Background/objectives/aims: Controversy exists regarding maxillary bone changes in nongrowing adults. However, previous studies have relied on two-dimensional (2D) cephalo metric analyses, which may be unable to capture three-dimen sional (3D) pheno mena. In this study, we investigated 2D and 3D parameters to test the null hypothesis that maxillary bone volume cannot be changed in nongrowing adults that had been diagnosed with mid facial underdevelopment.Methods: After obtaining informed consent, we undertook 3D cone beam computed tomography scans of 11 consecutive, adult patients prior to and after biomimetic, oral appliance therapy. The mean treatment time was 18.4 months ± 2.5 using the DNA appliance ® system. The intramolar width and 3D volume of the midface was calculated prior to and after the mid facial redevelopment protocol. The findings were subjected to statistical analysis.
Results:The mean intramolar increased from 33.5 mm ± 3.4 prior to treatment to 35.8 mm ± 2.9 after appliance therapy (p = 0.0003). Similarly, the mean midfacial bone volume was 17.4 cm 3 ± 3.9 prior to treatment and increased to 19.1 cm 3 ± 2.6 after appliance therapy (p = 0.0091).
Conclusion:These data support the notion that maxillary bone width and volume can be changed in nongrowing adults. Furthermore, midfacial redevelopment may provide a potentially-use ful method of managing adults diagnosed with obstructive sleep apnea, using biomimetic, oral appliances.
Biomimetic oral appliance therapy (BOAT) has been shown to increase midfacial bone volume in adults non-surgically. This study tests the hypothesis that facial enhancement can also be achieved using BOAT. In this investigation, 12 adults underwent BOAT by a dentist with advanced training in BOAT. The following craniofacial parameters were measured on standardized lateral photographs; frontonasal angle; nasolabial angle; labiomental angle, and thyromandibular angle. The mean configurations were also subjected to statistical analyses, principal components analysis (PCA), and finite-element analysis (FEA). The results showed that the mean labiomental angle improved from 126.3° to 134.0° (p<0.01) and the mean thyromandibular angle improved from 126.5° to 118.6° (p<0.01). The mean, preand post-treatment craniofacial configurations, however, were not statistically different when tested using PCA (p>0.05), with the first two principal components accounting for approx. 70% of the total shape change. But, using FEA, the submandibular region showed a relative 32% decrease in size and the labiomental region also showed a 20% relative size-decrease. Therefore, this study supports the notion that BOAT may enhance facial appearance non-surgically in adults.
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