Objectives: The objective of this study was to develop a reproducible method to measure the change of palatal volume and area through superimposition using maxillary expansion digital cast models. Materials and Methods: A total of 10 pre-and 10 postexpansion dental cast models were scanned by the same cone-beam computed tomography machine. Superimposition was performed using a fully automated surface-best fit of the palatal surfaces on the digital cast models. A gingival plane, identified only once on superimposed casts, and a distal plane with the lateral closing border and the palatal surface were used to localize this selection of air. Area and volume were calculated for pre-and postexpansion records. Pre-and postexpansion palatal volume and area were measured by the main investigator and three different observers for inter-and intra-observer reproducibility assessment. Results: The level of intra-and inter-observer agreement was very strong (intraclass correlation coefficients 0.953; P value , .0001) for all measurements. Conclusions: Palatal volume and area measurements based on the proposed superimposition are reproducible and can be used reliably. (Angle Orthod. 2018;88:397-402.)
Background The coronavirus disease (COVID-19), caused by the novel severe acute respiratory virus syndrome (SARS)-CoV-2, was defined as pandemic on March 11, 2020. All health care providers are at risk of a COVID-19 infection; however, dentists pose the highest risk since SARS-CoV-2 is transmitted through breathing and aerosol, coughing and droplets and direct or indirect contact with infected skin and surfaces. Guidelines for minimizing the risk of transmission in general dental clinics have been published and are regularly updated. Objective The present article aims to specifically address the concerns of the orthodontic profession amid the COVID-19 crisis, and suggest recommendations for orthodontic care settings, infection prevention measures and delivery of clinical procedures. Data Sources An electronic search was conducted via PubMed/MEDLINE, Google and health organization websites from two independent data abstractors. Study Selection All kinds of manuscripts describing guidelines for health care providers to follow during the COVID-19 pandemic were included. No language restrictions were considered. Any disagreements on study inclusion were resolved by discussion between the two reviewers. Data Extraction Information on guidelines and suggestions on the management of clinical orthodontic practice were extracted from studies identified for inclusion in the review. Data Synthesis Orthodontists are at a very high risk for COVID-19 infection and all published guidelines should be followed for the patient and DHCPs safety. The care settings, the infection protocols, and the delivery of AGP clinical procedures must be continuously revised and modified to overcome the threat of the SARS-CoV-2 infection in the orthodontic practice.
Objectives To compare the changes of palatal volume and area in patients treated with tooth-tissue-borne palatal expanders (conventional Haas) and miniscrew-supported palatal expanders (modified Haas). Materials and Methods The sample included casts of 22 patients treated as part of a clinical study at the Department of Orthodontics, Al-Azhar University, to correct their crossbite malocclusion. Patients were divided equally into two groups upon arrival. The first group, with a mean age of 12 years and 6 months, received the miniscrew-supported palatal expander. The second group, with a mean age of 12 years and 2 months, received the Haas design-palatal expansion appliance. Pre- and post-expansion dental casts were cone beam computed tomography scanned and the slices were constructed into 3D volumes. Fully automated superimposition was done for pre- and post-expansion 3D models. Palatal volume and area were determined, and all measurements were carried out blindly. Paired t-test was used to assess the mean differences within each group and Welch's t-test was applied to assess the mean changes between the two groups. Shapiro-Wilk test was used to test for the normality of the data. Results There were no statistical differences in volume changes either within each group or between the groups. Although area changes were statistically significant within each group, the difference between the groups was not significant. Conclusions Changes that result from the use of either method to expand the upper arch occur primarily in the shape of the palate, but not in its size.
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