No abstract

This study aimed to investigate the dental effects of a three-dimensional (3D) bimetric maxillary distalizing arch. The Wilson rapid molar distalization appliance for Class II molar correction was used in 14 patients (10 girls and four boys with a mean age of 12.18 years). The open coil springs were activated with bent Omega stops and Class II intermaxillary elastics. The mandibular anchorage was gained by a 0.016 x 0.016 utility arch with a 3D lingual arch or a lip bumper with a standard lingual arch. The lateral cephalograms taken before and after treatment formed the material of the research. A Wilcoxon test was used to statistically evaluate the treatment effects. The results showed that the distal tipping of the maxillary first and second molars, and first and second premolars and canines were statistically significant. Significant distal movement occurred in all posterior and canine teeth. The maxillary first molar distalization was found to be 3.5 mm. The maxillary incisor showed significant proclination and protrusion. The decrease in overbite was found to be statistically significant. The mandibular plane angle significantly increased by a mean of 0.5 mm. In addition, significant soft tissue changes were observed.

The NAM device provides significant decreases in both alveolar and palatal cleft deformities in UCLP and BCLP infants, as compared with their birth status.

There is little difference in the effects of the 2 different maxillary surgeries on the postoperative nasal profile.

Objectives:The aim of this retrospective study was to compare the consistency of orthodontic measurement performed on cephalometric films and 3D CT images of cleft lip and palate (CLP) patients.Methods:The study was conducted with 2D radiographs and 3D CT images of 9 boys and 6 girls aged 7–12 with CLP. 3D reconstructions were performed using MIMICS software.Results:Frontal analysis found statistical differences for all parameters except occlusal plane tilt (OcP-tilt) and McNamara analysis found statistical differences in 2D and 3D measurements for all parameters except ANS-Me and Co-Gn; Steiner analysis found statistical differences for all parameters except SND, SNB and Max1-SN. Intra-group variability in measurements was also very low for all parameters for both 2D and 3D images.Conclusions:Study results indicate significant differences between measurements taken from 2D and 3D images in patients with cleft lip and palate.

The authors aimed to present dental treatment of the cadaveric tooth in a transplanted maxilla in a patient with facial transplantation with bony framework and soft tissue envelope. The treatment procedure was scheduled after physical examination, and the final plan was designed according to the patient's special medical condition. The authors reported the first successful endodontic treatment of an allogeneic cadaveric donor tooth in a patient with facial transplantation. Dental disease represents a potential risk for infection in patients with allogeneic transplantation, which could affect the success of tissue transplantation and might lead to life-threatening conditions. The (re)treatment of the diseased teeth is possible even after the transplantation. The health of the teeth and jaws of the donor should be evaluated before transplantation, especially when maxilla or mandible transplantation is planned.

This study aimed to evaluate the results of maxillary advancement by using internal Le Fort 1 distractors on six patients with unilateral cleft lip and palate who had maxillary hypoplasia. The retrognathic maxilla of five patients were protracted with distractor bilaterally, and asymmetric advancement was performed in one patients. A removable intraoral acrylic appliance was used as an anchorage appliance in two patients, and Ragno fan-type expander appliance was used in the others to prevent maxillary collapse during the distraction period. The maxilla of one patient was not distracted successfully due to the maxillary collapse in result of breaking the removable anchorage appliance away. Lateral cephalograms were evaluated before 3 and 12 months after distraction.A desired level of advancement was attained in five patients. In one patient distraction was not performed due to the maxillary collapse. In one of the five patients with a wide oronasal fistula, the size of the fistula was decreased with asymmetric advancement of right and left maxillary segments. Following the retention period of 12 months, the results were stable. It was concluded that effective and easy distraction is possible with internal Le Fort 1 distractors in cleft lip and palate patients who requires maxillary advancement.

Many orthodontists working on patients with cleft lip and palate (CLP) have shown great enthusiasm for presurgical infant orthopedics (PSIO) to improve surgical outcomes with minimal intervention. Even though every clinician aims to use the best treatment modality for their patients, PSIO effects can be confounded by surgical type and timing of the primary repair, as is discussed in many studies. In such cases, one should be cautious when evaluating the particular outcomes for patients with CLP since it is difficult to differentiate the sole effect of an individual surgical or orthodontic intervention. As with any treatment methodology, nasoalveolar molding (NAM) has both benefits and limitations. Commonly cited concerns with NAM, and PSIO in general, include increased cost, increased burden of care, and a negative impact on maxillary growth. However, NAM cannot be deemed as having apparent long-term negative or positive effects on skeletal or soft tissue facial growth, based on previous studies. A review of the literature suggests that NAM does not alter skeletal facial growth when compared with the samples that did not receive PSIO. Nevertheless, the published studies on NAM show evidence of benefits to the patient, caregivers, the surgeon, and society. These benefits include documented reduction in severity of the cleft deformity prior to surgery and as a consequence improved surgical outcomes, reduced burden of care on the care givers, reduction in the need for revision surgery, and consequent reduced overall cost of care to the patient and society.