 year-old male was referred ...

Orthodontic correction of a transposed maxillary canine and first premolar in the permanent dentition.

Science.gov (United States)

Nishimura, Kazuaki; Nakao, Kimihisa; Aoki, Taijyu; Fuyamada, Mariko; Saito, Keisuke; Goto, Shigemi

2012-10-01

The patient was a 16-year-old Japanese girl whose chief complaints were crowding and transposition of the maxillary canine and first premolar. A setup model was used to preoperatively align the teeth in their transposed positions. The amount of postoperative reshaping was estimated for the occlusal surfaces of the teeth. However, the patient did not wish to have her teeth reduced by reshaping or to have composite materials for restorative camouflage. Because she strongly expected alignment of her teeth in the correct intra-arch position, her transposed teeth were corrected without extraction of the transposed teeth. Cone-beam computed tomography was used to obtain more detailed information about the transposition, and the direction of tooth movement was examined. Although the duration of the treatment was long, both the crowns and the roots of the transposed teeth were aligned correctly. Copyright © 2012 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Glossary to ARCH (GARCH)

DEFF Research Database (Denmark)

Bollerslev, Tim

The literature on modeling and forecasting time-varying volatility is ripe with acronyms and abbreviations used to describe the many different parametric models that have been put forth since the original linear ARCH model introduced in the seminal Nobel Prize winning paper by Engle (1982......).  The present paper provides an easy-to-use encyclopedic reference guide to this long list of ARCH acronyms.  In addition to the acronyms associated with specific parametric models, I have also included descriptions of various abbreviations associated with more general statistical procedures and ideas...

Occlusal stability in shortened dental arches.

NARCIS (Netherlands)

Witter, D.J.; Creugers, N.H.J.; Kreulen, C.M.; Haan, A. de

2001-01-01

Shortened dental arches consisting of anterior and premolar teeth have been shown to meet oral functional demands. However, the occlusal stability may be at risk as a result of tooth migration. The aim of this nine-year study was to investigate occlusal stability in shortened dental arches as a

The use of internal maxillary distraction for maxillary hypoplasia: a preliminary report.

Science.gov (United States)

Van Sickels, Joseph E; Madsen, Mathew J; Cunningham, Larry L; Bird, Douglas

2006-12-01

Distraction osteogenesis is a useful alternative to advance the maxilla in complicated cases of maxillary hypoplasia. The purpose of this article is to review the workup, experience, and preliminary results with the use of internal distraction osteogenesis for maxillary hypoplasia at one teaching institution. Over a 5-year period, more than 300 patients with craniofacial and dentofacial defects have undergone oral and maxillofacial surgery at our center to correct their skeletal discrepancies. Of these, 10 have had maxillary distraction osteogenesis done with internal distractors. Follow-up of 6 months or more was available for 8 patients. Stereolithographic models were used to bend distractors prior to surgery in 6 patients. Latency prior to the start of distraction was 3 to 7 days and varied with the age of the patient. Distraction occurred at approximately 1 mm per day with an average distraction length of 8.5 mm (range, 6-10 mm). Excellent occlusal results were obtained in 5 patients. Major complications including nonunion and failure to achieve acceptable occlusal results were observed in 3 patients. Minor complications including pain and loosening of the distracter devices were observed in 2 patients, but did not appear to affect the esthetic and functional results. Distraction osteogenesis is a useful alternative to traditional orthognathic surgery to treat maxillary hypoplasia. Internal distractions are attractive to patients, but are more difficult to place and can cause discomfort to patients when trying to achieve an ideal primary vector of distraction. Stereolithographic models can help with placement of the device. Changes in design of distractors may help with patient discomfort.

Maxillary unicystic ameloblastoma: a case report.

Science.gov (United States)

Agani, Zana; Hamiti-Krasniqi, Vjosa; Recica, Jehona; Loxha, Mergime Prekazi; Kurshumliu, Fisnik; Rexhepi, Aida

2016-10-18

Ameloblastoma is a benign epithelial odontogenic tumor. It is often aggressive and destructive, with the capacity to attain great size, erode bone and invade adjacent structures. Unicystic ameloblastoma is a rare odontogenic lesion, with clinical, radiographic and gross features of jaw cysts. The lesion histologically shows typical ameloblastomatous epithelium lining part of the cyst cavity with or without and/or mural tumor growth. Unicystic ameloblastoma usually presents in posterior mandibular ramus region, while it is rare and atypical in posterior maxillary region. . We report a case of 16 year old Kosovar male, Albanian ethnicity, who presented with a swelling located in right maxillary region. Clinical examination revealed a painless swelling extending from the maxillary right central incisor to the maxillary right first molar tooth. Panoramic radiograph disclosed a well corticated unilocular radiolucent lesion approximately 5 × 5 cm in diameter which was in contact with the roots of the teeth present inferiorly and with the maxillary sinus superiorly. Maxillary right canine impaction was noted and unerupted lateral incisor tooth was present inside the radiolucency. Preoperative diagnosis of the lesion was made as dentigerous cyst based on the age of the patient, location of the swelling, clinical and radiographic findings, but the unicystic ameloblastoma was also taken into consideration. The patient was treated by surgical enucleation of the lesion and extraction of lateral incisor tooth which was present inside the lesion. The histopathological examination of the lesion revealed confirmed finding for unicystic ameloblastoma mural form. No recurrence was observed in 1 year follow-up. Maxillary region is considered a rare and atypical location for unicystic ameloblastoma. We emphasize the importance of differential diagnosis of an odontogenic lesion with common clinical and radiological features that will impact the treatment planning and follow up

Aspergilloma of the maxillary sinus: report of a case

International Nuclear Information System (INIS)

Kang, Ju Han; Kim, Gyu Tae; Choi, Yong Suk; Hwang, Eui Hwan; Yu, Jae Jung

2010-01-01

Aspergilloma of the paranasal sinus is a non-invasive form of aspergillosis, most often in the maxillary sinus. This case presents an 86-year-old female with aspergilloma of the left maxillary sinus. The patient's chief complaint was intermittent pain on the left maxillary first premolar area. A radiopacification of the left maxillary sinus was observed on the panoramic radiograph. Cone-beam computed tomography revealed complete radiopacification of the left maxillary sinus and scattered multiple radiopaque mass inside the lesion. Biopsy was performed under local anesthesia. On microscopic examination, numerous fungal hyphae, which branch at acute angle, were observed. The diagnosis was made as an aspergilloma based on the histopathologic examination.

Maxillary sinus floor extension and posterior tooth inclination in adolescent patients with Class II Division 1 malocclusion treated with maxillary first molar extractions

NARCIS (Netherlands)

Livas, Christos; Halazonetis, Demetrios J.; Booij, Johan Willem; Pandis, Nikolaos; Tu, Yu-Kang; Katsaros, Christos

Introduction: Our objective was to investigate potential associations between maxillary sinus floor extension and inclination of maxillary second premolars and second molars in patients with Class II Division 1 malocclusion whose orthodontic treatment included maxillary first molar extractions.

Maxillary sinus floor extension and posterior tooth inclination in adolescent patients with Class II Division 1 malocclusion treated with maxillary first molar extractions

NARCIS (Netherlands)

Livas, C.; Halazonetis, D.J.; Booij, J.W.; Pandis, N.; Tu, Y.K.; Katsaros, C.

2013-01-01

INTRODUCTION: Our objective was to investigate potential associations between maxillary sinus floor extension and inclination of maxillary second premolars and second molars in patients with Class II Division 1 malocclusion whose orthodontic treatment included maxillary first molar extractions.

Comparison of Arch Width Changes Following Orthodontic ...

African Journals Online (AJOL)

2015-11-21

Nov 21, 2015 ... Materials and Methods: The study was conducted with pre- and post-treatment digital models from ... or posterior arch width following orthodontic treatment ..... premolar extraction cases show significant arch width increases in ...

Effect of aging on the configurational change of the aortic arch

Directory of Open Access Journals (Sweden)

Atsuhiro Kojima

2016-04-01

Full Text Available We explored the relationship between aging and the configuration of the aortic arch using computed tomography angiography (CTA. We retrospectively reviewed CTA obtained in 140 cases. The configuration of the aortic arch was categorized into three types based on the criteria mentioned by Madhwal et al., and the relationships between each configuration and patient characteristics were analyzed. Anomalies of the aortic arch were also explored. Twenty patients had a type-1 aortic arch (mean age, 56.1 years, 30 patients had a type-2 aortic arch (mean age, 66.3 years, and 89 patients had a type-3 aortic arch (mean age, 71.7 years. The mean age of patients with a type-3 aortic arch was significantly higher than that of patients with a type-1 aortic arch. No significant correlations between the type of aortic arch and other factors, such as smoking habit, were seen. The configuration of the aortic arch in our study appears to be significantly affected by the age of the patients.

Immediate prostheses on one-piece trans-mucosal implants in flapless surgical procedures Case Series Report. Part I: full arch rehabilitations

Directory of Open Access Journals (Sweden)

Aris Petros Tripodakis

2012-06-01

Full Text Available Aim: The aim of the present case series report is to illustrate a clinical technique and present the application of onepiece transmucosal implants in flapless surgical procedures, supporting full arch immediate prostheses. Materials and methods: A total of 294 implants (Xive TG, Friadent, Germany have been used to support full arch immediate prostheses, over the last six years and have been in function for at least one year. The surgical placement of five or more implants per case involved immediate extraction and intrasocket flapless placement, combined with minimal flap elevation in the areas of healed extraction sites (43 mandibular and 7 maxillary arches. In all cases immediate provisionalization followed. Detailed three-dimensional cone-beam localized volumetric tomography preceeded the surgical procedures. The delivery of the final ceramo-metal prostheses was accomplished within a 20 day period. Materials and methods: Results Six implants failed to osseointegrate. All other implants are still successfully bearing the final prosthesis for the time that they have been followed. Soft tissue reaction was favorable from both the biologic and esthetic point of view. Conclusion: The flapless placement of one piece implants into edentulous healed sites is a predictable procedure in the presence of abundance of supporting bone as confirmed by 3-D imaging. On the other hand, immediate extraction placement of one piece implants allows the engagement of sound bone located deeper into the socket and provides adequate mechanical support of the soft tissue architecture that is preserved predictably. In all cases the prosthetic procedures are accomplished without disturbing the hardsoft tissue interface as the abutment-prosthesis interface is coronally elevated by the virtual design of the implant.

An RCT on treatment of palatally displaced canines with RME and/or a transpalatal arch.

Science.gov (United States)

Baccetti, Tiziano; Sigler, Lauren M; McNamara, James A

2011-12-01

To investigate the effect of rapid maxillary expansion (RME) and/or transpalatal arch (TPA) therapy in combination with deciduous canine extraction on the eruption of palatally displaced canines (PDCs). Hundred and twenty subjects were enrolled in an RCT based on PDCs diagnosed on panoramic radiographs and they were randomly assigned to one of four study groups. Three treatment groups (TGs) (RME followed by TPA therapy plus extraction of deciduous canines, RME/TPA/EC group, 40 subjects; TPA therapy plus extraction of deciduous canines, TPA/EC group, 25 subjects; extraction of deciduous canines, EC group, 25 subjects) were analyzed. A control group (CG, 30 subjects) received no orthodontic treatment. Prevalence rates of eruption of PDCs in the three TGs were compared with the CG at T2. Predictive features at T1 for successful canine eruption were tested in the three TGs. The prevalence of canine eruption was 80 per cent for the RME/TPA/EC group, 79 per cent for the TPA/EC group, 62.5 per cent for the EC group, versus 28 per cent in the CG, with statistically significant differences between all the groups, with the exception of the comparison between RME/TPA/EC and TPA/EC. Predictive pretreatment variables for the success of treatment were less severe sectors of canine displacement, prepubertal stages of skeletal maturity, and an open root apex of PDCs. The use of a TPA in absence of RME can be equally effective than the RME/TPA combination in PDC cases not requiring maxillary expansion, thus reducing the burden of treatment for the patient.

Clarifying the anatomy of the fifth arch artery

Directory of Open Access Journals (Sweden)

Saurabh Kumar Gupta

2016-01-01

Full Text Available The artery allegedly forming in the fifth pharyngeal arch has increasingly been implicated as responsible for various vascular malformations in patients with congenitally malformed hearts. Observations from studies on developing embryos, however, have failed to provide support to substantiate several of these inferences such that the very existence of the fifth arch artery remains debatable. To the best of our knowledge, in only a solitary human embryo has a vascular channel been found that truly resembled the artery of the fifth arch. Despite the meager evidence to support its existence, the fifth arch artery has been invoked to explain the morphogenesis of double-barreled aorta, some unusual forms of aortopulmonary communications, and abnormalities of the brachiocephalic arteries. In most of these instances, the interpretations have proved fallible when examined in the light of existing knowledge of cardiac development. In our opinion, there are more plausible alternative explanations for the majority of these descriptions. Double-barreled aorta is more likely to result from retention of the recently identified dorsal collateral channels while abnormalities of brachiocephalic arteries are better explained on the basis of extensive remodeling of aortic arches during fetal development. Some examples of aortopulmonary communications, nonetheless, may well represent persistence of the developing artery of the fifth pharyngeal arch. We here present one such case - a patient with tetralogy of Fallot and pulmonary atresia, in whom the fifth arch artery provided a necessary communication between the ascending aorta and the pulmonary arteries. In this light, we discuss the features we consider to be essential before attaching the tag of "fifth arch artery" to a candidate vascular channel.

Aspergilloma of the maxillary sinus: report of a case

Energy Technology Data Exchange (ETDEWEB)

Kang, Ju Han; Kim, Gyu Tae; Choi, Yong Suk; Hwang, Eui Hwan [School of Dentistry, Kung Hee University, Seoul (Korea, Republic of); Yu, Jae Jung [Kangdong Scared Heart Hospital, Hallym Medical Center, Seoul (Korea, Republic of)

2010-12-15

Aspergilloma of the paranasal sinus is a non-invasive form of aspergillosis, most often in the maxillary sinus. This case presents an 86-year-old female with aspergilloma of the left maxillary sinus. The patient's chief complaint was intermittent pain on the left maxillary first premolar area. A radiopacification of the left maxillary sinus was observed on the panoramic radiograph. Cone-beam computed tomography revealed complete radiopacification of the left maxillary sinus and scattered multiple radiopaque mass inside the lesion. Biopsy was performed under local anesthesia. On microscopic examination, numerous fungal hyphae, which branch at acute angle, were observed. The diagnosis was made as an aspergilloma based on the histopathologic examination.

Nonstationary ARCH and GARCH with t-distributed Innovations

DEFF Research Database (Denmark)

Pedersen, Rasmus Søndergaard; Rahbek, Anders

Consistency and asymptotic normality are established for the maximum likelihood estimators in the nonstationary ARCH and GARCH models with general t-distributed innovations. The results hold for joint estimation of (G)ARCH effects and the degrees of freedom parameter parametrizing the t-distribut......Consistency and asymptotic normality are established for the maximum likelihood estimators in the nonstationary ARCH and GARCH models with general t-distributed innovations. The results hold for joint estimation of (G)ARCH effects and the degrees of freedom parameter parametrizing the t......-distribution. With T denoting sample size, classic square-root T-convergence is shown to hold with closed form expressions for the multivariate covariances....

Comparison of maxillary stability after Le Fort I osteotomy for occlusal cant correction surgery and maxillary advanced surgery.

Science.gov (United States)

Ueki, Koichiro; Hashiba, Yukari; Marukawa, Kohei; Yoshida, Kan; Shimizu, Chika; Nakagawa, Kiyomasa; Yamamoto, Etsuhide

2007-07-01

To compare postoperative maxillary stability following Le Fort I osteotomy for the correction of occlusal cant as compared with conventional Le Fort I osteotomy for maxillary advancement. The subjects were 40 Japanese adults with jaw deformities. Of these, 20 underwent a Le Fort I osteotomy and intraoral vertical ramus osteotomy (IVRO) to correct asymmetric skeletal morphology and inclined occlusal cant. The other 20 patients underwent a Le Fort I osteotomy and sagittal split ramus osteotomy (SSRO) to advance the maxilla. Lateral and posteroanterior cephalograms were taken postoperatively and assessed statistically. Thereafter, the 2 groups were followed for time-course changes. There was no significant difference between the 2 groups with regard to time-course changes during the immediate postoperative period. This suggests that maxillary stability after Le Fort I osteotomy for cant correction does not differ from that after Le Fort I osteotomy for maxillary advancement.

Maxillary palp glomeruli and ipsilateral projections in the antennal ...

Indian Academy of Sciences (India)

Maxillary palp glomeruli and ipsilateral projections in the antennal lobe of Drosophila melanogaster. K P Rajashekhar V R ... The number of glomeruli receiving the maxillary palp sensory projections tallies with the number of Drosophila olfactory receptors (seven) reported to be expressed exclusively in the maxillary palp.

[Percutaneous maxillary nerve block anesthesia in maxillofacial surgery].

Science.gov (United States)

Robiony, M; Demitri, V; Costa, F; Politi, M

1999-01-01

Personal experience in percutaneous maxillary nerve block anesthesia in association with transmucosal anesthesia of the sphenopalatine ganglion in oral and maxillofacial surgery, is presented. Six Caldwell-Luc, 9 anthrotomies and biopsies of maxillary sinus, 8 removals of extensive odontogenic cysts and 12 surgical maxillary expansions were performed from 1994 to 1996 at our Department. Maxillary transcutaneous nerve block in association with transmucosal anesthesia of the sphenopalatine ganglion were performed. Carbocaine without adrenaline in association with NaCO3 1/10 for maxillary nerve block anesthesia and lidocaineoprilocaine cream (EMLA) for transmucosal anesthesia were employed. Intra- and post-operative pain were evaluated by visual analogue scale in all the patients. Anesthesiological procedures revealed to be effective in all surgical interventions and postoperative analgesia allowed easier pain control. The simplicity of execution, the effective pre- and postoperative anesthesia and the absence of side effects make this procedure particularly indicated in oral and maxillofacial surgery.

Root Length and Anatomy of Impacted Maxillary Canines in Patients with Unilateral Maxillary Canine Impaction

OpenAIRE

Mostfa Shahabi; Maryam Omidkhoda; Seyedeh Haniyeh Omidi; Seyed Hosein Hoseini Zarch

2017-01-01

Introduction: Canine impaction is a common occurrence. In this study, we sought to investigate the root anatomy and length of impacted canines and lateral incisor adjacent to impacted maxillary canine. Materials and Methods: In this retrospective study, three-dimensional tomographic imaging was performed on 26 patients with unilateral maxillary canine impaction. In this study, we evaluated root length and anatomy of impacted canines, in terms of resorption intensity and curvature, with Planme...

[Extension of (extremely) shortened dental arches by fixed or removable partial dentures

NARCIS (Netherlands)

Witter, D.J.; Hoefnagel, R.A.; Snoek, P.A.; Creugers, N.H.J.

2009-01-01

Whether a shortened dental arch needs to be extended depends on the degree of the shortening. Four categories of shortened dental arches can be distinguished: 1. slightly shortened dental arches; 2. moderately shortened dental arches; 3. extremely shortened dental arches; and 4. asymmetrical

[Maxillary distraction complications in cleft patients].

Science.gov (United States)

Jeblaoui, Y; Morand, B; Brix, M; Lebeau, J; Bettega, G

2008-09-01

Cleft lip and palate (CLP) patients often present with a class III malocclusion in connection with a three dimensional maxillary hypoplasia. Twenty-five to 60% of these patients require a maxillary advancement. Two solutions are possible: orthognathic surgery and maxillary distraction. The purpose of this study was to evaluate the complications of the maxillary distraction in CLP patients. Data was collected from the records of patients treated at our Surgery Unit between 2000 and 2007. Among the eight patients (four male and four female), five presented a bilateral CLP, two a unilateral CLP and one a unilateral cleft lip associated to a soft palate cleft. The average age at surgery was 17 years old. All had a Le Fort I osteotomy with a pterygomaxillary disjunction. The first two patients had external distractors and the six following internal ones. After a seven-day latency, activation was led to the rate of 1mm per day twice. The period of consolidation was four months on average. The maxillary advancement varied between 7 and 19 mm with an average of 12.6mm. The average follow-up was four years. We encountered difficulties and/or complications in seven patients: one intraoperatively haemorrhage, one avulsion of a tooth fixed at the pterygoid process during the osteotomy, three device failures, two cases of significant pains during activation, one dissociation of the dental anchorage of an external system, two labial ulcerations and one maxillary sinusitis by migration of the 18. Difficulties of maxillary distraction in CLP patients are very frequent. The majority is related to the distractors and did not interfere with the final result. But this frequency must be taken into account in the indication and in the choice of the material. Two types of complications can occur during distraction: those related to the osteotomy and those related to the material. The complications related to the osteotomy are in connection with the cicatricial ground of the CLP. They are

Le Fort I Maxillary Advancement Using Distraction Osteogenesis

OpenAIRE

Combs, Patrick D.; Harshbarger, Raymond J.

2014-01-01

Treatment of maxillary hypoplasia has traditionally involved conventional Le Fort I osteotomies and advancement. Advancements of greater than 10 mm risk significant relapse. This risk is greater in the cleft lip and palate population, whose anatomy and soft tissue scarring from prior procedures contributes to instability of conventional maxillary advancement. Le Fort I advancement with distraction osteogenesis has emerged as viable, stable treatment modality correction of severe maxillary hyp...

Arch index and running biomechanics in children aged 10-14 years.

Science.gov (United States)

Hollander, Karsten; Stebbins, Julie; Albertsen, Inke Marie; Hamacher, Daniel; Babin, Kornelia; Hacke, Claudia; Zech, Astrid

2018-03-01

While altered foot arch characteristics (high or low) are frequently assumed to influence lower limb biomechanics and are suspected to be a contributing factor for injuries, the association between arch characteristics and lower limb running biomechanics in children is unclear. Therefore, the aim of this study was to investigate the relationship between a dynamically measured arch index and running biomechanics in healthy children. One hundred and one children aged 10-14 years were included in this study and underwent a biomechanical investigation. Plantar distribution (Novel, Emed) was used to determine the dynamic arch index and 3D motion capture (Vicon) to measure running biomechanics. Linear mixed models were established to determine the association between dynamic arch index and foot strike patterns, running kinematics, kinetics and temporal-spatial outcomes. No association was found between dynamic arch index and rate of rearfoot strikes (p = 0.072). Of all secondary outcomes, only the foot progression angle was associated with the dynamic arch index (p = 0.032) with greater external rotation in lower arched children. Overall, we found only few associations between arch characteristics and running biomechanics in children. However, altered foot arch characteristics are of clinical interest. Future studies should focus on detailed foot biomechanics and include clinically diagnosed high and low arched children. Copyright © 2018 Elsevier B.V. All rights reserved.

Le Fort I Maxillary Advancement Using Distraction Osteogenesis

Science.gov (United States)

Combs, Patrick D.; Harshbarger, Raymond J.

2014-01-01

Treatment of maxillary hypoplasia has traditionally involved conventional Le Fort I osteotomies and advancement. Advancements of greater than 10 mm risk significant relapse. This risk is greater in the cleft lip and palate population, whose anatomy and soft tissue scarring from prior procedures contributes to instability of conventional maxillary advancement. Le Fort I advancement with distraction osteogenesis has emerged as viable, stable treatment modality correction of severe maxillary hypoplasia in cleft, syndromic, and noncleft patients. In this article, the authors provide a review of current data and recommendations concerning Le Fort I advancement with distraction osteogenesis. In addition, they outline their technique for treating severe maxillary hypoplasia with distraction osteogenesis using internal devices. PMID:25383054

Simplified Model Surgery Technique for Segmental Maxillary Surgeries

Directory of Open Access Journals (Sweden)

Namit Nagar

2011-01-01

Full Text Available Model surgery is the dental cast version of cephalometric prediction of surgical results. Patients having vertical maxillary excess with prognathism invariably require Lefort I osteotomy with maxillary segmentation and maxillary first premolar extractions during surgery. Traditionally, model surgeries in these cases have been done by sawing the model through the first premolar interproximal area and removing that segment. This clinical innovation employed the use of X-ray film strips as separators in maxillary first premolar interproximal area. The method advocated is a time-saving procedure where no special clinical or laboratory tools, such as plaster saw (with accompanying plaster dust, were required and reusable separators were made from old and discarded X-ray films.

Arch translocation and the intra-arch elephant-trunk technique with collared graft for extended chronic dissecting aortic aneurysm

Directory of Open Access Journals (Sweden)

Ikenaga Shigeru

2013-01-01

Full Text Available Abstract Management of extensive, chronic, dissecting aortic aneurysms after prior repair of the ascending aorta presents a technical challenge for surgeons. A symptomatic 64-year-old patient was admitted for elective surgical repair of an aortic annular dilatation, causing severe aortic regurgitation, and a Crawford type II extended thoracoabdominal aneurysm, 4 years after he underwent primary repair of an acute aortic dissection. The aorta was diffusely dilated, and there were no sites beyond the distal aortic arch where anastomosis could be performed. We successfully performed total aortic replacement with a 2-stage strategy, using an arch translocation technique and an intra-arch elephant-trunk technique.

Simultaneous malaroplasty with porous polyethylene implants and orthognathic surgery for correction of malar deficiency.

Science.gov (United States)

Robiony, M; Costa, F; Demitri, V; Politi, M

1998-06-01

Patients with skeletal malrelationships caused by maxillary anteroposterior defect and midface hypoplasia may present with an alteration of cheekbone contour. High osteotomies, segmental osteotomies of the zygomatic complex, and malar expansion with alloplastic materials can be performed to improve facial aesthetics. This article describes the restoration of cheekbone-nasal base-lip contour by performing a malaroplasty using an alloplastic implant in addition to orthognathic surgery. From 1995 to 1996, 17 patients with maxillomandibular malrelationships and deficient cheekbone contour were tested by malar augmentation with porous high-density polyethylene in association with maxillary advancement and mandibular setback. The diagnosis of cheekbone contour alteration was made after observing the patient from a lateral, frontal, and oblique point of view. The position of the implant was determined by using Mladick's point, with lateral or medial extension in relation to the depressed area. By the restoration of normal cheekbone-nasal base-upper lip contour produced excellent aesthetic results in all patients. Malaroplasty in association with bimaxillary orthognathic surgery seems to be an effective procedure for treating midface skeletal deficiencies.

Is there a prospect for hybrid aortic arch surgery?

Science.gov (United States)

Bashir, Mohamad; Harky, Amer; Bilal, Haris

2018-05-16

The surge of endovascular repair of aortic aneurysm in current modern aortic surgery practice has been the key for surgical management of elective cases of thoracic aortic aneurysms. This has paved way for the combined hybrid approach to be amongst the armamentarium for the management of aortic arch disease. The pivotal understanding of the aortic arch natural history coupled with device technology advancement allowed surgeons insight into delivery of hybrid surgery with acceptable morbidity and mortality results. This review article provides current insights into hybrid technique of aortic arch aneurysm repair and the evidences behind its applicability to arch surgery. It is aimed to highlight the challenges encountered for this innovative approach and correlate its challenges to those that are met by the conventional open aortic arch repair.

Effect of Obesity on Arch Index in Young Adults

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Sneha Sameer Ganu

2013-01-01

Full Text Available Background: Excessive increases in weight bearing forces caused by obesity may negatively affect the lower limbs and feet but minimal research has examined the long-term loading effects of obesity on the musculoskeletal system, particularly in reference to the feet. Objectives: The purpose of the study was to investigate the effect of obesity on medial longitudinal arch of foot in young adults. Method: 60 subjects, 30 obese & 30 non obese were assessed for height & weight using standard technique. Radiographic images under static condition were used for calculating the arch index. Result: The arch index of obese subjects was significantly lower than the non obese subjects & there is a negative correlation between the BMI & the arch index. Conclusion: These results suggests that obesity lowers the medial longitudinal arch of foot.

Odontogenic maxillary sinusitis diagnosed using conebeam x-ray CT

International Nuclear Information System (INIS)

Sato, Kiminori

2007-01-01

We evaluated the usefulness of conebeam x-ray CT in the diagnosis of odontogenic maxillary sinusitis in 21 patients. Among teeth causing odontogenic maxillary sinusitis, 95% had apical lesions after root canal treatment. Most root canals were filled with filling materials incompletely. Apical lesions in inappropriately treated teeth thus caused odontogenic maxillary sinusitis. Conebeam CT involves 3-dimensional isotropic voxel image date in up to 512 frames for transaxial, coronal, and sagittal planes, so resolution in imaging on the body axis was especially high. Multiplanar reconstruction and volume rendering images at any optional plane could be obtained without interpolation. The relationship between causative teeth and the maxillary sinus could be observed and measured, and odontogenic maxillary sinusitis accurately diagnosed. In addition to the accurate diagnosis of apical lesions, maxilla, and maxillary sinus, periodontal ligament space, lamina dura, pulp cavity, root canal, canal-treated root, apical periodontitis, alveolar ostitis, marginal periodontitis of causative teeth could be observed. Metal artifacts were minimized, making conebeam CT useful in the diagnosis of periodontal tissue and causative teeth, including root-canal-treated and crown-restored teeth. (author)

Track-Bridge Longitudinal Interaction of Continuous Welded Rails on Arch Bridge

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Rong Chen

2013-01-01

Full Text Available Taking arch bridges, including deck, half-through, and through arch bridges (short for DAB, HTAB, and TAB as examples, mechanics analysis models of longitudinal interaction between continuously welded rails (short for CWRs and arch bridges are established. Based on the finite element method (FEM, the longitudinal interaction calculation software of CWR on arch bridges has been developed. Focusing on an HTAB, the tension, compression, and deflection conditions are calculated and analyzed. The results show that the mechanics analysis models of three types of arch bridges can truly reflect the real state of the structure; the calculation software can be used for systematic research of the CWR on arch bridge; as for HTAB, temperature difference of arch rib has a small effect on rail tension/compression, and arch bridge can be simplified as a continuous beam for rail tension/compression additional force calculation; in calculation of deflection conditions of HTAB, it is suggested that train loads are arranged on half span and full span and take the direction of load entering bridge into account. Additionally, the deflection additional force variation of CFST basket handle arch bridge is different from that of ordinary bridge.

Bovine aortic arch: A novel association with thoracic aortic dilation

International Nuclear Information System (INIS)

Malone, C.D.; Urbania, T.H.; Crook, S.E.S.; Hope, M.D.

2012-01-01

Aim: To investigate whether there is a link between bovine arch and thoracic aortic aneurysm. Materials and methods: Computed tomography (CT) and magnetic resonance imaging (MRI) images of the thorax of 191 patients with dilated thoracic aortas and 391 consecutive, unselected patients as controls were retrospectively reviewed. Bovine arch was considered present if either a shared origin of the left common carotid and innominate arteries or an origin of the left common carotid from the innominate artery was identified. A chi-square test was used to evaluate the significance of differences between subgroups. Results: A trend towards increased prevalence of bovine arch was seen in patients with dilated aortas (26.2%) compared to controls (20.5%, p = 0.12). The association was statistically significant in patients over 70 years old (31.9%, p = 0.019) and when dilation involved the aortic arch (47.6%, p = 0.003). Conclusions: An association between bovine arch and aortic dilation is seen in older patients, and when dilation involves the aortic arch. Bovine arch should be considered a potential risk factor for thoracic aortic aneurysm.

Tilted Implants for Full-Arch Rehabilitations in Completely Edentulous Maxilla: A Retrospective Study

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Nicolò Cavalli

2012-01-01

Full Text Available Purpose. The aims of this study were to assess the treatment outcome of immediately loaded full-arch fixed bridges anchored to both tilted and axially placed implants in the edentulous maxilla and to evaluate the incidence of biological and prosthetic complications. Materials and Methods. Thirty-four patients (18 women and 16 men were included in the study. Each patient received a maxillary full-arch fixed bridge supported by two axial implants and two distal tilted implants. A total of 136 implants were inserted. Loading was applied within 48 hours of surgery and definitive restorations were placed 4 to 6 months later. Patients were scheduled for followup at 6, 12, 18, and 24 months and annually up to 5 years. At each followup plaque level and bleeding scores were assessed and every complication was recorded. Results. The overall follow-up range was 12 to 73 months (mean 38.8 months. No implant failures were recorded to date, leading to a cumulative implant survival rate of 100%. Biological complications were recorded such as alveolar mucositis (11.8% patients, peri-implantitis (5.9% patients, and temporomandibular joint pain (5.9% patients. The most common prosthetic complications were the fracture or detachment of one or multiple acrylic teeth in both the temporary (20.6% patients and definitive (17.7% patients prosthesis and the minor acrylic fractures in the temporary (14.7% patients and definitive (2.9% patients prosthesis. Hygienic complications occurred in 38.2% patients. No patients’ dissatisfactions were recorded. Conclusions. The high cumulative implant survival rate indicates that this technique could be considered a viable treatment option. An effective recall program is important to early intercept and correct prosthetic and biologic complications in order to avoid implant and prosthetic failures.

Coexistence of bilateral first and second branchial arch anomalies

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Thakur, J S; Shekar, Vidya; Saluja, Manika; Mohindroo, N K

2013-01-01

Branchial arch anomalies are one of the most common congenital anomalies that are usually unilateral and bilateral presentation is rare. The simultaneous presence of bilateral second branchial arch anomalies along with bilateral first arch anomalies is extremely rare, with only three such cases reported in the literature. We present two non-syndromic cases of coexisting bilateral first and second arch anomalies. Developmental anomalies of the branchial apparatus account for 17% of all paediatric cervical masses and are the most common type of congenital cervical mass. They usually present in the paediatric age group. About 96–97% of these anomalies are unilateral. Bilateral presentation is seen in 2–3% having a strong familial association. Congenital syndromes also have been associated with first and second branchial arch anomalies. Thorough clinical examination and investigations should be done to rule out these syndromes. PMID:23580675

Five-year follow-up of maxillary distraction osteogenesis on the dentofacial structures of children with cleft lip and palate.

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Gürsoy, Seda; Hukki, Jyri; Hurmerinta, Kirsti

2010-04-01

To determine the long-term outcomes of maxillary distraction osteogenesis (DO) on skeletal and dental structures of growing children with cleft lip and palate. Severe maxillary deficiencies were treated with a rigid external distractor device followed by a consolidation period. Preoperative and postoperative orthodontic treatment lasted a mean of 14 months and 16 months, respectively. The landmarks on standard lateral cephalometric x-rays were digitized and angular and linear measurements were compared by Student's t test to assess the changes before distraction, after distraction, after consolidation, at 1-year follow-up, and at 2-year follow-up. Long-term follow-up (5 years) was interpreted according to mean values because of the small sample size. During DO, the maxilla was horizontally advanced and moved downward as indicated by the significant changes at the SNA and ANB angles (13 degrees) and at maxillary points A, ANS, and PNS. The increase at the divergence between the maxilla and mandible (ANS-PNS/Me-Go) was found to be significant. The mandible (B, Pg, Me) also moved downward (2-4 mm) and backward (Gn) significantly because of mandibular autorotation. The overjet increased (mean increase, 13.7 mm) and the overbite decreased significantly. The advancement of the upper incisors (13.3 mm) and upper molars (12.3 mm) was slightly more than the skeletal points. In a long-term follow-up (5 years), the ANB angle and horizontal overjet continued to decrease but both values remained positive, indicating a Class I relationship. This cephalometric study of young adolescents with cleft lips and palates found great improvement in dentofacial structure after maxillary DO and stability in maxillary skeletal advancement. During a 5-year follow-up, the achieved dentoskeletal treatment outcome was partly diminished. The extreme need for maxillary advancement or facial correction because of psychosocial stress and providing an easier approach for finalizing osteotomy are the

Arch-Axis Coefficient Optimization of Long-Span Deck-Type Concrete-Filled Steel Tubular Arch Bridge

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Liu, Q. J.; Wan, S.; Liu, H. C.

2017-11-01

This paper is based on Nanpuxi super major bridge which is under construction and starts from Wencheng Zhejiang province to Taishun highway. A finite element model of the whole bridge is constructed using Midas Civil finite element software. The most adverse load combination in the specification is taken into consideration to determine the method of calculating the arch-axis coefficient of long-span deck-type concrete-filled steel tubular arch bridge. By doing this, this paper aims at providing references for similar engineering projects.

Measurement of maxillary sinus volume using Computed Tomography

International Nuclear Information System (INIS)

Park, Chang Hee; Kim, Kee Deog; Park, Chang Seo

2000-01-01

To propose a standard value for the maxillary sinus volume of a normal Korean adult by measuring the width and height of the sinus and analyzing their correlation and the difference of the sinus size respectively between sexes, and on the right and left sides. Fifty-two (95 maxillary sinuses) out of 20 years or over aged patients who had taken CT in the Department of Dental Radiology, Yonsei University, Dental Hospital, between February 1997 and July 1999 who were no specific symptom, prominent bony septa, pathosis, clinical asymmetry and history of surgery in the maxillary sinus were retrospectively analyzed. The mean transverse width, antero-posterior width, height and volume of the normal Korean adult's maxillary sinuses were 28.33 mm, 39.69 mm, 46.60 mm and 21.90 cm 3 , respectively. There was a significant sex difference in the sinus volume (p<0.05). In the mean antero-posterior width, height and volume of the sinus, no significant difference was observed between both sides. All four measurements showed a significant correlation between both sides (p<0.0001). The widths and height of the sinus all showed a significant correlation with the sinus volume (p<0.0001). In the Korean normal adult's maxillary sinus, males tended to be larger than females. Except for the transverse width, all of the measurements showed no significant difference between the right and left side, but significant correlations in the four measurements between both sides were observed. Thus, the overgrowth or undergrowth in the unilateral maxillary sinus may suggest a certain pathosis or developmental abnormalities in the maxillary sinus.

Reaction of the nasal septal cartilage to rapid expansion of the maxillary dental arch

International Nuclear Information System (INIS)

Horisaka, Takashi

1981-01-01

1) In the control group, in which maxillary expansion was not performed, the cell proliferation and uptake of [ 3 H] proline in the septal cartilage were found to be more remarkable at the area of the septoethmoidal junction than other areas of the cartilage. In the experimental group, however, higher activity of the cell proliferation and more intense uptake of [ 3 H] proline were found at the area adjacent to the septoethmoidal junction than the control, while no change was observed in other areas of the septal cartilage. 2) The cartilaginous cells at the septoethmoidal junction represented the columnar pattern in their alignment and the cells were classified into five zones according to their morphological characteristics, i.e. resting, proliferative, transitional, hypertrophic and erosion zones. 3) Distribution of the labeled nuclei with [methyl- 3 H] thymidine was confined almost to the proliferative and transitional zones. In these two zones, the cell proliferation indicated by labeling index increased about 50% in the experimental group as compared with the control. 4) Uptake of [ 3 H] proline was the highest in the transitional zone followed by the proliferative zone. Uptake of [ 3 H] proline indicated by grain counts/2000 μm 2 increased about 50% in the transitional zone and about 30% in the proliferative zone respectively in the experimental group as compared with control. 5) The septo-premaxillary ligament named by Latham (1970) was found also in rats to arise from the perichondrium of antero-inferior portion of the nasal septum, to course postero-inferiorly and to insert into the anterior portion of the premaxillary bones. Uptake of [ 3 H] proline indicated by grain counts/400 μm 2 increased about 30% in the area of insertion of the ligament in the experimental group as compared with the control. (J.P.N.)

Surgical-Orthodontic Treatment of Gummy Smile with Vertical Maxillary Excess

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Sumit Kumar Yadav

2014-01-01

Full Text Available Vertical maxillary excess is a well-defined clinical entity with several treatment options available. Treatment of the condition requires extremely well-coordinated orthodontic and surgical treatment planning and execution. This case report describes a multidisciplinary approach in the successful management of a patient with severe vertical maxillary excess. Careful selection and good execution of a surgical-orthodontic treatment plan in the management of vertical maxillary excess provided the superior esthetic and functional results in this case. Maxillary Le Forte 1 procedure was performed for vertical maxillary impaction along with anterior segmental setback. The presented technique was unique as it shortened the treatment time and esthetic results in smile and vertical proportions were achieved.

Double aortic arch

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Surgery can be done to fix double aortic arch. The surgeon ties off the smaller branch and separates it from the larger branch. Then the surgeon closes the ends of the aorta with stitches. This relieves pressure on the esophagus and windpipe.

Monitoring system of arch bridge for safety network management

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Joo, Bong Chul; Yoo, Young Jun; Lee, Chin Hyung; Park, Ki Tae; Hwang, Yoon Koog

2010-03-01

Korea has constructed the safety management network monitoring test systems for the civil infrastructure since 2006 which includes airport structure, irrigation structure, railroad structure, road structure, and underground structure. Bridges among the road structure include the various superstructure types which are Steel box girder bridge, suspension bridge, PSC-box-girder bridge, and arch bridge. This paper shows the process of constructing the real-time monitoring system for the arch bridge and the measured result by the system. The arch type among various superstructure types has not only the structural efficiency but the visual beauty, because the arch type superstructure makes full use of the feature of curve. The main measuring points of arch bridges composited by curved members make a difference to compare with the system of girder bridges composited by straight members. This paper also shows the method to construct the monitoring system that considers the characteristic of the arch bridge. The system now includes strain gauges and thermometers, and it will include various sensor types such as CCTV, accelerometers and so on additionally. For the long term and accuracy monitoring, the latest optical sensors and equipments are applied to the system.

Developmental feature of the lumbosacral vertebral arch in childhood

International Nuclear Information System (INIS)

Yoshifuji, Kazuhisa; Morota, Nobuhito; Ihara, Satoshi

2007-01-01

We investigated a developmental feature of the lumbosacral vertebral arch in childhood that has rarely been reported previously. Sixty-seven patients underwent functional posterior rhizotomy from September 2000 to June 2006 at National Center for Child Health and Development. Sixty of these patients, who had no deformity in their lumbosacral spine, were included in this study and their Computed Tomography (CT) images were analyzed retrospectively. There were 36 boys and 24 girls, aged from 2-12 years. The rate and mean number of non-union vertebral arches between L1 and S3 were 78.3% (95% CI, 65.8-87.9%) and 1.7 (standard deviation (SD), 1.3). The non-union arch was most frequently found at the S1 level, and was more significantly observed in the younger age group (2-5 years of age). The S4 and S5 arches, which often remained open as the sacral hiatus, were constantly open in childhood. This study demonstrates that the vertebral arches of the lumbosacral spine in normal development are often not fused during childhood. It is important to differentiate normal non-union arches from pathological spina bifida. (author)

The radiographic localization of unerupted maxillary incisors and supernumeraries

International Nuclear Information System (INIS)

Kim, Jae Duk; Lee, Chang Yul; You, Choong Hyun

2003-01-01

To evaluate the use of the vertical tube shift from a panoramic film and a periapical film to localize unerupted maxillary incisors and supernumeraries. The total of 103 displaced maxillary incisors or embedded supernumeraries were examined in this study. The vertical tube shift technique with panoramic and periapical radiography by normal projection taken and compared to localize the position of the embedded maxillary incisors or supernumeraries by a radiologist and 5 general dentists. The gold standard used for the radiographic comparisons was the true position of the embedded tooth as confirmed by horizontal tube shift technique using three periapical radiographs. The general dentist examiners were instructed on the use of the modified acronym 'SLDOBU' by the radiologist as it pertains to panoramic radiographs as the principle of vertical tube shift. All of the embedded maxillary incisors and supernumeraries were successfully located using the vertical tube shift from a panoramic and a maxillary anterior periapical radiograph by the radiologist and 5 general dentists. The use of a panoramic film with a periapical film combination for a vertical tube shift can be useful to localize unerupted maxillary incisors and supernumeraries.

Evaluation of cephalometric changes in patients with class III malocclusion in mixed dentition period following face mask therapy and slow maxillary expansion

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Ahmad Akhondi MS.

2008-11-01

Full Text Available "nBackground and Aim: Among different treatments of patients with Class III malocclusion , orthopedic protraction of maxilla has been known as an effective method in mixed dentition period. The aim of this study was to evaluate the cephalometric changes of Cl III patients in mixed dentition period following face mask therapy and slow maxillary expansion. "nMaterials and Methods: This was a before-after study which was conducted on 10 children in mixed dentition period, who had class III malocclusion and maxillary deficiency according to the Stiener and Mc Namara's analysis. The patients were all treated by protraction face mask and slow maxillary expansion. The cephalometric changes of maxilla , mandible and dental relations during the treatment were analyzed by Paired sample T Test. P<0.05 was considered as the level of significant. "nResults: The overjet increasement was 1.7mm. Co. ANS distance improvement was 5.6mm, Ptm.ANS distance increasing was 3mm, and ultimately improvement of Gf.s distance was 1.5mm which were all statistically significant (p<0.05. "nConclusion: Based on the results of this study, face mask therapy with slow maxillary expansion is able to improve the horizotal position of maxilla, in patients with Cl III malocclusion , in mixed dentition period.

Whole genome microarray analysis of chicken embryo facial prominences

Czech Academy of Sciences Publication Activity Database

Buchtová, Marcela; Kuo, W. P.; Nimmagadda, S.; Benson, S. L.; Geetha-Loganathan, P.; Logan, C.; Au-Yeung, T.; Chiang, E.; Fu, K.; Richman, J. M.

2010-01-01

Roč. 239, - (2010), s. 574-591 ISSN 1058-8388 Institutional research plan: CEZ:AV0Z50450515 Keywords : pharyngeal arch * mandibular arch * maxillary prominence Subject RIV: EB - Genetics ; Molecular Biology Impact factor: 2.864, year: 2010

Desmineralização dentária de pacientes respiradores orais submetidos à expansão maxilar Demineralization of teeth in mouth-breathing patients undergoing maxillary expansion

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Silvia Fuerte Bakor

2010-12-01

Full Text Available A respiração oral pode causar deformações na arcada dentária e representar risco a cáries e doenças periodontais, podendo ser agravado pela utilização de aparelhos fixos. OBJETIVO: Avaliar o grau de mineralização do esmalte dentário e a microbiota cariogênica bucal de respiradores orais que utilizaram disjuntores maxilares. MATERIAL E MÉTODO: Estudo prospectivo com 20 pacientes respiradores orais com atresia maxilar, idades entre 9 e 13 anos. A mineralização do esmalte dentário foi medida pela técnica de fluorescência, antes da instalação do disjuntor maxilar e após sua remoção. A microbiota cariogênica foi avaliada pelo No Caries®. Na análise estatística utilizamos o teste "t" (pMouth breathing may cause deformities on the dental arch and be a risk factor for caries and periodontal disease; fixed orthodontic appliances compound the problem. AIM: to evaluate mineralization of tooth enamel and the oral cariogenic microbiota of mouth breathers that are using maxillary expanders. MATERIAL AND METHOD: a prospective study of 20 mouth-breathing patients with maxillary atresia, aged from 09 to 13 years. Enamel mineralization was measured using a fluorescence technique, before installing the expander and after its removal. The cariogenic microbiota was evaluated by the No Caries®. The t test (p<0.05 was applied for the statistical analysis, and the oral microbiota was analyzed by incidence. RESULTS: there was a statistically significant difference in the enamel mineralization level after maxillary expansion; the mean value was 3.08. The colorimetric test showed that the caries development potential was reduced in 45%, increased in 15%, and unaltered in 40% after maxillary expander use. CONCLUSION: there was a statistically significant difference in enamel mineralization after maxillary expansion; this difference was within the clinically normal range; the cariogenic potential increased in a small number of patients during

Evaluation of pre- and post-treatment changes in the alveolus of infants with cleft lip and palate using nasoalveolar molding

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Balakrishna Shetty

2013-01-01

Full Text Available Objectives: The purpose of this study was to evaluate the changes in maxillary alveolar morphology in unilateral and bilateral cleft lip palate infants treated with presurgical nasoalveolar molding (PNAM. Materials and Methods: In this retrospective study, 10 infants, less than 6 months of age, with cleft lip and palate (CLP treated with PNAM prior to surgical repair, were evaluated. Pre-PNAM (T1 and Post-PNAM (T2 study models were analyzed. Critical linear dimensions like inter-canine width, inter-tuberosity width, and arch length were measured and compared at the T1 and T2 stages using a grid comparison system. Results: The width of the alveolar cleft, arch length, and arch width showed a significant decrease in infants treated with PNAM. The inter-tuberosity width and arch perimeter showed a statistically significant increase with PNAM. Conclusion: PNAM was effective in reducing the severity of the initial cleft deformity mainly at the anterior portion of the maxillary arch.

Ectopic third molar in maxillary sinus: A rare case report

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Abhishek Sinha

2017-01-01

Full Text Available Ectopic tooth eruption in a non-dental area is a rare entity, and is most common in oral cavity. There have been a few case reports of teeth erupting in mandibular condyle, chin, palate, coronoid process, and maxillary sinus. Ectopic tooth in the maxillary sinus are found incidentally on routine radiological examination, same time they can be symptomatic and associated with pathologies usually dentigerous cyst or odontogenic keratocyst. Facial pain, purulent rhinorrhoea, epistaxis, headache, swelling, and epiphora-related naso-lacrimal duct obstruction can also be seen. By Caldwell-Luc procedure the ectopic teeth within the maxillary sinus are often removed. In this study, a case of ectopic maxillary third molar tooth on right maxillary sinus is presented.

Expansão maxilar em adultos e adolescentes com maturação esquelética avançada Maxillary expansion in adults and adolescents with advanced skeletal maturation

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Rowdley Robert Pereira Rossi

2009-10-01

Full Text Available A deficiência transversa da maxila é um fator agravante e complicador do tratamento ortodôntico em adultos. Sua correção ainda gera dúvidas e controvérsias entre clínicos e pesquisadores. O objetivo deste trabalho foi analisar e discutir fatores determinantes para o planejamento da expansão maxilar em adultos e adolescentes com maturação esquelética avançada. Ausências dentárias múltiplas, grandes inclinações dentoalveolares para vestibular, recessão gengival, perda óssea alveolar e mobilidade dos dentes posterossuperiores contraindicam a realização de expansão rápida da maxila em indivíduos adultos ou com maturação esquelética avançada. No entanto, esses fatores não devem ser considerados isoladamente para a escolha do método de expansão palatal nesses pacientes. Nessas situações, a Expansão Rápida da Maxila Assistida Cirurgicamente (ERMAC pode ser uma opção, entretanto, a escolha por essa técnica deve basear-se principalmente na idade do paciente, no grau de maturação esquelética, na localização da deficiência transversa da maxila e nas estruturas anatômicas que oferecem maior resistência à expansão maxilar. O Hyrax é o aparelho mais indicado para indivíduos que vão se submeter à ERMAC.The transverse maxillary deficiency is a complication factor in adults' orthodontic treatment. Its correction still generates doubts and controversies between clinicians and researchers. The aim of this paper is to discuss the determinative factors in planning maxillary expansion in adults and adolescents with advanced skeletal maturation. Multiple dental absences, several dentoalveolar buccal inclination, gingival recession, alveolar bone loss and mobility of posterosuperior teeth contraindicate the rapid maxillary expansion in adults or patients with advanced skeletal maturation. However, these factors should not be considered separately when choosing the method for palatal expansion in adults. In these

Distraction rate and latency: factors in the outcome of paediatric maxillary distraction.

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Higuera, Stephen; Cole, Patrick; Stephenson, J B; Hollier, Larry

2009-12-01

Over 50 years ago, current tenets of distraction osteogenesis were developed through work on the lower extremity; however, the application of these tenets in the paediatric craniofacial skeleton remains questionable. Prompted by recent concern that traditional aspects of distraction may be either outdated or wholly inapplicable to the paediatric maxilla, we retrospectively evaluated maxillary distraction protocol using a 24-h latency period in conjunction with a distraction rate of 2mm/day. Following maxillary advancement via a distraction protocol consisting of a 24-h latency period and a distraction rate of 2mm/day, seven consecutive paediatric cases were evaluated. Standard profile photos and cephalometric films taken preoperatively, at device removal and at 1-year follow-up were compared. With the sella as the point of registration, pre- and post-distraction films were superimposed on the sella-nasion plane. Sella-nasion-subspinale, the angle of convexity, the distance from incisal edges to the y-axis, and angulation of the upper incisor to the sella-nasion plane were analysed to evaluate hard-tissue changes. Patient age ranged from 3 to 14 years (mean=7.43 years). Maxillary distraction length averaged 11 mm (range=10-12 mm). Interval from device application to removal averaged 98 days (range=75-180 days). The interval of the active distraction ranged from 11 to 65 days (mean=24 days). From distraction completion to device removal averaged 85 days (range=60-150). Follow-up intervals ranged from 52 to 24 months (mean=34 months). All patients demonstrated substantial clinical advancement of the maxilla with correction of midfacial deficiencies. A single patient developed mild cellulitis at one skin-device interface; no other complications were noted. Cephalometric and clinical evaluations at 1 year post-distraction demonstrated stable results, and parental satisfaction was qualitatively high. The surgical dogma of lower-extremity distraction osteogenesis is not

Agenesis of maxillary lateral incisors and associated dental anomalies.

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Garib, Daniela Gamba; Alencar, Bárbara Maria; Lauris, José Roberto Pereira; Baccetti, Tiziano

2010-06-01

The objectives of this study were to evaluate the prevalence of dental anomalies in patients with agenesis of maxillary lateral incisors and to compare the findings with the prevalence of these anomalies in the general population. A sample of 126 patients, aged 7 to 35 years, with agenesis of at least 1 maxillary lateral incisor was selected. Panoramic and periapical radiographs and dental casts were used to analyze other associated dental anomalies, including agenesis of other permanent teeth, ectopia of unerupted permanent teeth, microdontia of maxillary lateral incisors, and supernumerary teeth. The occurrence of these anomalies was compared with prevalence data previously reported for the general population. Statistical testing was performed with the chi-square test (P <0.05) and the odds ratio. Patients with maxillary lateral incisor agenesis had a significantly increased prevalence rate of permanent tooth agenesis (18.2%), excluding the third molars. The occurrence of third-molar agenesis in a subgroup aged 14 years or older (n = 76) was 35.5%. The frequencies of maxillary second premolar agenesis (10.3%), mandibular second premolar agenesis (7.9%), microdontia of maxillary lateral incisors (38.8%), and distoangulation of mandibular second premolars (3.9%) were significantly increased in our sample compared with the general population. In a subgroup of patients aged 10 years or older (n = 115), the prevalence of palatally displaced canines was elevated (5.2%). The prevalences of mesioangulation of mandibular second molars and supernumerary teeth were not higher in the sample. Permanent tooth agenesis, maxillary lateral incisor microdontia, palatally displaced canines, and distoangulation of mandibular second premolars are frequently associated with maxillary lateral incisor agenesis, providing additional evidence of a genetic interrelationship in the causes of these dental anomalies. 2010 American Association of Orthodontists. Published by Mosby, Inc. All

Mechanics Evolution Characteristics Analysis of Pressure-arch in Fully-mechanized Mining Field

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S.R. Wang

2014-09-01

Full Text Available Based on a practical engineering, the three-dimension computational model was built using FLAC3D under the fullymechanized mining condition. Considering four variation factors, such as the distance of mining advancing, the strength of the surrounding rock, the speed of mining advancing and the dip angle of the coal seam, the mechanics evolution characteristics of the pressure-arch were analyzed. The result showed that for the horizontal seam, the geometric shape of the pressure-arch varied from flat arch to round arch gradually and the height and thickness of the pressure-arch also increased; the maximum principal stress in the skewback also increased with the working face advancing. With the strength of the surrounding rock from soft to hard, the arch thickness reduced, and the arch loading decreased. To improve the mining speed can do some contributions to the stability of the pressure-arch in the mining field. With the increase of dip angle of the seam, the pressure-arch displayed an asymmetric shape, the vault was tilted and moved to the upward direction. At the same time, the thickness of the pressure-arch increased, and the stress concentration in the skewback tended to be further intensified.

[Dental-radical cysts, a rare aetiology of maxillary sinus opacity].

Science.gov (United States)

Bassou, D; Darbi, A; Elkharras, A; Elhaddad, A; Boumdin, H; Amil, T; Benameur, M; Chaouir, S

2007-12-01

To specify CT scan roll in diagnosis of radicullar cyst invading maxillary sinus. Two cases of 23 and 34-year-old men presented with facial injury and sinusitis was explored by CT scan. CT scan showed in both patients a cystic lesion, developing into the maxillary sinus around a tooth apex and limits by a double dense thin rim. CT scan permits diagnosis of radicular cyst invading maxillary sinus, in the event of obscured maxillary sinus, when double dense thin rim corresponding to the repulsed wall of the sinus is looking.

Outcomes of single-stage total arch replacement via clamshell incision

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Ishizaka Toru

2011-09-01

Full Text Available Abstract Background Treatment of complex aortic pathologies involving the transverse arch with extensive involvement of the descending aorta remains a surgical challenge. Since clamshell incision provides superior exposure of the entire thoracic aorta, we evaluated the use of this technique for single-stage total arch replacement by arch vessel reconstruction. Methods The arch-first technique combined with clamshell incision was used in 38 cases of aneurysm and aortic disease in 2008 and 2009. Extensive total arch replacement was used with clamshell incision for reconstruction of arch vessels under deep hypothermic circulatory arrest. Results Overall 30-day mortality was 13%. The mean operating time was approximately 8 hours. Deep hypothermia resulted in mean CPB time exceeding 4.5 hours and mean duration of circulatory arrest was 25 minutes. The overall postoperative temporary and permanent neurologic dysfunction rates were 3% and 3% for elective and 3% and 0% for emergency surgery, respectively. All patients except the five who died in hospital were discharged without nursing care after an average post-operative hospital stay of 35 days. Conclusions The arch-first technique, combined with clamshell incision, provides expeditious replacement of the thoracic aorta with an acceptable duration of hypothermic circulatory arrest and minimizes the risk of retrograde atheroembolism by using antegrade perfusion.

Super-light pearl-chain arch vaults

DEFF Research Database (Denmark)

Hertz, Kristian Dahl; Halding, Philip Skov

2014-01-01

Arch vaults are known as optimal and impressive structures, but due to their curved shapes they are extremely costly to produce in countries, where the cost of labor is high. By means of super-light pearl-chain technology arch vaults can be constructed from equal plane prefabricated elements, which...... that it is also applicable as basic elements for super-light pearl-chain vaults. Machines and software have been developed for automatic mass production of the elements, and the first factory has started production in Denmark in 2014 delivering SL-deck elements for a variety of building projects. This means...... is known from curved voluminous elements. The paper describes the first full-scale test of an arch vault made of SL-deck elements demonstrating the principle, documenting the load-bearing capacity, and solving a number of details needed in order to create vaults in practice. Considerations and plans...

Incisor malalignment and the risk of periodontal disease progression.

Science.gov (United States)

Alsulaiman, Ahmed A; Kaye, Elizabeth; Jones, Judith; Cabral, Howard; Leone, Cataldo; Will, Leslie; Garcia, Raul

2018-04-01

The objective of this study was to investigate the association between incisor crowding, irregularity, and periodontal disease progression in the anterior teeth. Data collected over 35 years from men enrolled in the Veterans Affairs Dental Longitudinal Study included information concerning pocket depth and alveolar bone loss. Plaster casts of the maxillary (n = 400) and mandibular (n = 408) arches were available for baseline measurements. Periodontal disease in the anterior teeth was defined as per arch sum of pathologic pocket depth and sum of teeth with any alveolar bone loss in the anterior sextants. Incisor malalignment status was defined by the anterior tooth size-arch length discrepancy index and Little's Irregularity Index. Adjusted mixed effects linear models computed the beta (β) estimates and 95% confidence intervals (95% CI) of the amounts of change in periodontal disease outcomes by the level of malalignment. In the anterior maxillary arch, crowding and spacing were significantly associated with an increased per-arch sum of pathologic pocket depth (β, 0.70 mm; 95% CI, 0.20-1.21, and β, 0.49 mm; 95% CI, 0.06-0.91, respectively). In the anterior mandibular arch, incisor crowding and irregularity were significantly associated with an increased per-arch sum of pathologic pocket depth (mild crowding: β, 0.47 mm; 95% CI, 0.01-0.93; severe irregularity: β, 0.94 mm; 95% CI, 0.50-1.38), and the sum number of teeth with alveolar bone loss (mild and moderate-to-severe crowding: β, 0.45 teeth; 95% CI, 0.08-0.82; and β, 0.45 teeth; 95% CI, 0.13-0.83, respectively; moderate irregularity: β, 0.34 teeth; 95% CI, 0.06-0.62). Certain incisor malalignment traits (ie, maxillary incisor crowding, maxillary incisor spacing, mandibular incisor mild crowding, mandibular incisor moderate-to-severe crowding, mandibular incisor moderate irregularity, and mandibular incisor severe irregularity) are associated with significant periodontal disease progression

Plastic collapse load of crown-hinged steel circular arches : a theoretical method

NARCIS (Netherlands)

Spoorenberg, R.C.; Snijder, H.H.; Hoenderkamp, J.C.D.

2013-01-01

For construction purposes and to avoid detrimental influences of foundation settlements arches are not always made from a single arch-rib but are built by connecting two curvilinear elements at the crown with a hinge. These arches are also known as crown-hinged arches. This paper presents an

Agenesis of the posterior arch of the atlas

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Torriani Martin

2002-01-01

Full Text Available PURPOSE: To illustrate the radiological findings and review the current literature concerning a rare congenital abnormality of the posterior arch of the atlas. CASE REPORT: An adult female without neurological symptoms presented with an absent posterior arch of the atlas, examined with plain films and helical computerized tomography. Complete agenesis of the posterior arch of the atlas is a rare entity that can be easily identified by means of plain films. Although it is generally asymptomatic, atlantoaxial instability and neurological deficits may occur because of structural instability. Computerized tomography provides a means of assessing the extent of this abnormality and can help evaluate the integrity of neural structures. Although considered to be rare entities, defects of the posterior arch of the atlas may be discovered as incidental asymptomatic findings in routine cervical radiographs. Familiarity with this abnormality may aid medical professionals in the correct management of these cases.

Ecological and phylogenetic influences on maxillary dentition in snakes

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Kate Jackson

2010-12-01

Full Text Available The maxillary dentition of snakes was used as a system with which to investigate the relative importance of the interacting forces of ecological selective pressures and phylogenetic constraints indetermining morphology. The maxillary morphology of three groups of snakes having different diets, with each group comprising two distinct lineages — boids and colubroids — was examined. Our results suggest that dietary selective pressures may be more significantthan phylogenetic history in shaping maxillary morphology.

Introduction of a new removable adjustable intraoral maxillary distraction system for correction of maxillary hypoplasia.

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Figueroa, Alvaro A; Polley, John W; Figueroa, Alexander L

2009-09-01

Distraction osteogenesis has become a treatment alternative to treat severe craniofacial skeletal dysplasias. A rigid external distraction device has been successfully used to advance the maxilla as well as the maxillary, orbital, and forehead complex (monobloc) in children as young as 2 years, adolescents, and adults. For this severe group of patients, the technique has been found to be simpler and safer than traditional surgical methods. Maxillary and midfacial advancement through distraction has been found to be extremely stable in the patients in whom the technique was used.The authors introduce an intraoral distractor for those patients requiring a moderate maxillary advancement. The advantages of the device include ease of insertion, vector adjustability, reactivation capabilities, and no need for second procedure for its removal.The above approaches have provided predictable and stable results. A detailed description of the device, necessary orthodontic and surgical procedures, case reports, and cephalometric outcomes are presented. The techniques can be applied alone or as an adjunct to traditional orthognathic and craniofacial surgical procedures.

Transverse effect of Haas and Hyrax appliances on the upper dental arch in patients with unilateral complete cleft lip and palate: A comparative study

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Façanha, Anna Júlia de Oliveira; Lara, Tulio Silva; Garib, Daniela Gamba; da Silva Filho, Omar Gabriel

2014-01-01

Objective The aim of the present study was to evaluate the transverse effect of rapid maxillary expansion in patients with unilateral complete cleft lip and palate while comparing the Haas and Hyrax appliances. Methods The sample consisted of 48 patients divided into two groups: Group I - 25 patients treated with modified Haas appliance (mean age: 10 years 8 months); and Group II - 23 patients treated with Hyrax appliance (mean age: 10 years 6 months). Casts were taken during pre-expansion and after removal of the appliance at the end of the retention period. The models were scanned with the aid of the 3 Shape R700 3D scanner. Initial and final transverse distances were measured at cusp tips and cervical-palatal points of maxillary teeth by using the Ortho AnalyzerTM 3D software. Results The mean expansion obtained between cusp tips and cervical-palatal points for inter-canine width was 4.80 mm and 4.35 mm with the Haas appliance and 5.91 mm and 5.91 mm with the Hyrax appliance. As for first premolars or first deciduous molars, the values obtained were 6.46 mm and 5.90 mm in the Haas group and 7.11 mm and 6.65 mm in the Hyrax group. With regard to first molars, values were 6.11 mm and 5.24 mm in the Haas group and 7.55 mm and 6.31 mm in the Hyrax group. Conclusion Rapid maxillary expansion significantly increased the transverse dimensions of the upper dental arch in patients with cleft palate, with no significant differences between the Hass and Hyrax expanders. PMID:24945513

Transverse effect of Haas and Hyrax appliances on the upper dental arch in patients with unilateral complete cleft lip and palate: A comparative study

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Anna Júlia de Oliveira Façanha

2014-04-01

Full Text Available Objective: The aim of the present study was to evaluate the transverse effect of rapid maxillary expansion in patients with unilateral complete cleft lip and palate while comparing the Haas and Hyrax appliances. Methods: The sample consisted of 48 patients divided into two groups: Group I - 25 patients treated with modified Haas appliance (mean age: 10 years 8 months; and Group II - 23 patients treated with Hyrax appliance (mean age: 10 years 6 months. Casts were taken during pre-expansion and after removal of the appliance at the end of the retention period. The models were scanned with the aid of the 3 Shape R700 3D scanner. Initial and final transverse distances were measured at cusp tips and cervical-palatal points of maxillary teeth by using the Ortho Analyzer(tm 3D software. Results: The mean expansion obtained between cusp tips and cervical-palatal points for inter-canine width was 4.80 mm and 4.35 mm with the Haas appliance and 5.91 mm and 5.91 mm with the Hyrax appliance. As for first premolars or first deciduous molars, the values obtained were 6.46 mm and 5.90 mm in the Haas group and 7.11 mm and 6.65 mm in the Hyrax group. With regard to first molars, values were 6.11 mm and 5.24 mm in the Haas group and 7.55 mm and 6.31 mm in the Hyrax group. Conclusion: Rapid maxillary expansion significantly increased the transverse dimensions of the upper dental arch in patients with cleft palate, with no significant differences between the Hass and Hyrax expanders.

Maxillary Osteomyelitis: A Rare Entity

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Ayaaz Habib

2016-01-01

Full Text Available Osteomyelitis of the maxilla is now a rare event with the advent of antibiotics. The two predominant causes are odontogenic infections and sinusitis. Immunocompromised states such as diabetes, HIV, and malnutrition increase the risk of osteomyelitis. It is important to recognize this early as it is a difficult entity to treat with potentially serious consequences. We report an unusual case of right sided maxillary osteomyelitis in a lady with poorly controlled diabetes in rural Lincolnshire. Biopsy of the right maxillary bone showed features of acute osteomyelitis. This responded well to a prolonged course of oral antibiotics.

A case of complete double aortic arch visualized by transthoracic echocardiography.

Science.gov (United States)

Saito, Naka; Kato, Shingo; Saito, Noritaka; Nakachi, Tatsuya; Fukui, Kazuki; Iwasawa, Tae; Kosuge, Masami; Kimura, Kazuo

2017-08-01

A case of double aortic arch that was well visualized using transthoracic echocardiography is reported. A 38-year-old man underwent transthoracic echocardiography for the evaluation of dyspnea. A suprasternal view of transthoracic echocardiography showed the ascending aorta bifurcate to left and right aortic arches, with blood flow from the ascending aorta to bilateral aortic arches. The diagnosis of right side-dominant double aortic arch was made, and the patient's symptom was conceivably related to compression of the trachea due to a vascular ring. This report indicates the potential usefulness of transthoracic echocardiography for noninvasive detection of double aortic arch in adults. © 2017, Wiley Periodicals, Inc.

Radiographic evaluation of third molar development in 6 to 24 year olds

International Nuclear Information System (INIS)

Jung, Yun Hwa; Cho, Bong Hae

2014-01-01

This study investigated the developmental stages of third molars in relation to chronological age and compared third molar development according to location and gender. A retrospective analysis of panoramic radiographs of 2490 patients aged between 6 and 24 years was conducted, and the developmental stages of the third molars were evaluated using the modified Demirjian's classification. The mean age, standard deviation, minimal and maximal age, and percentile distributions were recorded for each stage of development. A Mann-Whitney U test was performed to test the developmental differences in the third molars between the maxillary and mandibular arches and between genders. A linear regression analysis was used for assessing the correlation between the third molar development and chronological age. The developmental stages of the third molars were more advanced in the maxillary arch than the mandibular arch. Males reached the developmental stages earlier than females. The average age of the initial mineralization of the third molars was 8.57 years, and the average age at apex closure was 21.96 years. The mean age of crown completion was 14.52 and 15.04 years for the maxillary and the mandibular third molars, respectively. The developmental stages of the third molars clearly showed a strong correlation with age. The third molars developed earlier in the upper arch than the lower arch; further, they developed earlier in males than in females.

A radiographic study of the experimental lesions in the maxillary sinus

International Nuclear Information System (INIS)

Lee, Joo Hyun; Hwang, Eui Hwan; Lee, Sang Rae

1994-01-01

The purpose of this study was to examine the differences in representation of a globular radiopaque mass on the pantomograms and Waters' views and to compare the efficacy of periapical radiograms, pantomograms and Waters' views in detection of defects on the internal walls of the maxillary sinus. This study was performed with dried human skull. For the study of difference of radiopaque mass shadow in the two views, rubber ball with a diameter of 10mm was used as the experimental lesion. It was placed successively on the internal wall of the anterior, posterior, medial, lateral walls and floor of the maxillary sinus. To examine the detectability of defects for radiographic techniques, defects were formed in the anterior, posterior, medial, lateral walls, and floor of the maxillary sinus. They were formed with 0.5 mm, 0.75 mm, 1.0 mm, 2.0 mm and 3.0 mm sized steel round burs with a slow speed dental handpiece. By subsequently plugging the holes with zinc oxide eugenol paste, radiopaque defects were produced. After that the periapical radiograms, the pantomograms and the Waters' views were taken each and every defect. The obtained results were as follows: 1. Rubber balls placed on each internal wall of maxillary sinus were correctly depicted on the posterior wall and the floor in case of the pantomogram, and on the anterior wall and the medial wall in case of the Waters' view. 2. On the detectability of defects for each radiographic technique, radiolucent defects were detected in different places of each technique. Periapical radiogram could detect 1.0 mm defect on the floor of the maxillary sinus, pantomogram could detect 2.0 mm defect on every internal wall of the maxillary sinus, and Waters' view could detect 3.0 mm defect on the anterior wall of the maxillary sinus. 3. On the detectability of defects for each radiographic technique, radiopaque defects were detected in different places for each technique. Periapical radiogram could clearly detect 0.5 mm defect on

Atypical presentation of bilateral supplemental maxillary central incisors with unusual talon cusp

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Sivakumar Nuvvula

2011-01-01

Full Text Available Delayed eruption of maxillary permanent central incisors in a child poses a distressing esthetic quandary to parents, by virtue of its location in the dental architecture. Well-aligned anterior teeth add confidence to smile and have enhanced self-esteem, which is critical even in early life. Impaction of the maxillary central incisors compared to third molars or the canines is less reported; bilateral supplemental maxillary central incisors related to impacted permanent maxillary central incisors are rare and one of the supplemental central incisors showing unusual talon is still infrequent. A case of impacted maxillary permanent central incisors related to supplemental maxillary central incisors, with one of them showing an unusual talon cusp, is presented.

Comparative study on the mechanical mechanism of confined concrete supporting arches in underground engineering.

Science.gov (United States)

Lv, Zhijin; Qin, Qian; Jiang, Bei; Luan, Yingcheng; Yu, Hengchang

2018-01-01

In order to solve the supporting problem in underground engineering with high stress, square steel confined concrete (SQCC) supporting method is adopted to enhance the control on surrounding rocks, and the control effect is remarkable. The commonly used cross section shapes of confined concrete arch are square and circular. At present, designers have no consensus on which kind is more proper. To search for the answer, this paper makes an analysis on the mechanical properties of the two shapes of the cross-sections. A full-scale indoor comparative test was carried out on the commonly used straight-wall semi-circular SQCC arch and circular steel confined concrete arch (CCC arch). This test is based on self-developed full-scale test system for confined concrete arch. Our research, combining with the numerical analysis, shows: (1) SQCC arch is consistent with CCC arch in the deformation and failure mode. The largest damages parts are at the legs of both of them. (2) The SQCC arch's bearing capability is 1286.9 kN, and the CCC arch's ultimate bearing capability is 1072.4kN. Thus, the SQCC arch's bearing capability is 1.2 times that of the CCC arch. (3) The arches are subjected to combined compression and bending, bending moment is the main reason for the arch failure. The section moment of inertia of SQCC arch is 1.26 times of that of CCC arch, and the former is better than the latter in bending performance. The ultimate bearing capacity is positively correlated with the size of the moment of inertia. Based on the above research, the engineering suggestions are as follows: (1) To improve the bearing capacity of the arch, the cross-sectional shape of the chamber should be optimized and the arch bearing mode changed accordingly. (2) The key damaged positions, such as the arch leg, should be reinforced, optimizing the state of force on the arch. SQCC arches should be used for supporting in underground engineering, which is under stronger influence of the bending moment and

Maxillary sinus agenesis - report of two cases

International Nuclear Information System (INIS)

Pierre, Jorge Henrique Arraes de Alencar; Santana, Expedito Araujo

2000-01-01

Agenesis or aplasia of the maxillary sinuses is an extremely rare condition, and only eight cases have been reported in the world medical literature. These malformations may arise as a result of developmental defects. Two cases of unilateral agenesis of the maxillary sinus are presented and the radiological abnormalities and the embryology are discussed. The literature is also reviewed. (author)

Comparison of arch forms between Turkish and North American

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Ahmet A. Celebi

2016-04-01

Full Text Available ABSTRACT Objective: The aim of this study was to clarify the morphological differences in the mandibular arches of Turkish and North American white subjects. Methods: The sample included 132 Turkish (34 Class I, 58 Class II, and 40 Class III and 160 North American (60 Class I, 50 Class II, and 50 Class III subjects. The most facial portion of 13 proximal contact areas was digitized from photocopied images of patients' mandibular dental arches. Clinical bracket points were calculated for each tooth based on mandibular tooth thickness data. Four linear and two proportional measurements were taken. The subjects were grouped according to arch form types (tapered, ovoid and square in order to have frequency distribution compared between ethnic groups in each Angle classification. Results: The Turkish group showed significantly lower molar depth and more significant molar width-depth (W/D ratio in all three Angle classifications. On the other hand, the Turkish group also showed a significantly larger intercanine width in Class III malocclusion and intermolar width in Class II malocclusion. The most frequent arch forms seen were the ovoid arch form in the Turkish group and the tapered form in the white group. Conclusions: Our results demonstrate that when treating Turkish patients, one should expect to use preformed ovoid arch form orthodontic wires in a significant percentage of patients.

Trans-sinusoidal maxillary distraction in three cleft patients.

NARCIS (Netherlands)

Wenghoefer, M.H.; Martini, M.; Nadjmi, N.; Schutyser, F.A.C.; Jagtman, A.K.; Bergé, S.J.

2006-01-01

The trans-sinusoidal maxillary distractor (TS-MD) was used to achieve maxillary advancement in three patients with repaired cleft lip and palate. After preoperative computer-aided planning of the distraction vectors, each TS-MD was bent on a stereolithographic model of the maxilla of the patient.

Treatment of severe maxillary cleft hypoplasia in a case with missing premaxilla with anterior maxillary distraction using tooth-borne hyrax appliance

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Akshai Shetty

2015-01-01

Full Text Available Cleft orthodontics generally poses a challenge and a missing premaxilla adds to the difficulty in managing them. The lack of bone support and anterior teeth in a case with missing premaxilla accounts not only for difficulty in rehabilitation but also in increasing the maxillary hypoplasia. This article presents a case report where planned orthodontic and surgical management using distraction has helped treat a severe maxillary hypoplasia in a patient with missing premaxilla. The treatment plan and method can be used to treat severe maxillary hypoplasia and yield reasonably acceptable results for such patients.

Penetration of flomoxef into human maxillary and mandibular bones.

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Igawa, H H; Sugihara, T; Yoshida, T; Kawashima, K; Ohura, T

1995-09-01

Penetration of flomoxef into the maxillary and mandibular bones was assayed clinically to provide data about its usefulness for the prevention of postoperative infection after maxillofacial surgery. Twenty-one patients undergoing maxillofacial surgery at our department were given flomoxef 2 g dissolved in 20 ml of physiological saline intravenously over 3 minutes during operation, and the serum, maxillary and mandibular concentrations were measured 1, 3, and 6 hours after injection by the band culture method using Escherichia coli 7437 as the indicator strain. The mean concentrations were 53.4, 16.1, and 2.6 micrograms/ml, respectively, in the serum, 17.6, 7.8, and 1.0 micrograms/g in maxillary bone, and 16.4, 4.2, and 0.9 micrograms/g in mandibular bone. The mean bone:serum ratios at 1, 3, and 6 hours were 33.0%, 48.2%, and 36.8%, respectively, for maxillary bone, and 30.7%, 26.2%, and 35.7% for mandibular bone. When compared with previously reported data on the bone:serum ratios in jaw of various other intravenous antibiotics, our results show that penetration of flomoxef into maxillary and mandibular bone is extremely high. As all the intramaxillary and intramandibular concentrations exceed its MIC80 values against clinical isolates of bacteria frequently isolated in cases of infection in the oral and maxillofacial region, it is apparent that one intravenous shot of flomoxef 2 g allows penetration of the drug into the maxillary and mandibular bones at effective concentrations. Flomoxef is therefore potentially useful for the prevention and treatment of infections in the oral and maxillofacial region, as it has excellent penetration into the maxillary and mandibular bones.

Transpalatal distraction for the management of maxillary constriction in pediatric patients.

Science.gov (United States)

Adolphs, Nicolai; Ernst, Nicole; Hoffmeister, Bodo; Raguse, Jan-Dirk

2015-01-01

The management of severe maxillary constriction can be challenging. For that purpose surgically assisted maxillary expansion by transpalatal distraction (TPD) can typically be recommended after skeletal maturity. However in selected cases bone borne transpalatal distraction devices can contribute to improve maxillary constriction considerably earlier already during mixed dentition. To assess the possibility of bone borne transpalatal distraction in pediatric patients. Clinical paper. Since 2010 TPD has been applied to six pediatric patients during mixed dentition when severe maxillary constriction was present and conventional orthodontic widening has already failed. Individually selected devices (Surgitec, Belgium) were inserted in general anaesthesia and distraction was performed according to well known parameters. Maxillary constriction could be improved in all six patients without any drawbacks by bone borne devices during mixed dentition. Skeletal conditions were obviously improved for subsequent orthodontic or orthognathic therapy without functional impairment. Follow-up is up to 36 months after device removal. Transpalatal Distraction is recommendable in selected pediatric patients if massive growth disturbance is present or has to be expected. TPD allows for individually adapted maxillary expansion by selection and positioning of appropriate devices in combination with intraoperative testing of maxillary movements and controlled bone removal.

Maxillary Tuberosity Reconstruction with Transport Distraction Osteogenesis

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F. Ugurlu

2012-01-01

Full Text Available Severe bone loss due to pathology in the maxillary tuberosity region is a challenging problem both surgically and prosthetically. Large bone grafts have a poor survival rate due to the delicate bony architecture in this area and presence of the maxillary sinus. Our case presentation describes a new technique for reconstructing severe bony defect in the maxillary tuberosity with horizontal distraction osteogenesis in a 45-year-old man. A 4×6×3cm cyst was discovered in the left maxillary molar region and enucleated. Three months postoperatively, the area had a severe bone defect extending to the zygomatic buttress superiorly and hamular notch posteriorly. Three months later, a bone segment including the right upper second premolar was osteotomised and distracted horizontally. The bone segment was distracted 15 mm distally. After consolidation, implants were placed when the distractor was removed. A fixed denture was loaded over the implants after 3 months. Complete alveolar bone loss extending to the cranial base can be reconstructed with transport distraction osteogenesis. Distalisation of the alveolar bone segment adjacent to the bony defect is an easy method for reconstructing such severe defects.

Level-ARCH Short Rate Models with Regime Switching

DEFF Research Database (Denmark)

Christiansen, Charlotte

This paper introduces regime switching volatility into level- ARCH models for the short rates of the US, the UK, and Germany. Once regime switching and level effects are included there are no gains from including ARCH effects. It is of secondary importance exactly how the regime switching is spec...

In vivo Study of the Accuracy of Dual-arch Impressions.

Science.gov (United States)

de Lima, Luciana Martinelli Santayana; Borges, Gilberto Antonio; Junior, Luiz Henrique Burnett; Spohr, Ana Maria

2014-06-01

This study evaluated in vivo the accuracy of metal (Smart®) and plastic (Triple Tray®) dual-arch trays used with vinyl polysiloxane (Flexitime®), in the putty/wash viscosity, as well as polyether (Impregum Soft®) in the regular viscosity. In one patient, an implant-level transfer was screwed on an implant in the mandibular right first molar, serving as a pattern. Ten impressions were made with each tray and impression material. The impressions were poured with Type IV gypsum. The width and height of the pattern and casts were measured in a profile projector (Nikon). The results were submitted to Student's t-test for one sample (α = 0.05). For the width distance, the plastic dual-arch trays with vinyl polysiloxane (4.513 mm) and with polyether (4.531 mm) were statistically wider than the pattern (4.489 mm). The metal dual-arch tray with vinyl polysiloxane (4.504 mm) and with polyether (4.500 mm) did not differ statistically from the pattern. For the height distance, only the metal dual-arch tray with polyether (2.253 mm) differed statistically from the pattern (2.310 mm). The metal dual-arch tray with vinyl polysiloxane, in the putty/wash viscosities, reproduced casts with less distortion in comparison with the same technique with the plastic dual-arch tray. The plastic or metal dual-arch trays with polyether reproduced cast with greater distortion. How to cite the article: Santayana de Lima LM, Borges GA, Burnett LH Jr, Spohr AM. In vivo study of the accuracy of dual-arch impressions. J Int Oral Health 2014;6(3):50-5.

Management of an impacted and transposed maxillary canine

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Deepti A

2010-03-01

Full Text Available Maxillary canine-lateral incisor transposition is a relatively rare anomaly, with both dental and facial esthetic implications. This is a case report of a maxillary canine-lateral incisor transposition that was successfully treated by surgical-orthodontic treatment followed by esthetic reshaping of the involved teeth.

Mass in right maxillary

International Nuclear Information System (INIS)

Marins, J.L.C.

1988-01-01

A radiological study in a patient with increasing of the volume in the naso-maxillary region was done. The proposed diagnosis were carcinomas, lymphomas, sarcomas, teeth cyst, granulomas, mycoses and other. (L.M.J.)

Space maintenance in the primary and mixed dentitions.

Science.gov (United States)

Simon, Thomas; Nwabueze, Ifechide; Oueis, Hassan; Stenger, James

2012-01-01

Loss of space in the primary dentition is considered one of the main causes of malocclusion in the permanent dentition. The purpose of this paper is to review ond summarize the indications and use of space maintainers in primary and mixed dentitions as preventive measures of future malocclusion. Two main types of space maintainers are used to maintain the space in primary ond mixed dentitions: fixed and removable appliances. Band and loop is the appliance of choice when a primary maxillary or mandibular first molar is prematurely lost. With the premature loss of a second primary molar, Nance or transpalatal (TPA) appliances can be used on the maxillary arch and the lower lingual holding arch (LLHA) for the mandibular arch.

Analysis of the golden proportion and width/height ratios of maxillary anterior teeth in Arab and Kurdish populations.

Science.gov (United States)

Al-Kaisy, Neda; Garib, Balkees Taha

2017-11-15

Dentists providing anterior restorations are guided by the principles of anatomic tooth dimension. Dental biometrics should consider ethnicity to produce a more comprehensive evaluation. The purpose of this clinical study was to analyze the anatomic crowns of maxillary central incisors (CI), lateral incisors (LI), and canines (C) with respect to the golden proportion (GP) and width/height (W/H) ratio in Kurdish and Arab populations. Maxillary gypsum casts were obtained from 100 participants (50 from a Kurdish and 50 from an Arab population). Standardized digital photographs of each cast were recorded. The apparent and actual anterior tooth dimensions were determined by ImageJ software for the calculation of the GP and W/H ratio. Data were statistically analyzed using ANOVA to investigate ethnic, sex, and arch side differences. The chi-square test was used to explore the GP, and the 1-sample t test was used to test the ideal W/H ratio (α=.05). The GP was found in both the Kurdish and Arab groups in the LI/CI mean (0.62, 0.63), but not in the C/LI mean (0.69, 0.73). No difference due to sex was detected in the LI/CI in either ethnic group, but Kurdish men had significantly larger C/LI than women (0.73, 0.66, P=.006) and larger right-side LI/CI than left (0.63, 0.60, P=.049). The W/H ratio was higher than the predicted ideal ratio of 80% (range, 88% to 90%). The LI W/H ratio in Arabs was significantly larger than in Kurds (90.3% versus 82.7%, respectively; P<.001). The GP was found to exist between the apparent widths of maxillary anterior teeth LI/CI for the both populations in both men and women but not for C/LI. No ideal ratio was detected for the W/H ratios. Specific population characteristics must be taken into consideration, especially when applying the proportions to Kurdish individuals. Copyright © 2017 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Dental arch dimensions, form and tooth size ratio among a Saudi sample

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Haidi Omar

2018-01-01

Full Text Available Objectives: To determine the dental arch dimensions and arch forms in a sample of Saudi orthodontic patients, to investigate the prevalence of Bolton anterior and overall tooth size discrepancies, and to compare the effect of gender on the measured parameters. Methods: This study is a biometric analysis of dental casts of 149 young adults recruited from different orthodontic centers in Jeddah, Saudi Arabia. The dental arch dimensions were measured. The measured parameters were arch length, arch width, Bolton’s ratio, and arch form. The data were analyzed using IBM SPSS software version 22.0 (IBM Corporation, New York, USA; this cross-sectional study was conducted between April 2015 and May 2016. Results: Dental arch measurements, including inter-canine and inter-molar distance, were found to be significantly greater in males than females (p less than 0.05. The most prevalent dental arch forms were narrow tapered (50.3% and narrow ovoid (34.2%, respectively. The prevalence of tooth size discrepancy in all cases was 43.6% for anterior ratio and 24.8% for overall ratio. The mean Bolton’s anterior ratio in all malocclusion classes was 79.81%, whereas the mean Bolton’s overall ratio was 92.21%. There was no significant difference between males and females regarding Bolton’s ratio. Conclusion: The most prevalent arch form was narrow tapered, followed by narrow ovoid. Males generally had larger dental arch measurements than females, and the prevalence of tooth size discrepancy was more in Bolton’s anterior teeth ratio than in overall ratio.

Maxillary distraction osteogenesis in cleft lip and palate cases with midface hypoplasia using rigid external distractor: an alternative technique.

Science.gov (United States)

Dua, Gaurav; Navin Kumar, Andrews; Roy, Indranil Deb; Roy, Supriyo Kumar

2014-05-01

Patients with operated cleft lip and palate present with a problem of midface hypoplasia, and such patients have been traditionally treated with orthognathic surgery. Such a procedure has its own limitations of relapse and hence a newer modality of distraction osteogenesis with histiogenesis can be chosen to overcome such limitations for midfacial advancement. The purpose of this study is to evaluate an alternative technique and its postoperative stability in maxillary distraction osteogenesis in patients of cleft lip and cleft palate using a rigid external device (RED). Nine patients with midface bone stock deficiency were selected for maxillary advancement. At the first surgery under general anesthesia, after Le Fort I osteotomy, RED system was used with the alternative technique. After distraction, evaluation was done for ease of the procedure, stability, and complications. Lateral cephalograms were evaluated at 3 stages: T1, pre-distraction; T2, post-distraction; and T3, 1 year post-distraction. A mean 13.4-mm midface advancement was shown with bone formation at the pterygomaxillary region without losing the vector and having a standby mode in case the wire broke during distraction The results were stable even at 1 year of follow-up. Maxillary position improved in relation to the cranial base. This study showed that the RED was versatile in midface advancement.

Does Andrews facial analysis predict esthetic sagittal maxillary position?

Science.gov (United States)

Resnick, Cory M; Daniels, Kimberly M; Vlahos, Maryann

2018-04-01

Cephalometric analyses have limited utility in planning maxillary sagittal position for orthognathic surgery. In Six Elements of Orofacial Harmony, Andrews quantified maxillary position relative to forehead projection and angulation and proposed an ideal relationship. The purpose of this study was to investigate the ability of this technique to predict esthetic sagittal maxillary position. Survey study including a male and female with straight facial profiles, normal maxillary incisor angulations, and Angle's Class I. Maxillary position was modified on lateral photographs to create 5 images for each participant with incisor-goal anterior limit line (GALL) distances of -4, -2, 0, +2, and +4 mm. A series of health care professionals and laypeople were asked to rate each photo in order of attractiveness. A total of 100 complete responses were received. Incisor-GALL distances of +4 mm (41%) and +2 mm (40%) were most commonly considered "most esthetic" for the female volunteer (P < .001). For the male volunteer, there were 2 peak "most esthetic" responses: incisor-GALL distances of 0 mm (37%) and -4 mm (32%) (P < .001). Respondents considered maxillary incisor position 2 to 4 mm anterior to GALL most attractive in a woman and 0 to 4 mm posterior to GALL most esthetic in a man. Using these modified target distances, this analysis may be useful for orthognathic surgery planning. Copyright © 2018 Elsevier Inc. All rights reserved.

CASE REPORT - Maxillary Herpes Zoster with Corneal Involvement ...

African Journals Online (AJOL)

Corneal involvement in maxillary herpes zoster is very rare. This report presents the case of a 32 years old 7 months pregnant para2+1 female, who presented with vesiculopapular rashes with hyperpigmented crusts over the maxillary area of the face on the left side with periocular oedema, conjunctivitis and mild punctate ...

First Branchial Arch Fistula: A Rarity and a Surgical Challenge.

Science.gov (United States)

Rajkumar, J S; Ganesh, Deepa; Anirudh, J R; Akbar, S; Joshi, Niraj

2016-06-01

Although 2(nd) Branchial arch fistulae (from incomplete closure of Cervical sinus of His) are well known, 1(st) arch fistulae are much rarer (branchial arch fistula of the type II Arnot classification, which presented with two external openings of more than 20 years duration. Patient had a successful resection of all the concerned fistulous tract. Review of literature and the surgical challenges of the procedure are presented herewith.

Variations in tooth size and arch dimensions in Malay schoolchildren.

Science.gov (United States)

Hussein, Khalid W; Rajion, Zainul A; Hassan, Rozita; Noor, Siti Noor Fazliah Mohd

2009-11-01

To compare the mesio-distal tooth sizes and dental arch dimensions in Malay boys and girls with Class I, Class II and Class III malocclusions. The dental casts of 150 subjects (78 boys, 72 girls), between 12 and 16 years of age, with Class I, Class II and Class III malocclusions were used. Each group consisted of 50 subjects. An electronic digital caliper was used to measure the mesio-distal tooth sizes of the upper and lower permanent teeth (first molar to first molar), the intercanine and intermolar widths. The arch lengths and arch perimeters were measured with AutoCAD software (Autodesk Inc., San Rafael, CA, U.S.A.). The mesio-distal dimensions of the upper lateral incisors and canines in the Class I malocclusion group were significantly smaller than the corresponding teeth in the Class III and Class II groups, respectively. The lower canines and first molars were significantly smaller in the Class I group than the corresponding teeth in the Class II group. The lower intercanine width was significantly smaller in the Class II group as compared with the Class I group, and the upper intermolar width was significantly larger in Class III group as compared with the Class II group. There were no significant differences in the arch perimeters or arch lengths. The boys had significantly wider teeth than the girls, except for the left lower second premolar. The boys also had larger upper and lower intermolar widths and lower intercanine width than the girls. Small, but statistically significant, differences in tooth sizes are not necessarily accompanied by significant arch width, arch length or arch perimeter differences. Generally, boys have wider teeth, larger lower intercanine width and upper and lower intermolar widths than girls.

Lucy's flat feet: the relationship between the ankle and rearfoot arching in early hominins.

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Jeremy M DeSilva

Full Text Available BACKGROUND: In the Plio-Pleistocene, the hominin foot evolved from a grasping appendage to a stiff, propulsive lever. Central to this transition was the development of the longitudinal arch, a structure that helps store elastic energy and stiffen the foot during bipedal locomotion. Direct evidence for arch evolution, however, has been somewhat elusive given the failure of soft-tissue to fossilize. Paleoanthropologists have relied on footprints and bony correlates of arch development, though little consensus has emerged as to when the arch evolved. METHODOLOGY/PRINCIPAL FINDINGS: Here, we present evidence from radiographs of modern humans (n = 261 that the set of the distal tibia in the sagittal plane, henceforth referred to as the tibial arch angle, is related to rearfoot arching. Non-human primates have a posteriorly directed tibial arch angle, while most humans have an anteriorly directed tibial arch angle. Those humans with a posteriorly directed tibial arch angle (8% have significantly lower talocalcaneal and talar declination angles, both measures of an asymptomatic flatfoot. Application of these results to the hominin fossil record reveals that a well developed rearfoot arch had evolved in Australopithecus afarensis. However, as in humans today, Australopithecus populations exhibited individual variation in foot morphology and arch development, and "Lucy" (A.L. 288-1, a 3.18 Myr-old female Australopithecus, likely possessed asymptomatic flat feet. Additional distal tibiae from the Plio-Pleistocene show variation in tibial arch angles, including two early Homo tibiae that also have slightly posteriorly directed tibial arch angles. CONCLUSIONS/SIGNIFICANCE: This study finds that the rearfoot arch was present in the genus Australopithecus. However, the female Australopithecus afarensis "Lucy" has an ankle morphology consistent with non-pathological flat-footedness. This study suggests that, as in humans today, there was variation in arch

Crozat appliance therapy for an arch-length discrepancy problem.

Science.gov (United States)

Parker, M

1991-01-01

The case involved a white male subject, aged 10 years 6 months, with a Class I molar relationship complicated by a deep overbite and impaction of all four permanent canines, which were completely blocked out of the arches. The growth rate of the arches was found to be abnormal, and there was premature loss of the deciduous teeth. Over a period of approximately 5 years, with intermittent pauses to allow growth to catch up with treatment, the Crozat removable appliance was used to help establish the arch form and correct the plane of occlusion.

Bilateral postoperative maxillary cysts after orthognathic surgery: A case report

International Nuclear Information System (INIS)

Lee, Jung Hye; Huh, Kyung Hoe; Yi, Won Jin; Heo, Min Suk; Lee, Sam Sun; Choi, Soon Chul

2014-01-01

Postoperative maxillary cysts are locally aggressive lesions, usually developing as delayed complications many years after radical antral surgery. This report describes a case of bilateral postoperative maxillary cysts following orthognathic surgery performed approximately 21 years previously. The patient complained of stinging pain on her right cheek. Radiographic examination revealed low-attenuation lesions on both maxillary sinuses with discontinuously corticated margins without distinct expansion or bone destruction. The cysts were enucleated with the removal of metal plates and screws for pain relief. Histopathological examination confirmed the diagnosis of postoperative maxillary cysts lined by ciliated, pseudostratified columnar cells. The patient has remained asymptomatic thus far, and there was no evidence of local recurrence at 21 months of postoperative follow-up.

Bilateral postoperative maxillary cysts after orthognathic surgery: A case report

Energy Technology Data Exchange (ETDEWEB)

Lee, Jung Hye; Huh, Kyung Hoe; Yi, Won Jin; Heo, Min Suk; Lee, Sam Sun; Choi, Soon Chul [Dept. of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul (Korea, Republic of)

2014-12-15

Postoperative maxillary cysts are locally aggressive lesions, usually developing as delayed complications many years after radical antral surgery. This report describes a case of bilateral postoperative maxillary cysts following orthognathic surgery performed approximately 21 years previously. The patient complained of stinging pain on her right cheek. Radiographic examination revealed low-attenuation lesions on both maxillary sinuses with discontinuously corticated margins without distinct expansion or bone destruction. The cysts were enucleated with the removal of metal plates and screws for pain relief. Histopathological examination confirmed the diagnosis of postoperative maxillary cysts lined by ciliated, pseudostratified columnar cells. The patient has remained asymptomatic thus far, and there was no evidence of local recurrence at 21 months of postoperative follow-up.

Contrast-enhanced magnetic resonance angiography of persistent fifth aortic arch in children

International Nuclear Information System (INIS)

Zhong, Yumin; Zhu, Ming; Sun, Aimin; Li, Yuhua; Jaffe, Richard B.; Gao, Wei

2007-01-01

Cine angiography and echocardiography have been utilized to diagnose congenital aortic arch anomalies. However, the visualization of great vessels by echocardiography is limited, while cine angiography requires cardiac catheterization with ionizing radiation. Contrast-enhanced magnetic resonance angiography (MRA) is a noninvasive modality suitable for visualization of congenital aortic arch anomalies. To evaluate the utility of contrast-enhanced MRA in the diagnosis of persistent fifth aortic arch, a rare congenital aortic arch anomaly, and to compare the diagnostic accuracy of MRA with that of echocardiography and cine angiography. In four pediatric patients, contrast-enhanced MRA studies were performed for diagnosing persistent fifth aortic arch. The findings of MRA were compared with echocardiographic findings and confirmed by cine angiography and operation. Transthoracic surface echocardiography noted an aberrant vessel arising from the ascending aorta in two of four patients; the etiology of this vessel was uncertain. In the other two patients a diagnosis of coarctation was made. Of the four patients, only one was diagnosed with interruption of the aortic arch. Contrast-enhanced MRA clarified uncertain echocardiographic findings, enabling the correct diagnosis of persistent fifth aortic arch with fourth aortic arch interruption in all four patients. Contrast-enhanced MRA is a safe, accurate, and fast imaging technique for the evaluation of persistent fifth aortic arch and may obviate the need for conventional cine angiography. Cardiac catheterization may be reserved for some types of complicated congenital heart disease and for obtaining hemodynamic information. (orig.)

Relationship between conductive hearing loss and maxillary constriction.

Science.gov (United States)

Peyvandi, A A; Jamilian, A; Moradi, E

2014-09-01

To evaluate the relationship between conductive hearing loss and maxillary constriction. A total of 120 people, aged from 7 to 40 years, who were referred to an audiologist when taking out health insurance or for school pre-registration check-up, were selected for this study. A total of 60 participants who had hearing threshold levels greater than 15 dB in both ears were chosen as the conductive hearing loss group. The remaining 60, with normal hearing thresholds of less than 15 dB, were used as the control group. All participants were referred to an orthodontic clinic. Participants who had a posterior crossbite and high palatal vault were considered to suffer from maxillary constriction. There were no significant differences between the sex ratios and mean ages of the groups. However, participants with conductive hearing loss were 3.5 times more likely than controls to suffer from maxillary constriction. Patients who suffer from conductive hearing loss are likely to show a maxillary abnormality when examined by an orthodontist.

Is the South African exchange rate volatile? Application of the arch framework.

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Thato Julius Mokoma

2015-04-01

Full Text Available This study applies the autoregressive conditional heteroscedasticity (ARCH model to forecast exchange rate volatility in South Africa for the period 1990Q1 to 2014Q2. The ARCH (1 and ARCH (2 models were constructed using four variables; namely, exchange rate, gross domestic product, inflation and interest rates. Upon addressing the issue of stationarity, the models were fitted and the ARCH (1 model was found to be fit. This model revealed a high volatility of exchange rate compared to the ARCH (2 model. Prior to forecasting, the selected model was subjected to a battery of diagnostics tests and was found to be stable and well specified. The forecasts from the ARCH (1 model proved that in the near future, exchange rate will not be highly volatile though SA will experience depreciation in its currency.

A novel route for placing free flap pedicle from a palatal defect

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Rajeev B Ahuja

2014-01-01

Full Text Available One of the better options available to repair a large palatal defect is by employing a free flap. Almost all the times such free flaps are plumbed to facial vessels. The greatest challenge in such cases is the placement of the pedicle from palatal shelf to recipient vessels because there is no direct route available. As majority of large palatal fistulae are encountered in operated cleft palates there is a possibility of routing the pedicle through a cleft in the maxillary arch or via pyriform aperture. When such a possibility doesn′t exist the pedicle is routed behind the maxillary arch. We describe a novel technique of pedicle placement through a maxillary antrostomy, in this case report, where a large palatal fistula in a 16 year old boy was repaired employing a free radial artery forearm flap. The direct route provided by maxillary antrostomy is considered the most expeditious of all possibilities mentioned above.

Perceptual Speech Assessment After Anterior Maxillary Distraction in Patients With Cleft Maxillary Hypoplasia.

Science.gov (United States)

Richardson, Sunil; Seelan, Nikkie S; Selvaraj, Dhivakar; Khandeparker, Rakshit V; Gnanamony, Sangeetha

2016-06-01

To assess speech outcomes after anterior maxillary distraction (AMD) in patients with cleft-related maxillary hypoplasia. Fifty-eight patients at least 10 years old with cleft-related maxillary hypoplasia were included in this study irrespective of gender, type of cleft lip and palate, and amount of required advancement. AMD was carried out in all patients using a tooth-borne palatal distractor by a single oral and maxillofacial surgeon. Perceptual speech assessment was performed by 2 speech language pathologists preoperatively, before placement of the distractor device, and 6 months postoperatively using the scoring system of Perkins et al (Plast Reconstr Surg 116:72, 2005); the system evaluates velopharyngeal insufficiency (VPI), resonance, nasal air emission, articulation errors, and intelligibility. The data obtained were tabulated and subjected to statistical analysis using Wilcoxon signed rank test. A P value less than .05 was considered significant. Eight patients were lost to follow-up. At 6-month follow-up, improvements of 62% (n = 31), 64% (n = 32), 50% (n = 25), 68% (n = 34), and 70% (n = 35) in VPI, resonance, nasal air emission, articulation, and intelligibility, respectively, were observed, with worsening of all parameters in 1 patient (2%). The results for all tested parameters were highly significant (P ≤ .001). AMD offers a substantial improvement in speech for all 5 parameters of perceptual speech assessment. Copyright © 2016 The American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Radiographic evaluation of third molar development in 6- to 24-year-olds

Science.gov (United States)

Jung, Yun-Hoa

2014-01-01

Purpose This study investigated the developmental stages of third molars in relation to chronological age and compared third molar development according to location and gender. Materials and Methods A retrospective analysis of panoramic radiographs of 2490 patients aged between 6 and 24 years was conducted, and the developmental stages of the third molars were evaluated using the modified Demirjian's classification. The mean age, standard deviation, minimal and maximal age, and percentile distributions were recorded for each stage of development. A Mann-Whitney U test was performed to test the developmental differences in the third molars between the maxillary and mandibular arches and between genders. A linear regression analysis was used for assessing the correlation between the third molar development and chronological age. Results The developmental stages of the third molars were more advanced in the maxillary arch than the mandibular arch. Males reached the developmental stages earlier than females. The average age of the initial mineralization of the third molars was 8.57 years, and the average age at apex closure was 21.96 years. The mean age of crown completion was 14.52 and 15.04 years for the maxillary and the mandibular third molars, respectively. Conclusion The developmental stages of the third molars clearly showed a strong correlation with age. The third molars developed earlier in the upper arch than the lower arch; further, they developed earlier in males than in females. PMID:25279338

Structural properties and out-of-plane stability of roller bent steel arches

NARCIS (Netherlands)

Spoorenberg, R.C.

2011-01-01

In contemporary architecture the use of steel arches has seen a significant increase. They are applied in buildings and large span bridges, combining structural design with architectural merits. For arches lacking lateral support (or freestanding arches) the out-of-plane structural stability

Asymptotics of the QMLE for General ARCH(q) Models

DEFF Research Database (Denmark)

Kristensen, Dennis; Rahbek, Anders Christian

2009-01-01

-ARCH -- are derived. Strong consistency is established under the assumptions that the ARCH process is geometrically ergodic, the conditional variance function has a finite log-moment, and finite second moment of the rescaled error. Asymptotic normality of the estimator is established under the additional assumption...

Comparative analysis of the construction solution variants for flat arch coverings of buildings

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Ibragimov Aleksandr Mayorovich

2014-03-01

Full Text Available Arch structures of long span buildings’ coverings are more beneficial in respect to material expenses, than beam and frame systems. Constructive schemes of roof frameworks of arch coverings are diverse, which means their operation under loading differs much. The authors offer a number of construction solutions for flat arch coverings of long span buildings. The comparative analysis of these construction solutions is presented. The operation of radial link arch is observed. The arch consists of discontinuous top chord and radial bowstring under the single load (uniformly distributed and concentrated in nods with different spans and rises. The problem of radial link arch optimization is solved in dependence with arising forces and rise. The optimal camber of arch was found. In further works the authors plan to analyze spans more than 36 meters and solve the problem in case of asymmetrical loadings.

Transpalatal distraction for the management of maxillary constriction in pediatric patients

OpenAIRE

Adolphs, Nicolai; Ernst, Nicole; Hoffmeister, Bodo; Raguse, Jan-Dirk

2015-01-01

Context: The management of severe maxillary constriction can be challenging. For that purpose surgically assisted maxillary expansion by transpalatal distraction (TPD) can typically be recommended after skeletal maturity. However in selected cases bone borne transpalatal distraction devices can contribute to improve maxillary constriction considerably earlier already during mixed dentition. Aims: To assess the possibility of bone borne transpalatal distraction in pediatric patients. Settings ...

Tissue tolerance under the combination treatment of maxillary cancer

Energy Technology Data Exchange (ETDEWEB)

Egawa, J [Teikyo Univ., Tokyo (Japan). Faculty of Medicine; Ono, I; Suzuki, K; Takeda, C; Ebihara, S

1977-06-01

The tissue tolerance doses of the maxillary sinus structures were estimated when they were subjected to treatment for maxillary cancer by the usual combination of surgery, radiotherapy, and regional arterial infusion of 5-fluorouracil. Equivalent single dose calculation was applied with irreversible tissue damage as an indicator. The retardation of epithelialization of the maxillary sinus operated upon appeared to be correlated with the dose delivered. The study indicated that 2,200 rad expressed by equivalent single dose is a safe dose level for sufficient epithelialization. The safety dose level for the bony structure, exposed by surgery, seemed to be at 1,800 rad.

Lateral testing of glued laminated timber tudor arch

Science.gov (United States)

Douglas R. Rammer; Philip Line

2016-01-01

Glued laminated timber Tudor arches have been in wide use in the United States since the 1930s, but detailed knowledge related to seismic design in modern U.S. building codes is lacking. FEMA P-695 (P-695) is a methodology to determine seismic performance factors for a seismic force resisting system. A limited P-695 study for glued laminated timber arch structures...

Twin - Arch technique. Revival of the "edgewise -Technique"?

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Jacob Karp

2012-01-01

The SNB – Bracket brings a new dimension into the orthodontic world which is most apparent in extraction cases. Its Teflon – like material has a very low friction coefficient thus, reducing the treatment time considerably. Through the use of low dimensioned arch wires, the Twin – Arch Technique becomes a Light – wire system and simultaneously provides good anchorage and torque control.

A case of Sotos syndrome treated with distraction osteogenesis in maxilla and mandible.

Science.gov (United States)

Takano, Masayuki; Kasahara, Kiyohiro; Ogawa, Chiharu; Katada, Hidenori; Sueishi, Kenji

2012-01-01

Sotos syndrome is inherited in an autosomal-dominant manner and is characterized by increased birth weight, excessive growth, advanced bone age, and distinctive facial features, including dolichocephaly, hypertelorism, and a prominent mandible. We treated a jaw deformity due to Sotos syndrome consisting of malocclusion due to a narrow maxillary dental arch and mandibular retrusion from hypoplasia of the rami. The patient was a 17-year-old man. Malocclusion due to a narrow maxillary dental arch and mandibular retrusion was diagnosed. Rapid maxillary expansion with Lines corticotomy and mandibular advancement with distraction osteogenesis were performed. The maxilla was expanded laterally a total of 3 mm and the mandible prolonged 12 mm in the posterior area of the mandibular body. Subsequently, orthodontic treatment was continued. At present, 5 years after surgery, occlusion remains good and stable.

Endoscopic anatomy of the orbital floor and maxillary sinus.

Science.gov (United States)

Moore, Corey C; Bromwich, Matthew; Roth, Kathy; Matic, Damir B

2008-01-01

Endoscopic repair of orbital blow-out fractures could become a predictable and efficient treatment alternative to traditional methods. However, maxillary sinus endoscopy provides a complex and disorienting view of the orbital floor. To be a useful and consistent technique for providing access to the orbital floor, specific knowledge of maxillary endoscopic anatomy is required. The purpose of the study was to provide an anatomic description of the orbital floor via the endoscopic approach. Objectives include defining consistent landmarks for use in endoscopic repair of orbital floor fractures. Using 0- and 30-degree rigid endoscopes, 6 fresh cadavers (12 maxillary sinuses) were examined via a standard Caldwell-Luc approach. Computed tomographic scans, plastic molds, and digital images were used to compare observable averages within bony anatomy. Potential bony landmarks were correlated with soft-tissue anatomy in fresh specimens. The maxillary ostium, orbital floor, and lateral ethmoid air cells were visualized, and their structures were described. Observations were made in relation to the anatomy of the orbital floor and maxillary sinus, including fracture pattern and force transmission pathways. An "orbitomaxillary" sinus bony thickening was identified and described for the first time. This study provides the basis for further refinement of surgical technique and opens the door for future clinical trials using endoscopic repair.

Discussion on construction project of lining arch reinforcing stone arch bridge%内衬拱加固石拱桥施工方案探讨

Institute of Scientific and Technical Information of China (English)

乔钧

2012-01-01

分析了石拱桥的常见病害及其原因，总结了石拱桥的加固技术，结合一个工程实例，对内衬拱加固石拱桥的有效施工方案进行了详细阐述，并证明了该加固方案的有效性。%This paper analysed the common diseases and its reasons of stone arch bridge, summed up the reinforcement technology of stone arch bridge, combining with an engineering example, elaborated in detail the effective construction scheme of lining arch reinforcing stone arch bridge, and proved the effectiveness of this reinforcement scheme.

Optimal graft diameter and location reduce postoperative complications after total arch replacement with long elephant trunk for arch aneurysm.

Science.gov (United States)

Kondoh, Haruhiko; Funatsu, Toshihiro; Toda, Koich; Kainuma, Satoshi; Kuki, Satoru; Taniguchi, Kazuhiro

2011-08-01

Total arch replacement with an elephant trunk is a standard treatment for arch aneurysm, but serious complications, such as paraplegia and peripheral embolization caused by flapping of the elephant trunk, remain. Moreover, dilation of the descending aorta and retrograde flow into the peri-graft space at the distal elephant trunk are frequent problems. We hypothesized that optimal graft diameter and location would reduce complications after total arch replacement with a long elephant trunk by achieving complete thrombosis and minimal dilation of the descending aorta around the elephant trunk. We treated 65 patients with arch aneurysm by total arch replacement with a long elephant trunk anastomosed at the base of the innominate artery. The graft diameter was undersized (10%-20% of the distal aorta's diameter). Elephant trunk length was determined by preoperative computed tomography to locate the distal end at Th6 to Th8. Thrombosis around the elephant trunk, diameter of the descending aorta, and distance between the descending aorta and the graft near the distal end of the elephant trunk were evaluated using computed tomography. The distal end of the elephant trunk was located at Th 8 ± 1. There were no operative deaths, 3 patients (5%) died in the hospital, and 3 patients (5%) experienced spinal cord injury, including 1 in whom permanent paraplegia developed. Computed tomography revealed complete thrombosis around the elephant trunk in 58 patients (89%). The descending aorta did not dilate further, and distance between the descending aorta and the graft progressively decreased. Optimal graft diameter and location minimized postoperative complications, with complete thrombosis and no dilation of the descending aorta around the long elephant trunk in most patients. Copyright © 2011 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

Unusual anatomy of maxillary central incisor with two roots

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T S Ashwini Shivakumar

2012-01-01

Full Text Available Introduction: Knowledge of root canal morphology is essential for successful endodontic therapy. Failure to recognize unusual root canal anatomy may lead to unsuccessful endodontic treatment. Case Report: This case report describes the successful endodontic treatment of the maxillary central incisor with unusual anatomy of two roots and two root canals. A 23-year-old male patient was referred for dental consultation with discoloration of the maxillary right central incisor with periapical lesion, which revealed unusual anatomy of root on radiographic examination, and was confirmed upon exploration. Discussion: As described by Vertucci, the maxillary central incisor presents a single root and single root canal in 100% of the cases. However, few cases of maxillary central incisors with two canals were reported in the literature, most of which were associated with developmental anomalies like fusion, germination or dens invaginatus. Clinician should be aware of the unusual anatomical variations that should be detected by the different diagnostic resources available.

NASA ARCH- A FILE ARCHIVAL SYSTEM FOR THE DEC VAX

Science.gov (United States)

Scott, P. J.

1994-01-01

The function of the NASA ARCH system is to provide a permanent storage area for files that are infrequently accessed. The NASA ARCH routines were designed to provide a simple mechanism by which users can easily store and retrieve files. The user treats NASA ARCH as the interface to a black box where files are stored. There are only five NASA ARCH user commands, even though NASA ARCH employs standard VMS directives and the VAX BACKUP utility. Special care is taken to provide the security needed to insure file integrity over a period of years. The archived files may exist in any of three storage areas: a temporary buffer, the main buffer, and a magnetic tape library. When the main buffer fills up, it is transferred to permanent magnetic tape storage and deleted from disk. Files may be restored from any of the three storage areas. A single file, multiple files, or entire directories can be stored and retrieved. archived entities hold the same name, extension, version number, and VMS file protection scheme as they had in the user's account prior to archival. NASA ARCH is capable of handling up to 7 directory levels. Wildcards are supported. User commands include TEMPCOPY, DISKCOPY, DELETE, RESTORE, and DIRECTORY. The DIRECTORY command searches a directory of savesets covering all three archival areas, listing matches according to area, date, filename, or other criteria supplied by the user. The system manager commands include 1) ARCHIVE- to transfer the main buffer to duplicate magnetic tapes, 2) REPORTto determine when the main buffer is full enough to archive, 3) INCREMENT- to back up the partially filled main buffer, and 4) FULLBACKUP- to back up the entire main buffer. On-line help files are provided for all NASA ARCH commands. NASA ARCH is written in DEC VAX DCL for interactive execution and has been implemented on a DEC VAX computer operating under VMS 4.X. This program was developed in 1985.

A theoretical method for calculating the collapse load of steel circular arches

NARCIS (Netherlands)

Spoorenberg, R.C.; Snijder, H.H.; Hoenderkamp, J.C.D.

2012-01-01

Arches are frequently used in large span structures like bridges and roofs. Although these structural elements may be prone to various instability phenomena, stocky arches or slender arches with sufficient lateral bracing fail due to plastic collapse instead of in-plane buckling or out-of-plane

Non-surgical Management of Skeletal Class III Malocclusion with Bilateral Posterior Crossbite: A Case Report.

Science.gov (United States)

Kumari, Lalima; Nayan, Kamal

2016-12-01

A 16-year-old female patient with skeletal Class III malocclusion and bilateral posterior cross bite complaining of difficulty in chewing was treated orthodontically without surgery (camouflage treatment). The treatment comprised of fixed orthodontic treatment with MBT prescription (0.022˝×0.028˝ slot) using quad helix appliance for bilateral expansion of maxillary arch and Class III elastics for occlusal correction. Post-treatment records showed normal overbite and overjet with acceptable occlusion. So with this treatment strategy of expanding the maxillary arch using a quad helix appliance and use of Class III elastics, we achieved a good result with optimal occlusion.

Treatment of Class II Malocclusion by Nonextraction Therapy using Microimplants and Pendex Appliance

Directory of Open Access Journals (Sweden)

Rajkumar S Alle

2012-01-01

Full Text Available The treatment of Class II cases is always challenging. Treatment modalities involve growth modulation, expansion of the maxillary arch or extraction of premolars and retraction. The patient compliance is key factor in success of the treatment. In the present article a male patient with Class II malocclusion was treated using a Pendex appliance to simultaneously expand the upper arch and distalize the molars. The maxillary anteriors were retracted using microimplants. The results were satisfactory. This approach can be used in patients with mild skeletal discrepancy and with slight increase in the gingival display.

Bilateral iatrogenic maxillary fractures after dental treatment in two aged horses

OpenAIRE

Widmer, A; Fürst, A; Bettschart-Wolfensberger, R; Makara, M; Geyer, H; Kummer, M

2010-01-01

This clinical report describes two horses with bilateral maxillary fractures following dental treatment. The fractures occurred during dental treatment by a veterinarian, and both had rostral, transverse, and complete bilateral maxillary fractures with instability and minimal displacement. The fractures were repaired using bilateral intraoral wiring with the patients under general anesthesia. The postoperative period was without complications and the fractures healed as expected. Maxillary fr...

Surgical Splint Design Influences Transverse Expansion in Segmental Maxillary Osteotomies

DEFF Research Database (Denmark)

Stokbro, Kasper; Aagaard, Esben; Torkov, Peter

2017-01-01

splint designs on achieving the planned transverse expansion in bimaxillary surgery with segmental maxillary procedures. Materials and Methods: Forty-two participants were included in a retrospective observational study. All participants had completed virtually planned bimaxillary surgery with 3-piece......Purpose: In segmental maxillary procedures, it is imperative to obtain as much of the planned expansion as possible. Lack of obtained expansion, in addition to late relapse after splint removal, can result in relapse of the posterior crossbite. This study investigated the influence of 2 surgical...... maxillary segmentation. The primary outcome variable was the transverse expansion obtained, measured as the expansion between the maxillary first molars on preoperative and postoperative cone-beam computed tomograms. The postoperative scan was performed 1 week after surgery with the splint still in place...

CREATIVITY METHODS IN TEACHING THE ARCH-DESIGN STUDIO

Directory of Open Access Journals (Sweden)

EIGBEONAN Andrew B.

2013-07-01

Full Text Available The aim of this paper is to search and find methods of fostering creativity or ideas relating to creativity in teaching the arch-design studio. Teaching creativity through its methods will be making the students grounded in designing with creativity ideas and therefore we can have professionals that design and build with satisfaction, safety and complementary. It means we can have real buildings and places that satisfy our clients, the society and in harmony with the environment. Although there are similarities in the curricula of training architects all over the world, but educators go about it in their own convenient and suitable ways and styles. The ideas of creativity have been part of architecture from the onset, but are not deligently applied and also not formally incorporated in the curricula of training. The topic is also very relevant and timely as arch-educators and other stakeholders are of the opinion that something has to be done to improve the ways and methods of training architects, especially the teaching of the arch-design studio with regards to creativity. Through exploration of literature and interviews (physical and telephone call this paper finds methods of stimulating creativity ideas in the teaching of arch-design studio. Some of the methods of motivating creativity found in teaching the arch-design studio are: analogy, metaphors, biomimicry, brainstorming, attribute listing, mental map, TRIZ, restrictions, charrette, browsing, excursions, focus groups, other peoples viewpoints, using crazy ideas, using experts, visualizing a goal, working with dreams and images and giving students design tools such as drawings CAD and model making.

Long-term results of surgically-assisted maxillary protraction.

Science.gov (United States)

Nevzatoğlu, Sirin; Küçükkeleş, Nazan

2014-05-01

The long-term treatment results of surgically-assisted facemask therapy were assessed by a comparison of the immediate protraction effects with those seen at five years review. Nine patients treated with a corticotomy-assisted maxillary protraction protocol were recalled five years following protraction. Cephalometric films taken before treatment (T0), immediately after maxillary protraction (T1) and five years after treatment (T2) were compared. The short-term results of surgically-assisted facemask therapy showed significant skeletal and soft tissue changes. After five years, the profile and dental relationships were well maintained and a cephalometric analysis revealed a stable vertical increase but only partially maintained soft tissue changes with loss of sagittal advancement. There was significant upper incisor proclination providing dental camouflage. Patients who are treated with corticotomy-assisted maxillary advancement should be very carefully selected. Assessment criteria include a low mandibular plane angle Class III patients who have severe maxillary retrognathism unable to be treated by conventional orthopaedic correction alone; patients who have almost completed growth and missed the chance of earlier orthopaedic correction, as well as patients who are not willing to accept bimaxillary orthognathic surgery, may be successfully treated.

Motion planning and synchronized control of the dental arch generator of the tooth-arrangement robot.

Science.gov (United States)

Jiang, Jin-Gang; Zhang, Yong-De

2013-03-01

The traditional, manual method of reproducing the dental arch form is prone to numerous random errors caused by human factors. The purpose of this study was to investigate the automatic acquisition of the dental arch and implement the motion planning and synchronized control of the dental arch generator of the multi-manipulator tooth-arrangement robot for use in full denture manufacture. First, the mathematical model of the dental arch generator was derived. Then the kinematics and control point position of the dental arch generator of the tooth arrangement robot were calculated and motion planning of each control point was analysed. A hardware control scheme is presented, based on the industrial personal computer and control card PC6401. In order to gain single-axis, precise control of the dental arch generator, we studied the control pulse realization of high-resolution timing. Real-time, closed-loop, synchronous control was applied to the dental arch generator. Experimental control of the dental arch generator and preliminary tooth arrangement were gained by using the multi-manipulator tooth-arrangement robotic system. The dental arch generator can automatically generate a dental arch to fit a patient according to the patient's arch parameters. Repeated positioning accuracy is 0.12 mm for the slipways that drive the dental arch generator. The maximum value of single-point error is 1.83 mm, while the arc-width direction (x axis) is -33.29 mm. A novel system that generates the dental arch has been developed. The traditional method of manually determining the dental arch may soon be replaced by a robot to assist in generating a more individual dental arch. The system can be used to fabricate full dentures and bend orthodontic wires. Copyright © 2012 John Wiley & Sons, Ltd.

Dynamic stability analysis of circular arch subjected to follower forces with small disturbances; Judo kaju wo ukeru enkei arch no yuran ni yoru doteki kyodo to anteisei kaiseki

Energy Technology Data Exchange (ETDEWEB)

Fukuchi, N.; Okada, K. [Kyushu University, Fukuoka (Japan). Faculty of Engineering; Hirano, Y. [Sumitomo Heavy Industries, Ltd., Tokyo (Japan)

1997-09-04

This paper describes the deformation and dynamic stability of circular arch subjected to follower forces in a submerged membrane type marine structure reinforced by arch frames. Governing equations for finite deformations of the circular arch subjected to follower forces are introduced using an embedded curve coordinate, which are formulated by applying Galerkin method. In addition, equations of motion due to small disturbances under given condition of loading are introduced. Based on these equations, dynamic stability of the arch is analyzed by means of Runnge-Kutta-Gill method, to clarify the relationship between disturbances and instability regions and the resulting phenomena. Near the boundary regions of stability, both amplitude and cycle of deformation are greatly affected by the amplitude of disturbances. The dynamic instability is governed by the inverse symmetry primary mode with minimum characteristic frequency which is specific for the circular arch. The dynamic stability has high parameter dependency, and the instability regions have a complicated shapes. Although flattened arch has a smaller static critical load, it provides the dynamic stability against the disturbance. 5 refs., 10 figs.

Strengthening Masonry Arches with Lime-Based Mortar Composite

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Valerio Alecci

2017-06-01

Full Text Available In recent decades, many strengthening interventions on masonry elements were performed by using fiber reinforced polymers (FRPs. These advanced materials proved to be effective to increase the load-carrying capacity of masonry elements and to improve their structural behavior, avoiding the most critical failure modes. Despite the advantages of this technique compared to more traditional methods, FRP systems have disadvantages related to their low resistance to high temperatures, impossibility of application on wet surfaces, low permeability, and poor compatibility with masonry supports. Therefore, composite materials made of a fiber textile embedded in an inorganic matrix were recently proposed as alternatives to FRPs for strengthening historic masonry constructions. These composite materials are easier to install, have higher resistance to high temperatures, and permit higher vapor permeability than FRPs. The inorganic matrix is frequently a cement-based mortar, and the composite materials made of a fiber textile embedded in a cement-based mortar are usually identified as FRCM (fabric reinforced cementitious matrix composites. More recently, the use of natural lime mortar as an inorganic matrix has been proposed as an alternative to cement-based mortars when historic compatibility with the substrate is strictly required, as in case of restoration of historic buildings. In this paper, the effectiveness of a fabric made of basalt fibers embedded in lime mortar matrix (Basalt-FRLM for the strengthening of masonry arches is investigated. An experimental investigation was performed on 1:2 scaled brick masonry arches strengthened at the extrados with a layer of Basalt-FRLM and tested under vertical load. The results obtained are compared with previous results obtained by the authors by testing masonry arches strengthened at their extrados with FRCM and FRP composites. This investigation highlights the effectiveness of Basalt-FRLM in increasing load

Three-Dimensional Evaluation of the Upper Airway Morphological Changes in Growing Patients with Skeletal Class III Malocclusion Treated by Protraction Headgear and Rapid Palatal Expansion: A Comparative Research.

Directory of Open Access Journals (Sweden)

Xueling Chen

Full Text Available The aim of this study was to evaluate the morphological changes of upper airway after protraction headgear and rapid maxillary expansion (PE treatment in growing patients with Class III malocclusion and maxillary skeletal deficiency compared with untreated Class III patients by cone-beam computed tomography (CBCT.Thirty growing patients who have completed PE therapy were included in PE group. The control group (n = 30 was selected from the growing untreated patients with the same diagnosis. The CBCT scans of the pre-treatment (T1 and post-treatment (T2 of PE group and the control group were collected. Reconstruction and registration of the 3D models of T1 and T2 were completed. By comparing the data obtained from T1, T2 and control group, the morphological changes of the upper airway during the PE treatment were evaluated.Comparing with the data from T1 group, the subspinale (A of maxilla and the upper incisor (UI of the T2 group were moved in the anterior direction. The gnathion (Gn of mandible was moved in the posterior-inferior direction. The displacement of the hyoid bone as well as the length and width of dental arch showed significant difference. The volume and mean cross-sectional area of nasopharynx, velopharynx and glossopharynx region showed significant difference. The largest anteroposterior/the largest lateral (AP/LR ratios of the velopharynx and glossopharynx were increased, but the AP/LR ratio of the hypopharynx was decreased. In addition, the length and width of the maxillary dental arch, the displacement of the hyoid bone, the volume of nasopharynx and velopharynx, and the AP/LR ratio of the hypopharynx and velopharynx showed significant difference between the data from control and T2 group.The PE treatment of Class III malocclusion with maxillary skeletal hypoplasia leads to a significant increase in the volume of nasopharynx and velopharynx.

Maxillary obturator

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Aruna Jawahirlal Bhandari

2017-01-01

Full Text Available Defects in the maxillary jaw can be congenital, developmental, acquired, traumatic or surgical involving the oral cavity and related anatomic structure. Absence or loss of some or all of the soft palate and / or hard palate results in insufficient structure or altered function of the remaining tissues. Defects can cause disruption of articulation and airflow during speech production and also nasal reflux during deglutition. Patients after surgical resection have altered anatomy due to scaring, tissue contracture, lack of bony support and tissue edema. These patients have problem of regurgitation of water and food through nose and difficulty in speech. These changes require the fabrication of prosthesis and also sometimes repeated prosthesis adjustments to confirm to the soft tissue changes. To prevent this and to help the patient in deglutition and speech defects must be restored with prosthesis. In such situation an obturator is designed to close the opening between the residual hard and / or soft palate and the pharynx. The prosthesis provided for these patients are called as obturators. An obturator is a prosthesis which is fabricated for the patients with the palatal defects in the form of cleft lip and palate, oroantral fistula or surgical resection after removable of pathology like tumor or cancer. This review article will highlight on the Prosthetic Rehabilitation of the maxillary defects and the types of obturators.

Reliability and Correlation of Static and Dynamic Foot Arch Measurement in a Healthy Pediatric Population.

Science.gov (United States)

Scholz, Timo; Zech, Astrid; Wegscheider, Karl; Lezius, Susanne; Braumann, Klaus-Michael; Sehner, Susanne; Hollander, Karsten

2017-09-01

Measurement of the medial longitudinal foot arch in children is a controversial topic, as there are many different methods without a definite standard procedure. The purpose of this study was to 1) investigate intraday and interrater reliability regarding dynamic arch index and static arch height, 2) explore the correlation between both arch indices, and 3) examine the variation of the medial longitudinal arch at two different times of the day. Eighty-six children (mean ± SD age, 8.9 ± 1.9 years) participated in the study. Dynamic footprint data were captured with a pedobarographic platform. For static arch measurements, a specially constructed caliper was used to assess heel-to-toe length and dorsum height. A mixed model was established to determine reliability and variation. Reliability was found to be excellent for the static arch height index in sitting (intraday, 0.90; interrater, 0.80) and standing positions (0.88 and 0.85) and for the dynamic arch index (both 1.00). There was poor correlation between static and dynamic assessment of the medial longitudinal arch (standing dynamic arch index, r = -0.138; sitting dynamic arch index, r = -0.070). Static measurements were found to be significantly influenced by the time of day (P body mass index (P mind. For clinical purposes, static and dynamic arch data should be interpreted separately.

EPITHELIAL MYOEPITHELIAL CARCINOMA OF MAXILLARY SINUS —A DIAGNOSTIC DILEMMA

OpenAIRE

Rajeev Sen; Sumiti Gupta; Kanika Taneja; Nisha Marwah; Sonia Chhabra; Sonia Hasija

2015-01-01

Epithelial – Myoepithelial Carcinoma (EMC) is a rare malignant salivary gland neoplasm that most commonly occurs in the Parotid gland, but can also arise in the Minor Salivary Glands. EMC of the maxillary sinus extremely rare. We describe here a case of a 74-year-old patient who presented with maxillary swelling for 4months and nasal discharge for 3 months. Computed Tomography Scan revealed an expansile soft tissue mass in the left maxillary sinus eroding all its walls. In View of high sus...

Modified custom made J-hook for maxillary protraction in a rapid maxillary expansion appliance

Directory of Open Access Journals (Sweden)

Jithesh Kumar Kodoth

2014-01-01

Full Text Available A simple yet innovative attaching the J-hook along with an rapid maxillary appliance for the protraction of maxilla is presented. The proposed method not only simplifies construction but also is equally effective.

Occlusal accommodation and mouthguards for prevention of orofacial trauma.

Science.gov (United States)

Geary, Julian Lindsay; Clifford, Thomas Joseph; Kinirons, Martin James

2009-01-01

The aim of this study was to investigate the effect of two types of occlusal accommodation on the arch separation in centric and eccentric arch positions and to assess the opposing tooth contacts in professionally made, thermoformed sports mouthguards. Maxillary and mandibular alginate impressions, a wax interocclusal record of centric occlusion together with maxillary/condylar face-bow registrations, were recorded clinically for 10 undergraduate dental students who are sports activist volunteers of the School of Medicine and Dentistry, Queen's University Belfast. Two ethylene vinyl acetate thermoformed maxillary mouthguards were made for each player (N = 20) using a standardised procedure. Ten mouthguards served both as the control (i.e. the non-accommodated) group and also the accommodated, occlusally 'imprinted' group. The other 10 mouthguards served as the accommodated, occlusally 'ground' group. Casts were articulated, each non-accommodated and accommodated mouthguard was seated and the extent of the interocclusal opening was recorded in all three arch relationships. The number of mouthguard and mandibular tooth contacts were also recorded in each position. The increased vertical occlusal dimension that was found in the presence of non-accommodated mouthguards equated to the full-sheet thickness of the material that was used to form the mouthguards. Only mouthguards accommodated by grinding retained high levels of occlusal contact in all arch relationships that were tested. Within the limitations of this study, the modification of the occlusal surface made by flat grinding reduced the arch separation in eccentric movements and increased the opposing tooth contacts in custom-made mouthguards. This may contribute to increased comfort, compliance and the protective effect of these appliances thus resulting in a reduction of injuries to the teeth, arches and soft tissues.

Tissue tolerance under the combination treatment of maxillary cancer

International Nuclear Information System (INIS)

Egawa, Jun; Ono, Isamu; Suzuki, Kunio; Takeda, Chisato; Ebihara, Satoshi.

1977-01-01

The tissue tolerance doses of the maxillary sinus structures were estimated when they were subjected to treatment for maxillary cancer by the usual combination of surgery, radiotherapy and regional arterial infusion of 5-fluorouracil. Equivalent single dose calculation was applied with irreversible tissue damage as an indicator. The retardation of epithelialization of the maxillary sinus operated upon appeared to be correlated with the dose delivered. The study indicated that 2,200 rad expressed by equivalent single dose is a safe dose level for sufficient epithelialization. The safety dose level for the bony structure, exposed by surgery, seemed to be at 1,800 rad. (auth.)

Application of computer-aided three-dimensional skull model with rapid prototyping technique in repair of zygomatico-orbito-maxillary complex fracture.

Science.gov (United States)

Li, Wei Zhong; Zhang, Mei Chao; Li, Shao Ping; Zhang, Lei Tao; Huang, Yu

2009-06-01

With the advent of CAD/CAM and rapid prototyping (RP), a technical revolution in oral and maxillofacial trauma was promoted to benefit treatment, repair of maxillofacial fractures and reconstruction of maxillofacial defects. For a patient with zygomatico-facial collapse deformity resulting from a zygomatico-orbito-maxillary complex (ZOMC) fracture, CT scan data were processed by using Mimics 10.0 for three-dimensional (3D) reconstruction. The reduction design was aided by 3D virtual imaging and the 3D skull model was reproduced using the RP technique. In line with the design by Mimics, presurgery was performed on the 3D skull model and the semi-coronal incision was taken for reduction of ZOMC fracture, based on the outcome from the presurgery. Postoperative CT and images revealed significantly modified zygomatic collapse and zygomatic arch rise and well-modified facial symmetry. The CAD/CAM and RP technique is a relatively useful tool that can assist surgeons with reconstruction of the maxillofacial skeleton, especially in repairs of ZOMC fracture.

“Maxillary lateral incisor partial anodontia sequence”: a clinical entity with epigenetic origin

Science.gov (United States)

Consolaro, Alberto; Cardoso, Maurício Almeida; Consolaro, Renata Bianco

2017-01-01

ABSTRACT The relationship between maxillary lateral incisor anodontia and the palatal displacement of unerupted maxillary canines cannot be considered as a multiple tooth abnormality with defined genetic etiology in order to be regarded as a “syndrome”. Neither were the involved genes identified and located in the human genome, nor was it presumed on which chromosome the responsible gene would be located. The palatal maxillary canine displacement in cases of partial anodontia of the maxillary lateral incisor is potentially associated with environmental changes caused by its absence in its place of formation and eruption, which would characterize an epigenetic etiology. The lack of the maxillary lateral incisor in the canine region means removing one of the reference guides for the eruptive trajectory of the maxillary canine, which would therefore, not erupt and /or impact on the palate. Consequently, and in sequence, it would lead to malocclusion, maxillary atresia, transposition, prolonged retention of the deciduous canine and resorption in the neighboring teeth. Thus, we can say that we are dealing with a set of anomalies and multiple sequential changes known as sequential development anomalies or, simply, sequence. Once the epigenetics and sequential condition is accepted for this clinical picture, it could be called “Maxillary Lateral Incisor Partial Anodontia Sequence.” PMID:29364376

“Maxillary lateral incisor partial anodontia sequence”: a clinical entity with epigenetic origin

Directory of Open Access Journals (Sweden)

Alberto Consolaro

Full Text Available ABSTRACT The relationship between maxillary lateral incisor anodontia and the palatal displacement of unerupted maxillary canines cannot be considered as a multiple tooth abnormality with defined genetic etiology in order to be regarded as a “syndrome”. Neither were the involved genes identified and located in the human genome, nor was it presumed on which chromosome the responsible gene would be located. The palatal maxillary canine displacement in cases of partial anodontia of the maxillary lateral incisor is potentially associated with environmental changes caused by its absence in its place of formation and eruption, which would characterize an epigenetic etiology. The lack of the maxillary lateral incisor in the canine region means removing one of the reference guides for the eruptive trajectory of the maxillary canine, which would therefore, not erupt and /or impact on the palate. Consequently, and in sequence, it would lead to malocclusion, maxillary atresia, transposition, prolonged retention of the deciduous canine and resorption in the neighboring teeth. Thus, we can say that we are dealing with a set of anomalies and multiple sequential changes known as sequential development anomalies or, simply, sequence. Once the epigenetics and sequential condition is accepted for this clinical picture, it could be called “Maxillary Lateral Incisor Partial Anodontia Sequence.”

Effect of maxillary distraction osteogenesis on velopharyngeal function: a pilot study.

Science.gov (United States)

Harada, Kiyoshi; Ishii, Yoshimasa; Ishii, Masatoshi; Imaizumi, Humiko; Mibu, Michiko; Omura, Ken

2002-05-01

The purpose of this study was to examine preoperative and postoperative changes of velopharyngeal function in cleft patients who underwent maxillary distraction osteogenesis using the Rigid External Distraction System. Six cleft patients followed for a minimum of 12 months after maxillary distraction were examined. Plain and contrast lateral-cephalograms were obtained preoperatively and postoperatively, and speech evaluation was performed by the same authorized speech therapist at the same time points. The mean distraction amount at the anterior nasal spine was 11.7 mm (range, 7.4 mm - 15.0 mm). Both the nasopharyngeal depth and velar length increased after maxillary distraction, but the need ratio (nasopharyngeal depth/velar length) also increased after distraction. Although scores for velopharyngeal closure dropped a few points after maxillary distraction, the rating for hypernasality remained unchanged in all patients but the patient whose distraction amount was 15.0 mm. These results suggest that maxillary distraction of less than 15 mm may not markedly affect velopharyngeal function in cleft patients.

A case of unusual root morphology: Maxillary canine with two roots

Directory of Open Access Journals (Sweden)

Nagesh Bolla

2009-01-01

Full Text Available The case describes a 3 months follow-up of the treatment of a maxillary canine with two roots. Clinical examination revealed a maxillary canine with a large carious lesion and an exaggerated response to cold thermal tests. Radiographic examination revealed a large distal carious lesion that appeared to invade the pulp chamber. The radiograph also revealed what appeared to be an extra root in this permanent maxillary canine.

Complex branchial fistula: a variant arch anomaly.

Science.gov (United States)

De Caluwé, D; Hayes, R; McDermott, M; Corbally, M T

2001-07-01

A 5-year-old boy presented with an infected left-sided branchial fistula. Despite antibiotic treatment and repeated excision of the fistula, purulent discharge from the wound persisted. Three-dimensional computed tomography (3D CT) reconstruction greatly facilitated the diagnosis and management of this case by showing the course of the fistulous tract. The complexity of the tract suggests that this represents a variant arch anomaly because it contains features of first, second, third, and fourth arch remnants. Copyright 2001 by W.B. Saunders Company.

Orthodontic management of bilateral maxillary canine-first premolar transposition and bilateral agenesis of maxillary lateral incisors: a case report.

Science.gov (United States)

Di Palma, Elena; Di Giuseppe, Biagio; Tepedino, Michele; Chimenti, Claudio

2015-01-01

Maxillary canine-first premolar transposition (Mx.C.P1) is an uncommon dental positional anomaly that may create many orthodontic problems from both esthetic and functional points of view. In this report we show the orthodontic management of a case of Mx.C.P1 associated with bilateral maxillary lateral incisor agenesis and unilateral mandibular second premolar agenesis The patient was treated with a multibracket appliance and the extraction of the lower premolar. treatment was completed without the need for any prosthetic replacement.

Transnasal endoscopic medial maxillectomy in recurrent maxillary sinus inverted papilloma.

Science.gov (United States)

Kamel, Reda H; Abdel Fattah, Ahmed F; Awad, Ayman G

2014-12-01

Maxillary sinus inverted papilloma entails medial maxillectomy and is associated with high incidence of recurrence. To study the impact of prior surgery on recurrence rate after transnasal endoscopic medial maxillectomy. Eighteen patients with primary and 33 with recurrent maxillary sinus inverted papilloma underwent transnasal endoscopic medial maxillectomy. Caldwell-Luc operation was the primary surgery in 12 patients, transnasal endoscopic resection in 20, and midfacial degloving technique in one. The follow-up period ranged between 2 to 19.5 years with an average of 8.8 years. Recurrence was detected in 8/51 maxillary sinus inverted papilloma patients (15.7 %), 1/18 of primary cases (5.5 %), 7/33 of recurrent cases (21.2 %); 3/20 of the transnasal endoscopic resection group (15%) and 4/12 of the Caldwell-Luc group (33.3%). Redo transnasal endoscopic medial maxillectomy was followed by a single recurrence in the Caldwell-Luc group (25%), and no recurrence in the other groups. Recurrence is more common in recurrent maxillary sinus inverted papilloma than primary lesions. Recurrent maxillary sinus inverted papilloma after Caldwell-Luc operation has higher incidence of recurrence than after transnasal endoscopic resection.

FEATURES OF DESIGN OF TIED-ARCH BRIDGES WITH FLEXIBLE INCLINED SUSPENSION HANGERS

Directory of Open Access Journals (Sweden)

V. O. Samosvat

2017-10-01

Full Text Available Purpose. Investigation and analysis of the hanger arrangement and the structural stability of a Network arch bridge – a tied-arch bridge with inclined hangers that cross each other at least twice. It is also necessary to make a comparative analysis with other types of hanger arrangements. Methodology. The authors in their research investigated a large number of parameters to determine their influence in the force distribution in the arch. Eventually they determined optimal values for all parameters. These optimal values allowed developing a design guide that leads to optimal arch design. When solving this problem, the authors used three-dimensional finite element models and the objective was to determine the most suitable solution for a road bridge, with a span of 100 meters, consisting of two inclined steel arches, located on a road with two traffic lanes, subjected to medium traffic. The virtual prototype of the model is performed by finite element simulator Midas Civil. Findings. In this study, for the bridge deck, a concrete tie appears to be the best solution considering the structural behavior of network arches, but economic advantages caused by easier erection may lead to steel or a composite bridge deck as better alternatives. Design requirements and local conditions of each particular bridge project will decide the most economic deck design.Originality. To ensure passenger comfort and the stability and continuity of the track, deformations of bridges are constricted. A network arch is a stiff structure with small deflections and therefore suitable to comply with such demands even for high speed railway traffic.
A network arch bridge with a concrete tie usually saves more than half the steel required for tied arches with vertical hangers and concrete ties. Practical value. Following the study design advice given in this article leads to savings of about 60 % of structural steel compared with conventional tied arch bridges with

Tracheal Compression Caused by a Mediastinal Hematoma After Interrupted Aortic Arch Surgery.

Science.gov (United States)

Hua, Qingwang; Lin, Zhiyong; Hu, Xingti; Zhao, Qifeng

2017-08-03

Congenital abnormalities of the aortic arch include interrupted aortic arch (IAA), coarctation of the aorta (CoA), and double aortic arch (DAA). Aortic arch repair is difficult and postoperative complications are common. However, postoperative tracheobronchial stenosis with respiratory insufficiency is an uncommon complication and is usually caused by increased aortic anastomotic tension. We report here a case of tracheal compression by a mediastinal hematoma following IAA surgery. The patient underwent a repeat operation to remove the hematoma and was successfully weaned off the ventilator.In cases of tracheobronchial stenosis after aortic arch surgery, airway compression by increased aortic anastomotic tension is usually the first diagnosis considered by clinicians. Other causes, such as mediastinal hematomas, are often ignored. However, the severity of symptoms with mediastinal hematomas makes this an important entity.

Morphologic study of the maxillary molars. Part II: Internal anatomy.

Science.gov (United States)

Pécora, J D; Woelfel, J B; Sousa Neto, M D; Issa, E P

1992-01-01

The internal anatomy of three hundred and seventy (370) decalcified and cleared human maxillary molars was studied. Seventy-five percent of the first molars, 58% of the second molars and 68% of the third molars studied presented three (3) root canals and 25% of the first molars, 42% of the second molars and 32% of the third molars presented four (4) root canals. The authors observed that the incidence of two root canals in the mesiobuccal root was higher in second maxillary molars than in first maxillary molars.

Rare occurrence of the left maxillary horizontal third molar impaction ...

African Journals Online (AJOL)

Rare occurrence of the left maxillary horizontal third molar impaction, the right maxillary third molar vertical impaction and the left mandibular third molar vertical impaction with inferior alveolar nerve proximity in a 30 year old female: a case report.

Trans-sinusal maxillary distraction for correction of midfacial hypoplasia: long-term clinical results.

NARCIS (Netherlands)

Nadjmi, N.; Schutyser, F.A.C.; Erum, R. van

2006-01-01

Maxillary distraction osteogenesis is indicated in severe angle class III malocclusions, and severe maxillary hypoplasia among some cleft patients and other craniofacial deformities. Twenty patients, aged 8-48 years (mean 17.8+/-10.5 SD) with maxillary and midfacial hypoplasia were treated. The

Macrodontic maxillary incisor in alagille syndrome

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Mauro Cozzani

2012-01-01

Full Text Available This case report describes the surgical-orthodontic guided-eruption of a deeply impacted macrodontic maxillary central incisor in a 10-year-old patient with Alagille syndrome (ALGS. In the first stage, orthodontic treatment with fixed appliance on deciduous teeth allowed to create enough space for the eruption of the maxillary right central incisor. The second stage included closed surgical exposure and vertical traction. After impacted tooth erupted in the proper position, accessory periodontal treatment and dental reshaping procedures may be indicated to camouflage macrodontic incisor with the adjacent teeth. This is the first report that presents a patient with ALGS undergoing orthodontic and surgical treatment.

Recurrent neck infection with branchial arch fistula in children.

Science.gov (United States)

Madana, J; Yolmo, Deeke; Kalaiarasi, R; Gopalakrishnan, S; Saxena, S K; Krishnapriya, S

2011-09-01

Acute suppurative neck infections associated with third or fourth branchial arch fistulas are frequently recurrent. Third and fourth branchial arch anomalies are much less common than those of second arch and usually present with left thyroid lobe inflammation. The authors present their experience with 15 cases of pyriform sinus fistulae (PSF) of third branchial arch origin and 3 cases of fourth arch origin, all of which presented as recurrent neck infection mainly on the left side. A retrospective review of 18 cases of third and fourth arch fistulae treated at JIPMER from 2005 to 2010. This study includes 18 patients with PSF diagnosed by the existence of fistulous tract radiologically and intraoperatively with pathological correlation. Neck exploration with excision of tract and left hemithyroidectomy was performed in all cases. The patients consisted of 7 males and 11 females, and the ages ranged from 3 to 15 years. All of them presented with recurrent episodes of neck infection. Investigations performed include computed tomography (CT) fistulography, barium swallow and ultrasound which were useful in delineating pyriform sinus fistulous tract preoperatively. All cases were on the left side and the fistula was identified by barium swallow in 14 cases (80%), while intraoperative and pathologic confirmation of the tract was possible in all cases (100%). Neck exploration with an emphasis on complete exposure of the recurrent laryngeal nerve and exposure of the pyriform sinus opening to facilitate complete fistulous tract excision with left hemithyroidectomy was successful in all patients. A follow up period of 1-3 years showed no recurrence. Recurrent neck infection in a child should alert the physician to the possibility of an underlying pyriform sinus fistula of branchial origin and CT fistulography should be performed after the resolution of the neck infection to delineate the tract anatomically. Crown Copyright © 2011. Published by Elsevier Ireland Ltd. All

Initial arch wires for tooth alignment during orthodontic treatment with fixed appliances.

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Jian, Fan; Lai, Wenli; Furness, Susan; McIntyre, Grant T; Millett, Declan T; Hickman, Joy; Wang, Yan

2013-04-30

Initial arch wires are the first arch wires to be inserted into the fixed appliance at the beginning of orthodontic treatment and are used mainly for the alignment of teeth by correcting crowding and rotations. With a number of different types of orthodontic arch wires available for initial tooth alignment, it is important to understand which wire is most efficient, as well as which wires cause the least amount of root resorption and pain during the initial aligning stage of treatment. This is an update of the review 'Initial arch wires for alignment of crooked teeth with fixed orthodontic braces' first published in the Cochrane Database of Systematic Reviews 2010, Issue 4. To assess the effects of initial arch wires for alignment of teeth with fixed orthodontic braces in relation to alignment speed, root resorption and pain intensity. We searched the following electronic databases: the Cochrane Oral Health Group's Trials Register (to 2 August 2012), CENTRAL (The Cochrane Library 2012, Issue 7), MEDLINE via OVID (1950 to 2 August 2012) and EMBASE via OVID (1980 to 2 August 2012). We also searched the reference lists of relevant articles. There was no restriction with regard to publication status or language of publication. We contacted all authors of included studies to identify additional studies. We included randomised controlled trials (RCTs) of initial arch wires to align teeth with fixed orthodontic braces. Only studies involving participants with upper and/or lower full arch fixed orthodontic appliances were included. Two review authors were responsible for study selection, validity assessment and data extraction. All disagreements were resolved by discussion amongst the review team. Corresponding authors of included studies were contacted to obtain missing information. Nine RCTs with 571 participants were included in this review. All trials were at high risk of bias and a number of methodological limitations were identified. All trials had at least one

Complete-arch accuracy of intraoral scanners.

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Treesh, Joshua C; Liacouras, Peter C; Taft, Robert M; Brooks, Daniel I; Raiciulescu, Sorana; Ellert, Daniel O; Grant, Gerald T; Ye, Ling

2018-04-30

Intraoral scanners have shown varied results in complete-arch applications. The purpose of this in vitro study was to evaluate the complete-arch accuracy of 4 intraoral scanners based on trueness and precision measurements compared with a known reference (trueness) and with each other (precision). Four intraoral scanners were evaluated: CEREC Bluecam, CEREC Omnicam, TRIOS Color, and Carestream CS 3500. A complete-arch reference cast was created and printed using a 3-dimensional dental cast printer with photopolymer resin. The reference cast was digitized using a laboratory-based white light 3-dimensional scanner. The printed reference cast was scanned 10 times with each intraoral scanner. The digital standard tessellation language (STL) files from each scanner were then registered to the reference file and compared with differences in trueness and precision using a 3-dimensional modeling software. Additionally, scanning time was recorded for each scan performed. The Wilcoxon signed rank, Kruskal-Wallis, and Dunn tests were used to detect differences for trueness, precision, and scanning time (α=.05). Carestream CS 3500 had the lowest overall trueness and precision compared with Bluecam and TRIOS Color. The fourth scanner, Omnicam, had intermediate trueness and precision. All of the scanners tended to underestimate the size of the reference file, with exception of the Carestream CS 3500, which was more variable. Based on visual inspection of the color rendering of signed differences, the greatest amount of error tended to be in the posterior aspects of the arch, with local errors exceeding 100 μm for all scans. The single capture scanner Carestream CS 3500 had the overall longest scan times and was significantly slower than the continuous capture scanners TRIOS Color and Omnicam. Significant differences in both trueness and precision were found among the scanners. Scan times of the continuous capture scanners were faster than the single capture scanners

Evaluation of arch form between Vietnamese and North American Caucasians using 3-dimensional virtual models.

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Trang, Vu Thi Thu; Park, Jae Hyun; Bayome, Mohamed; Shastry, Shruti; Mellion, Alex; Kook, Yoon-Ah

2015-01-01

The purpose of this study was to investigate the three-dimensional (3D) morphologic differences in the mandibular arch of Vietnamese and North American White subjects. The sample included 113 Vietnamese subjects (41 Class I, 37 Class II and 35 Class III) and 96 White subjects (29 Class I, 30 Class II and 37 Class III). The samples were regrouped according to arch form types (tapered, ovoid, and square) to compare the frequency distribution of the three arch forms between ethnic groups in each angle classification. The facial axis point of each tooth was digitized on 3D virtual models. Four linear and two ratio variables were measured. In comparing arch dimensions, the intercanine and intermolar widths were wider in Vietnamese than in Whites (p Vietnamese group, the square arch form was the most frequent followed by tapered and ovoid arch forms. The arch forms of Whites were narrower than Vietnamese. In North American Whites, the distribution of the arch form types showed similar frequency. In Vietnamese, the square arch form was more frequent.

Cone Beam Computed Tomography Analysis of Incidental Maxillary Sinus Pathologies in North Indian Population

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Sangeeta S Malik

2017-01-01

Full Text Available Introduction: Maxillary sinus can be visualized in both two-dimensional and three-dimensional images. Computed tomography (CT is considered the gold standard method for the examination of maxillary sinus. Cone beam computed tomography (CBCT addresses the limitation of CT and provides many dental advantages. It can provide valuable knowledge about the pathology with limited exposure and low cost compared with other imaging used for diagnostic purposes. Aims and Objectives: The aim of the study is to analyze the prevalence of pathological changes in maxillary sinus of asymptomatic cases using CBCT for diagnostic purposes. Materials and Methods: This retrospective study evaluated 231 patients for incidental maxillary sinus pathologies. Pathological findings were categorized as mucosal thickening, polypoid mucosal thickening, radiopacification, and no pathological findings. Evaluation of pathological findings was done using factors of age and gender. Results: The present study showed 86 cases with maxillary sinus pathology and 145 cases with no pathological findings. Patients with maxillary sinus pathology were mostly diagnosed with mucosal thickening on both sides. In right maxillary sinus, 45 cases (52.3% showed mucosal thickening, and on the left side 36 cases (41.9% were diagnosed with mucosal thickening. Among 86 cases reported, 20 right maxillary sinus (23.3% and 25 left maxillary sinus (29.1% showed no signs of pathology. Conclusion: The incidental maxillary sinus pathologies are highly prevalent in asymptomatic patients. Therefore, oral radiologists should be aware of these incidental findings which will help in early diagnosis and treatment of disease.

Digital versus analog complete-arch impressions for single-unit premolar implant crowns: Operating time and patient preference.

Science.gov (United States)

Schepke, Ulf; Meijer, Henny J A; Kerdijk, Wouter; Cune, Marco S

2015-09-01

Digital impression-making techniques are supposedly more patient friendly and less time-consuming than analog techniques, but evidence is lacking to substantiate this assumption. The purpose of this in vivo within-subject comparison study was to examine patient perception and time consumption for 2 complete-arch impression-making methods: a digital and an analog technique. Fifty participants with a single missing premolar were included. Treatment consisted of implant therapy. Three months after implant placement, complete-arch digital (Cerec Omnicam; Sirona) and analog impressions (semi-individual tray, Impregum; 3M ESPE) were made, and the participant's opinion was evaluated with a standard questionnaire addressing several domains (inconvenience, shortness of breath, fear of repeating the impression, and feelings of helplessness during the procedure) with the visual analog scale. All participants were asked which procedure they preferred. Operating time was measured with a stopwatch. The differences between impressions made for maxillary and mandibular implants were also compared. The data were analyzed with paired and independent sample t tests, and effect sizes were calculated. Statistically significant differences were found in favor of the digital procedure regarding all subjective domains (P<.001), with medium to large effect sizes. Of all the participants, over 80% preferred the digital procedure to the analog procedure. The mean duration of digital impression making was 6 minutes and 39 seconds (SD=1:51) versus 12 minutes and 13 seconds (SD=1:24) for the analog impression (P<.001, effect size=2.7). Digital impression making for the restoration of a single implant crown takes less time than analog impression making. Furthermore, participants preferred the digital scan and reported less inconvenience, less shortness of breath, less fear of repeating the impression, and fewer feelings of helplessness during the procedure. Copyright © 2015 Editorial Council

Optical silencing of C. elegans cells with arch proton pump.

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Ayako Okazaki

Full Text Available BACKGROUND: Optogenetic techniques using light-driven ion channels or ion pumps for controlling excitable cells have greatly facilitated the investigation of nervous systems in vivo. A model organism, C. elegans, with its small transparent body and well-characterized neural circuits, is especially suitable for optogenetic analyses. METHODOLOGY/PRINCIPAL FINDINGS: We describe the application of archaerhodopsin-3 (Arch, a recently reported optical neuronal silencer, to C. elegans. Arch::GFP expressed either in all neurons or body wall muscles of the entire body by means of transgenes were localized, at least partially, to the cell membrane without adverse effects, and caused locomotory paralysis of worms when illuminated by green light (550 nm. Pan-neuronal expression of Arch endowed worms with quick and sustained responsiveness to such light. Worms reliably responded to repeated periods of illumination and non-illumination, and remained paralyzed under continuous illumination for 30 seconds. Worms expressing Arch in different subsets of motor neurons exhibited distinct defects in the locomotory behavior under green light: selective silencing of A-type motor neurons affected backward movement while silencing of B-type motor neurons affected forward movement more severely. Our experiments using a heat-shock-mediated induction system also indicate that Arch becomes fully functional only 12 hours after induction and remains functional for more than 24 hour. CONCLUSIONS/SGNIFICANCE: Arch can be used for silencing neurons and muscles, and may be a useful alternative to currently widely used halorhodopsin (NpHR in optogenetic studies of C. elegans.

Hybrid treatment of aortic arch disease

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Metzger, Patrick Bastos; Rossi, Fabio Henrique; Moreira, Samuel Martins; Issa, Mario; Izukawa, Nilo Mitsuru; Dinkhuysen, Jarbas J.; Spina Neto, Domingos; Kambara, Antônio Massamitsu

2014-01-01

Introduction The management of thoracic aortic disease involving the ascending aorta, aortic arch and descending thoracic aorta are technically challenging and is an area in constant development and innovation. Objective To analyze early and midterm results of hybrid treatment of arch aortic disease. Methods Retrospective study of procedures performed from January 2010 to December 2012. The end points were the technical success, therapeutic success, morbidity and mortality, neurologic outcomes, the rate of endoleaks and reinterventions. Results A total of 95 patients treated for thoracic aortic diseases in this period, 18 underwent hybrid treatment and entered in this study. The average ages were 62.3 years. The male was present in 66.7%. The technical and therapeutic success was 94.5% e 83.3%. The perioperative mortality rate of 11.1%. There is any death during one-year follow- up. The reoperation rates were 16.6% due 2 cases of endoleak Ia and one case of endoleak II. There is any occlusion of anatomic or extra anatomic bypass during follow up. Conclusion In our study, the hybrid treatment of aortic arch disease proved to be a feasible alternative of conventional surgery. The therapeutic success rates and re- interventions obtained demonstrate the necessity of thorough clinical follow-up of these patients in a long time. PMID:25714205

Structural behaviour of masonry arch with no-horizontal springing settlement

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P. Zampieri

2018-01-01

Full Text Available This paper presents a calculation procedure for assessing the structural integrity of a masonry arch with non-horizontal springing settlement. By applying the Principle of Virtual Work (PVW to the deformed arch system, the procedure proposed herein details the reaction forces and thrust lines for each step of imposed settlement of the support. The procedure can also be used estimate the final displacement that causes complete failure of arch structural capacity. The results of the analysis procedure were compared against those obtained by experimental testing so as to validate the proposed calculation method

Technical improvement of arch setting machine for roadway drive. Kusshin kirihayo sewakuki no hensen

Energy Technology Data Exchange (ETDEWEB)

Fujino, T [Taiheiyo Coal Mining Co. Ltd., Tokyo (Japan)

1991-09-25

The following contents are described for a new type arch setting machine introduced to the Taiheiyo Coal Mining Co. (1) The excavation of drift in this coal mine is carried out by the excavating system combining the excavating machine (CM) and the transporter (SC) and the supporting method where arch type steel beams are used as the supporting material is used. (2) In order to automatize the arch setting work, this machine which combined the both functions of the arch lifter (developed in 1983) and the arch setting manipulator (ASM, developed in 1990). (3) This machine has the total weight of 1,500kg, is mounted on CM, and consists of the running part, the arm part, the boom part, and the end saucer part of steel arches. Further, simple fitting or removing can be made and the coal falling down is prevented by holding the coal wall during the arch setting work. (4) When this machine and the ASM were compared for the arch setting time in the working site, the former required about the half time period of the latter. 5 figs., 1 tab.

Maxillary sinusitis - a comparative study of different imaging diagnosis methods

International Nuclear Information System (INIS)

Hueb, Marcelo Miguel; Borges, Fabiano de Almeida; Pulcinelli, Emilte; Souza, Wandir Ferreira; Borges, Luiz Marcondes

1999-01-01

We conducted prospective study comparing different methods (plain X-rays, computed tomography and ultrasonography mode-A) for the initial diagnosis of maxillary sinusitis. Twenty patients (40 maxillary sinuses) with a clinical history suggestive of sinusitis included in this study. The results were classified as abnormal or normal, using computed tomography as gold standard. The sensitivity for ultrasonography and plain X-rays was 84.6% and 69.2%, respectively. The specificity of both methods was 92.6%. This study suggests that ultrasonography can be used as a good follow-up method for patients with maxillary. sinusitis. (author)

Ductal Stent Implantation in Tetralogy of Fallot with Aortic Arch Abnormality

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Ergul, Yakup; Saygi, Murat; Ozyilmaz, Isa; Guzeltas, Alper; Odemis, Ender

2015-01-01

Stenting of patent ductus arteriosus is an alternative to palliative cardiac surgery in newborns with duct-dependent or decreased pulmonary circulation; however, the use of this technique in patients with an aortic arch abnormality presents a challenge. Tetralogy of Fallot is a congenital heart defect that is frequently associated with anomalies of the aortic arch and its branches. The association is even more common in patients with chromosome 22q11 deletion. We present the case of an 18-day-old male infant who had cyanosis and a heart murmur. After an initial echocardiographic evaluation, the patient was diagnosed with tetralogy of Fallot and right-sided aortic arch. The pulmonary annulus and the main pulmonary artery and its branches were slightly hypoplastic; the ductus arteriosus was small. Conventional and computed tomographic angiograms revealed a double aortic arch and an aberrant left subclavian artery. The right aortic arch branched into the subclavian arteries and continued into the descending aorta, whereas the left aortic arch branched into the common carotid arteries and ended with the patent ductus arteriosus. After evaluation of the ductal anatomy, we implanted a 3.5 × 15-mm coronary stent in the duct. Follow-up injections showed augmented pulmonary flow and an increase in oxygen saturation from 65% to 94%. The patient was also found to have chromosome 22q11 deletion. PMID:26175649

Maxillary incisor retraction: evaluation of different mechanisms

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Antônio Carlos de Oliveira Ruellas

2013-04-01

Full Text Available OBJECTIVE: To mechanically evaluate different systems used for incisors retraction. METHODS: Three different methods for incisors retraction using 0.019 x 0.025-in stainless steel wire were evaluated. The samples were divided into three groups: Group A (retraction arch with 7-mm high vertical hooks; Group G3 (elastic chain attached to the miniimplant and to the 3-mm stainless steel hook soldered to the retraction arch; Group G6 (elastic chain attached to the mini-implant and to the 6-mm stainless steel hook soldered to the retraction arch. A dental mannequin was used for evaluation in order to simulate the desired movements when the device was exposed to a heat source. The analysis of variance (ANOVA and the Tukey test were used (p < 0.05. RESULTS: The results demonstrated that Groups G3 and G6 exhibited less extrusion and less incisor inclination during the retraction phase (p < 0.05. With regard to incisor extrusion, statistically significant differences were observed between Groups A and G3, and between Groups A and G6 (p < 0.05. Regarding incisor inclination, statistically significant differences were observed between the three systems evaluated (p < 0.05. CONCLUSIONS: Arches with 6-mm vertical hooks allow the force to be applied on the center of resistance of the incisors, thus improving mechanical control when compared with the other two systems.

Full-scale load tests of Pearl-Chain arches

DEFF Research Database (Denmark)

Halding, Philip Skov; Hertz, Kristian Dahl; Schmidt, Jacob Wittrup

2017-01-01

-Decks: First an investigation of the system’s elastic response (maximum load of 648kN), and second a demonstration of its collapse mechanism and ultimate capacity (maximum load of 970kN). The full-scale test showed formation of plastic hinges and clear warning signs are observed at 84% of the failure load......A full-scale load test is made of two Pearl-Chain (PC) concrete arches in order to evaluate the structural response and assess the design safety. Pearl-Chain structures and Pearl-Chain arches are invented and patented at the Technical University of Denmark. PC-Arches consist of specially designed....... The ultimate, experimental load capacity is 14% higher than the calculated mainly due to the assumed static system used for the calculation. In addition to the full-scale test bridge the first ever permanent PC-Bridge is erected in Denmark in 2015....

Impact of the Distance of Maxillary Advancement on Horizontal Relapse After Orthognathic Surgery.

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Fahradyan, Artur; Wolfswinkel, Erik M; Clarke, Noreen; Park, Stephen; Tsuha, Michaela; Urata, Mark M; Hammoudeh, Jeffrey A; Yamashita, Dennis-Duke R

2018-04-01

The maxillary horizontal relapse following Le Fort I advancement has been estimated to be 10% to 50%. This retrospective review examines the direct association between the amounts of maxillary advancement and relapse. We hypothesize that the greater the advancement, the greater the relapse amount. Patients with class III skeletal malocclusion underwent maxillary advancement with either a Le Fort I or a Le Fort I with simultaneous mandibular setback (bimaxillary surgery) from 2008 to 2015. Patients were assessed for a history of cleft lip or cleft palate. Patients with known syndromes were excluded. Cephalometric analysis was performed to compare surgical and postsurgical changes. Of 136 patients, 47.1% were males and 61.8% had a history of cleft. The mean surgery age was 18.9 (13.8-23) years and 53.7% underwent a bimaxillary procedure. A representative subgroup of 35 patients had preoperative, immediate postoperative, and an average of 1-year postoperative lateral cephalograms taken. The mean maxillary advancement was 6.3 mm and the horizontal relapse was 1.8 mm, indicating a 28.6% relapse. A history of cleft and amount of maxillary advancement were directly correlated, whereas bone grafting of the maxillary osteotomy sites was inversely correlated with the amount of relapse ( P < .05). Our data suggest positive correlation between amount of maxillary advancement and horizontal relapse as well as a positive correlation between history of cleft and horizontal relapse. Bone grafting of the maxillary osteotomy sites has a protective effect on the relapse.

In-Plane MEMS Shallow Arch Beam for Mechanical Memory

KAUST Repository

Hafiz, Md Abdullah Al; Kosuru, Lakshmoji; Ramini, Abdallah; Chappanda, Karumbaiah N.; Younis, Mohammad I.

2016-01-01

We demonstrate a memory device based on the nonlinear dynamics of an in-plane microelectromechanical systems (MEMS) clamped–clamped beam resonator, which is deliberately fabricated as a shallow arch. The arch beam is made of silicon, and is electrostatically actuated. The concept relies on the inherent quadratic nonlinearity originating from the arch curvature, which results in a softening behavior that creates hysteresis and co-existing states of motion. Since it is independent of the electrostatic force, this nonlinearity gives more flexibility in the operating conditions and allows for lower actuation voltages. Experimental results are generated through electrical characterization setup. Results are shown demonstrating the switching between the two vibrational states with the change of the direct current (DC) bias voltage, thereby proving the memory concept.

In-Plane MEMS Shallow Arch Beam for Mechanical Memory

KAUST Repository

Hafiz, Md Abdullah Al

2016-10-18

We demonstrate a memory device based on the nonlinear dynamics of an in-plane microelectromechanical systems (MEMS) clamped–clamped beam resonator, which is deliberately fabricated as a shallow arch. The arch beam is made of silicon, and is electrostatically actuated. The concept relies on the inherent quadratic nonlinearity originating from the arch curvature, which results in a softening behavior that creates hysteresis and co-existing states of motion. Since it is independent of the electrostatic force, this nonlinearity gives more flexibility in the operating conditions and allows for lower actuation voltages. Experimental results are generated through electrical characterization setup. Results are shown demonstrating the switching between the two vibrational states with the change of the direct current (DC) bias voltage, thereby proving the memory concept.

Regional cerebral perfusion for surgical correction of neonatal aortic arch obstruction.

Science.gov (United States)

Zhang, Hui; Cheng, Pei; Hou, Jia; Li, Lei; Liu, Hu; Liu, Ruifang; Ji, Bingyang; Luo, Yi

2009-05-01

One-stage repair of aortic arch obstruction and associated cardiac anomalies is a surgical challenge in infants.The purpose of the present study is to review the current outcome using regional cerebral perfusion (RCP) during a procedure correcting interrupted aortic arch (IAA) and also isolated aortic coarctation (CoA) and CoA combined with hypoplastic aortic arch (CoA-HyAA) in our center. Between January 2007 and July 2008, 24 infant patients with interrupted aortic arch (IAA) (n=3), isolated aortic coarctation (iCoA) (n=9) and aortic coarctation with hypoplastic aortic arch (CoA-HyAA) (n=12) underwent one-stage surgical correction in our hospital. End-to-end anastomosis was employed in 12 infants (IAA n=3 and iCoA n=9); for the other 12 patients with CoA-HyAA, an end-to-end extended anastomosis was used in 8 cases, end-to-side anastomosis in 2 cases, and composite heterologous pericardial patch in 2 cases. RCP with 40 mL/kg/min through the innominate artery during aortic arch reconstruction was employed for all pediatric patients. One single-dose histidine-ketoglutarate-tryptophan (HTK) solution was used for myocardial protection during CPB. Cardiopulmonary bypass time and aortic cross-clamp time were 165.6+/-32.4 min and 81.7+/-30.0 min, respectively. The mean regional cerebral perfusion time was 31.0+/-10.6 min; lowest nasopharyngeal temperature was 19.1+/-1.1 degrees C. Operative mortality rate in both groups was 8.3%. Mean follow-up was 10.5+/-4.8 months. There was no late mortality or postoperative neurologic, renal or hepatic complications. All patients are asymptomatic and are developing normally. One-stage total arch repair using the RCP technique is an excellent method that may minimize neurologic and renal complications. Our surgical strategy for arch anomaly has a low rate of residual and recurrent coarctation when performed in these infants.

Bilateral maxillary fused second and third molars: a rare occurrence.

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Liang, Rui-Zhen; Wu, Jin-Tao; Wu, You-Nong; Smales, Roger J; Hu, Ming; Yu, Jin-Hua; Zhang, Guang-Dong

2012-12-01

This case report describes the diagnosis and endodontic therapy of maxillary fused second and third molars, using cone-beam computed tomography (CBCT). A 31-year-old Chinese male, with no contributory medical or family/social history, presented with throbbing pain in the maxillary right molar area following an unsuccessful attempted tooth extraction. Clinical examination revealed what appeared initially to be a damaged large extra cusp on the buccal aspect of the distobuccal cusp of the second molar. However, CBCT revealed that a third molar was fused to the second molar. Unexpectedly, the maxillary left third molar also was fused to the second molar, and the crown of an unerupted supernumerary fourth molar was possibly also fused to the apical root region of the second molar. Operative procedures should not be attempted without adequate radiographic investigation. CBCT allowed the precise location of the root canals of the right maxillary fused molar teeth to permit successful endodontic therapy, confirmed after 6 months.

Assessment of the influence of jogging on the shape of female foot arches.

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Maslon, Agata; Golec, Joanna; Szczygiel, Elzbieta; Czechowska, Dorota; Golec, Boguslaw

2017-12-23

Both walking and its faster, running, consist of cyclical subsequent phases of swing and support; however, they differ in their time proportions as well as magnitude of acting forces. There is a lack of studies concerning the long-term consequences of repeated jogging cycles on the function of feet and, above all, on their permanent impact on the shape of foot arches. The objective of this study was to answer the question whether regular jogging changes the shape of the transverse and medial longitudinal arches of the feet. The research material consisted of 96 women with an average age of 26.57, and included 50 actively jogging women, and 46 of non-joggers. The study was performed with the use of EMED-SF force platform. The plantar surface of the foot was divided into 10 regions according to Cavanagh, for which peak pressure and contact time were established. Two indicators were defined: metatarsal bone pressure distribution pattern acc. to Kantali, and longitudinal arch index acc. to Cavanagh. The data obtained revealed more frequent occurrence of the greatest pressure under the centrally located metatarsal heads (lack of functional foot transverse arch) among the female joggers, compared with the non-joggers. Moreover, the findings indicate the higher frequency of medial longitudinal foot arch flattening among female runners, with a great deal of consistency between both feet, whereas results for the control group show asymmetrical medial arch shapes with right foot propensity to normal arch shape and left foot tendency for excessive arch. The observed differences in feet arch shapes between female joggers and non-joggers indicate the influence of jogging on feet functional adaptations.

Orthodontic exposure of multiple lmpactions: a case report.

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Munda-Lacson, Maridin C; Venugopal, Adith

2014-01-01

There are rare cases of impacted permanent central incisors with dilacerations, a dental deformity characterized by pronounced angulations of the longitudinal tooth axis. Impaction of maxillary canines is an orthodontic anomaly that causes facial and dentoalveolar system problems, both functional and esthetic. A combination of surgery and orthodontics is important in bringing impacted teeth to their ideal position in the dental arch. This is a case report of a 10-year-old patient with impacted and dilacerated right central incisor and impacted left maxillary canine, following surgical exposure and appropriate orthodontic traction, the impacted teeth were surgically exposed and aligned into the dental arch.

Antrolith in the Maxillary Sinus; Report of a Case

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A. Haraji

2006-06-01

Full Text Available A case of maxillary antrolith in a 14-year-old girl is presented. A radiopaque mass,thought to be a supernumerary tooth, was incidentally found on a panoramic radiograph obtained for orthodontic purposes. During surgical exploration the maxillary sinus was penetrated and 6 calcified masses were discovered. Histopathologic analysis revealed a calcium deposition around a necrotic mass.

Ligation of the internal maxillary artery for intractable epistaxis. 3D imaging of internal maxillary artery using helical CT scan

International Nuclear Information System (INIS)

Handa, Toru; Yazin, Koji; Hirakawa, Katsuhiro; Fukushima, Noriyuki; Takumida, Masaya; Hirata, Shitau; Iguchi, Tetsuhiko; Amano, Yoshiharu

2001-01-01

Sever posterior epistaxis is one of the serious clinical problems. Nasal bleeding usually occurs in the anterior septal region, where it can be seen easily and controlled with topical cautery or localized packing. When the bleeding occurs in the posterior nose, it becomes a more serious problem. Many methods have been used to control posterior epistaxis. Some of these are electrocautery, posterior nasal packing, vascular ligation and therapeutic percutaneous embolization. Between 1997 and 2000, nineteen patients were admitted to our hospital because of intractable epistaxis. There were 16 male and 3 female patients whose average age was 55 years. Ten of 19 patients were hypertensive, and none of these had undergoing treatment. Five of 19 patients received maxillary artery ligation. Clinical applications of 3D imaging of the internal maxillary artery using helical CT scan were done for 5 patients. These images were helpful for planning of ligation of the internal maxillary artery. (author)

Ligation of the internal maxillary artery for intractable epistaxis. 3D imaging of internal maxillary artery using helical CT scan

Energy Technology Data Exchange (ETDEWEB)

Handa, Toru [Akitsu Prefectual Hospital, Hiroshima (Japan); Yazin, Koji; Hirakawa, Katsuhiro; Fukushima, Noriyuki; Takumida, Masaya; Hirata, Shitau; Iguchi, Tetsuhiko; Amano, Yoshiharu

2001-03-01

Sever posterior epistaxis is one of the serious clinical problems. Nasal bleeding usually occurs in the anterior septal region, where it can be seen easily and controlled with topical cautery or localized packing. When the bleeding occurs in the posterior nose, it becomes a more serious problem. Many methods have been used to control posterior epistaxis. Some of these are electrocautery, posterior nasal packing, vascular ligation and therapeutic percutaneous embolization. Between 1997 and 2000, nineteen patients were admitted to our hospital because of intractable epistaxis. There were 16 male and 3 female patients whose average age was 55 years. Ten of 19 patients were hypertensive, and none of these had undergoing treatment. Five of 19 patients received maxillary artery ligation. Clinical applications of 3D imaging of the internal maxillary artery using helical CT scan were done for 5 patients. These images were helpful for planning of ligation of the internal maxillary artery. (author)

Combined maxillary and mandibular distraction osteogenesis in patients with hemifacial microsomia.

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Sant'Anna, Eduardo Franzotti; Lau, Geórgia W T; Marquezan, Mariana; de Souza Araújo, Mônica Tirre; Polley, John W; Figueroa, Alvaro A

2015-05-01

Hemifacial microsomia is a deformity of variable expressivity with unilateral hypoplasia of the mandible and the ear. In this study, we evaluated skeletal soft tissue changes after bimaxillary unilateral vertical distraction. Eight patients (4 preadolescents 4 adolescents) each with a grade II mandibular deformity underwent a LeFort I osteotomy and an ipsilateral horizontal mandibular ramus osteotomy. A semiburied distraction device was placed over the ramus, and intermaxillary fixation was applied. Anteroposterior cephalometric and frontal photographic analyses were conducted before and after distraction. Statistics were used to analyze the preoperative and postoperative changes. Cephalometrically, the nasal floor and the occlusal and gonial plane angles decreased. The ratios of affected-unaffected ramus and gonial angle heights improved by 15% and 20%, respectively. The position of menton moved toward the midline. The photographic analysis showed a decrease of the nasal and commissure plane angles, and the chin moved to the unaffected side. The parallelism between the horizontal skeletal and soft tissue planes improved, with an increase in the affected side ramus height and correction of the chin point toward the midline. Simultaneous maxillary and mandibular distraction improved facial balance and symmetry. Patients in the permanent dentition with fixed orthodontic appliances and well-aligned dental arches responded well to this intervention. Copyright © 2015 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Maxillary reconstruction: Current concepts and controversies

Directory of Open Access Journals (Sweden)

Subramania Iyer

2014-01-01

Full Text Available Maxillary reconstruction is still an evolving art when compared to the reconstruction of the mandible. The defects of maxilla apart from affecting the functions of the speech, swallowing and mastication also cause cosmetic disfigurement. Rehabilitation of the form and function in patients with maxillary defects is either by using an obturator prosthesis or by a surgical reconstruction. Literature is abundant with a variety of reconstructive methods. The classification systems are also varied, with no universal acceptance of any one of them. The oncologic safety of these procedures is still debated, and conclusive evidence in this regard has not emerged yet. Management of the orbit is also not yet addressed properly. Tissue engineering, that has been hyped to be one of the possible solutions for this vexing reconstructive problem, has not come out with reliable and reproducible results so far. This review article discusses the rationale and oncological safety of the reconstructing the maxillary defects, critically analyzes the classification systems, offers the different reconstructive methods and touches upon the controversies in this subject. The management of the retained and exenterated orbit associated with maxillectomy is reviewed. The surgical morbidity, complications and the recent advances in this field are also looked into. An algorithm, based on our experience, is presented.

Maxillary reconstruction: Current concepts and controversies

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Iyer, Subramania; Thankappan, Krishnakumar

2014-01-01

Maxillary reconstruction is still an evolving art when compared to the reconstruction of the mandible. The defects of maxilla apart from affecting the functions of the speech, swallowing and mastication also cause cosmetic disfigurement. Rehabilitation of the form and function in patients with maxillary defects is either by using an obturator prosthesis or by a surgical reconstruction. Literature is abundant with a variety of reconstructive methods. The classification systems are also varied, with no universal acceptance of any one of them. The oncologic safety of these procedures is still debated, and conclusive evidence in this regard has not emerged yet. Management of the orbit is also not yet addressed properly. Tissue engineering, that has been hyped to be one of the possible solutions for this vexing reconstructive problem, has not come out with reliable and reproducible results so far. This review article discusses the rationale and oncological safety of the reconstructing the maxillary defects, critically analyzes the classification systems, offers the different reconstructive methods and touches upon the controversies in this subject. The management of the retained and exenterated orbit associated with maxillectomy is reviewed. The surgical morbidity, complications and the recent advances in this field are also looked into. An algorithm, based on our experience, is presented. PMID:24987199

Highly tunable NEMS shallow arches

KAUST Repository

Kazmi, Syed N. R.; Hajjaj, Amal Z.; Da Costa, Pedro M. F. J.; Younis, Mohammad I.

2017-01-01

and surface nanomachining of a highly conductive device layer on a silicon-on-insulator wafer. By designing the structures to have gap to thickness ratio of more than four, the mid-plane stretching of the nano arches is maximized such that an increase

Electrostatically Tunable Nanomechanical Shallow Arches

KAUST Repository

Kazmi, Syed N. R.; Hajjaj, Amal Z.; Da Costa, Pedro M. F. J.; Younis, Mohammad I.

2017-01-01

-beam lithography and surface nanomachining of a highly conductive device layer on a silicon-on-insulator (SOI) wafer. The experimental results show good agreement with the analytical results with a maximum tunability of 108.14% for 180 nm thick arch with a

Selective cerebro-myocardial perfusion in complex congenital aortic arch pathology: a novel technique.

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De Rita, Fabrizio; Lucchese, Gianluca; Barozzi, Luca; Menon, Tiziano; Faggian, Giuseppe; Mazzucco, Alessandro; Luciani, Giovanni Battista

2011-11-01

Simultaneous cerebro-myocardial perfusion has been described in neonatal and infant arch surgery, suggesting a reduction in cardiac morbidity. Here reported is a novel technique for selective cerebral perfusion combined with controlled and independent myocardial perfusion during surgery for complex or recurrent aortic arch lesions. From April 2008 to April 2011, 10 patients with arch pathology underwent surgery (two hypoplastic left heart syndrome [HLHS], four recurrent arch obstruction, two aortic arch hypoplasia + ventricular septal defect [VSD], one single ventricle + transposition of the great arteries + arch hypoplasia, one interrupted aortic arch type B + VSD). Median age was 63 days (6 days-36 years) and median weight 4.0 kg (1.6-52). Via midline sternotomy, an arterial cannula (6 or 8 Fr for infants) was directly inserted into the innominate artery or through a polytetrafluoroethylene (PTFE) graft (for neonates cerebro-myocardial perfusion was 39 ± 18 min (17-69). Weaning from cardiopulmonary bypass was achieved without inotropic support in three and with low dose in seven patients. One patient required veno-arterial extracorporeal membrane oxygenation. Four patients, body weight cerebro-myocardial perfusion is feasible in patients with complex or recurrent aortic arch disease, starting from premature newborn less than 2.0 kg of body weight to adults. The technique is as safe as previously reported methods of cerebro-myocardial perfusion and possibly more versatile. © 2011, Copyright the Authors. Artificial Organs © 2011, International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Reduction of Zygomatic Arch Isolated Fracture Using Ultra Sound and Needle Marking.

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Kim, Jun Sik; Park, Young Ji; Lee, Yoon Jung; Kim, Nam Gyun; Lee, Kyung Suk

2016-12-01

Zygomatic arch is a bony arch constituting the lateral midface, which consists of 25% of all midface fractures. There are a number of ways to evaluate the extent of zygomatic arch fracture. Some authors have reported successful treatment outcomes using ultrasound (U/S). To add to the previous methods, we have considered ways to accurately display the location of the fracture line while using U/S with 23 gauge needle marking. We introduce our method, which provided satisfactory results for reduction using a portable U/S, and it can evaluate the fracture line simultaneously when reduction of an isolated zygomatic arch fracture is necessary, and needle marking, which can easily point out the fracture line on U/S. We studied 21 patients with an isolated zygomatic arch fracture who underwent closed reduction using U/S and needle marking between 2013 and 2015. We achieved satisfactory results in all our cases with respect to reduction by using the Dingman elevator after performing a temporal approach incision, while confirming relative positioning between needle marking and zygomatic fracture at the same time, after insertion of a 23 gauge needle in the skin above the zygomatic arch fracture line parallel to it. We treated 21 patients with an isolated zygomatic arch fracture using U/S and the needle marking method, which provided satisfactory results because the extent of reduction of the fracture could be evaluated in real-time during the operation and exposure to radiation was reduced.

Two-rooted maxillary first molars with two canals: a case series.

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Shakouie, Sahar; Mokhtari, Hadi; Ghasemi, Negin; Gholizadeh, Seddigheh

2013-01-01

Thorough understanding of the anatomic and internal morphology of a root canal system is absolutely essential for the success of endodontic treatment. Since permanent maxillary first molars have shown variation in internal anatomy, morphology, this tooth has been reviewed extensively. Presence of two canals in a two-rooted maxillary first molar has rarely been reported in studies describing tooth and root canal anatomies. In this report, three cases are presented, which involve the root canal treatment of maxillary first molars with fusion of the two buccal roots.

Apinhamento ântero-superior: revisão e análise crítica da literatura Maxillary crowding and long-term stability: a review of literature

Directory of Open Access Journals (Sweden)

Patrícia Paschoal Martins

2007-04-01

Full Text Available INTRODUÇÃO: o tratamento do apinhamento dentário da região anterior superior e inferior é comumente acometido pela recidiva, entretanto a maior parte dos estudos aborda apenas a estabilidade do tratamento do arco dentário inferior. OBJETIVO: este artigo propõe uma revisão e análise crítica da literatura, enfatizando os fatores etiológicos do apinhamento dentário, as diversas formas de tratamento e a recidiva no arco superior, considerando o plano de tratamento, os fatores periodontais e a expansão rápida da maxila. CONCLUSÕES: a severidade inicial da má oclusão, as alterações dimensionais dos arcos dentários e as alterações na fisiologia do ligamento periodontal são os principais fatores etiológicos de recidiva. O estudo da etiologia da recidiva permite ao ortodontista o correto planejamento dos casos clínicos e a previsibilidade da estabilidade pós-contenção.INTRODUCTION: The treatment of crowding of maxillary and mandibular anterior teeth commonly suffers relapse. Therefore, major studies focus only on stability of mandibular anterior segment. OBJECTIVE: This article propose a review and critical analysis of the literature, emphasizing the etiologic factors of incisors crowding, the various treatment plans and the relapse of the maxillary anterior segment, considering the treatment protocols, the periodontal factors and the rapid maxillary expansion. CONCLUSIONS: The main factors influencing the relapse are the severity of the initial malocclusion, the changes in arch dimensions and the changes in physiology of periodontal tissue. The study of the causes of relapse is important to help in achieving a correct treatment planning and to predict the postretention stability.