Class III malocclusion due to a retrognathic maxilla is common in patients with cleft lip and palate. Skeletally anchored maxillary protraction using screw-anchored mini-plates combined with intraoral elastics has shown promising results in achieving orthopedic changes and maintaining the outcome until the completion of the growth. This case report presents the course of treatment in a patient with unilateral cleft lip and palate and multiple congenitally missing teeth treated with bone-anchored maxillary protraction until the end of growth. Four mini-plates (Bollard plates) were used during comprehensive fixed orthodontic treatment to protract the dentition and close the space where teeth were missing, extrude the canine, and force eruption of the second premolar using extension arms and cantilevers. A 2-year follow-up at age 17 showed stable occlusion and maintenance of soft tissue results. Bone-anchored maxillary protraction treatment in a patient with cleft lip and palate demonstrates proper orthopedic results and could be a viable alternative to orthognathic surgery.

BACKGROUND:Dental students' personalities are strongly correlated with their didactic and clinical performances. With the significant changes in the social environment in the past decades, students' personalities may also change dramatically. Additionally, with the increasing number of international students admitted into US dental programs, educators must pay attention to the potential personality differences between domestic and international students. BACKGROUND:A systematic review focusing on the Myers-Briggs Type Indicator personality types of dental students was conducted with 11 literature databases following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline. The quality assessment of each included article was conducted following the Joanna Briggs Institute Prevalence Critical Appraisal Tool. Meta-analyses were conducted for each personality type within the United States in the past 50 years, and in each country in the past 20 years. RESULTS:Eighteen articles (17 reports) were included after the eligibility assessment. The longitudinal trends within the United States showed the predominant two personality types have changed from Extraversion, Sensing, Feeling, and Judging (ESFJ) and Extraversion, Sensing, Thinking, and Judging (ESTJ) to ESTJ and Introversion, Sensing, Thinking, and Judging (ISTJ) during the past 50 years. When comparing different countries, the United States, China, Korea, and Iran have the same two dominant personality types (ESTJ and ISTJ) but not the Philippines (Extraversion, Intuition, Feeling, and Perceiving and Introversion, Intuition, Feeling, and Perceiving). However, there are large variations in the prevalence of other personality types. CONCLUSION:There have been constant changes in the predominant personalities of dental students over the years. Additionally, understanding the diversity of personality types within the United States as well as among different countries could serve as the foundation for further improvements in teaching strategies and student support services.

OBJECTIVES:This pilot study aimed to quantify the magnitude and type of tooth movement occurring in short time intervals within the regular monthly orthodontic visits for patients with fixed appliances and undergoing maxillary canine retraction. Additionally, this pilot study aimed to provide a descriptive evaluation for the accuracy and reliability of the Dental Monitoring (DM)-captured scans to those of an iTero digital scans in an extraction space closure model.SETTINGS AND SAMPLE POPULATION:3D intraoral photographic scans (DM) for 12 patients with maxillary first premolar extractions in a single-centre academic institution.MATERIALS AND METHODS:Twelve patients treated with fixed appliances and undergoing space closure for maxillary premolar extraction(s) were included. Nickel-titanium (200 g) closing coil springs were used for canine retraction. At initiation of space closure (T1), iTero scans were acquired, and patients were instructed to take DM scans every 4-5 days until their next visit in 4-5 weeks (T2). At T2, a final iTero scan in addition to a DM scan was taken. The number of patients who did the scans regularly as instructed declined as time elapsed. Stereolithography (STL) files generated from the DM scans were superimposed with the STL files from the iTero scans using GOM Inspect software to determine the accuracy of the DM 3D models. To assess rate, type and direction of tooth movement, each of the 3D image STL files generated from the DM scans, taken every 4-5 days by each patient, was superimposed on the previously captured scan. The rate of tooth movement for the maxillary molars and canines was calculated in the 3 planes of space (X, Y, Z) at each time point, until the end of the experiment.RESULTS:Preliminary results indicated that the maxillary canines appeared to be displaced the greatest amount in the first 4-5 days with initial distolateral movement. As time elapsed, the rate of tooth movement decreased, and the tooth started moving distolingually.CONCLUSIONS:Dental monitoring software provides a high-tech platform to monitor tooth movement in a 'real-time' approach. Accuracy of the photographic scans in relationship to the intraoral scans appears promising. There seems to be some evidence that the greatest amount of movement occurs initially in the first few days after activation, dropping thereafter to become a slower constant rate of tooth movement.

Appliances and techniques prescribed in the early management of Class III malocclusion have varied throughout the years. Earlier, tooth-anchored protraction facemask therapy was prescribed to correct the skeletal maxillary deficiency associated with Class III malocclusion. More recently, bone-anchored mechanism for maxillary protraction has been introduced and it has been used in conjunction with the conventional facemask or Class III elastics. Proponents of orthopedic treatment highlight the importance of early treatment and improvement of the skeletal discrepancy which, in turn, would minimize the severity of future dental compensation, establish proper occlusal function, possibly eliminate the need for orthognathic surgery, and provide pleasing esthetics. Therefore, this article revisits the various protraction protocols (tooth-borne) vs bone-anchored) used in the early management of Class III patients. Its main focus is to describe the efficacy of timely intervention of the different protraction techniques.

Surgery first is an option in orthognathic surgery that meets the demands of patients with dentofacial deformity looking for an expedited solution to their esthetic concerns. These cosmetically driven patients are also looking to maximize facial esthetics with the surgical procedures. Ancillary surgical procedures such as implants in the malar region, mandibular angle region, and chin are some of the options to enhance the surgical result. Fat grafting and submental lipectomy are also minimally invasive procedures that can add volume in certain areas of the face and reduce in others such as the submental region to achieve better facial contours. Rhinoplasty also is a major cosmetic adjunct to orthognathic surgery that often is done in an asynchronous manner to enhance facial esthetics. In some instances, rhinoplasty is required to correct the undesired soft tissue effects in the nasomaxillary complex with orthognathic surgery.

Background and Aim: This study compares a new technique for teeth alignment to the conventional method. The teeth were aligned using an open-coil spring, i.e. simultaneous space opening and alignment, on round nickel-titanium (NiTi) archwires. The purpose of this 2-arm parallel trial (1:1 allocation ratio) was to evaluate the alignment efficiency of conventional and open-coil spring techniques in anterior crowding treatment. Materials and Methods: In this clinical trial study, sixty-two non-extraction patients (70 dental arches: 24 upper arches and 46 lower arches) with ≥3mm of Little’s Irregularity Index (LII) were recruited in two groups based on the minimization method. Blinding was applicable for outcome assessment only. In one group, the teeth were aligned using an open-coil spring, whereas the alignment in the other group was done conventionally, (space opening on steel wires followed by alignment with an auxiliary NiTi wire). The alignment duration was the primary outcome that was investigated for survival analysis and alignment rate ratios, and levels of crowding were calculated with Cox proportional hazard regression. The pre- and post-treatment intercanine widths were also recorded as the secondary outcome. The chi-square and t-test were used to compare other variables between the groups. The level of statistical significance was set at P<0.05. Results: There was no significant difference in the alignment duration between the conventional (185.48±74.82 days) and open-coil (179.19±64.15 days) groups (P=0.725). No harm was detected using the mentioned methods. Conclusion: The use of open-coil spring over brackets on NiTi or steel wires does not seem to affect anterior crowding treatment time.

BACKGROUND AND OBJECTIVES Orthodontic relapse is a physiologic process that involves remodelling of the alveolar bone and principle periodontal ligament fibres. Raloxifene is an Food and Drug Administration (FDA)-approved selective oestrogen receptor modulator that inhibits systemic bone loss. In our study, we examined the effects of Raloxifene on alveolar bone modelling and orthodontic relapse in a rodent model. MATERIALS AND METHODS The efficacy of raloxifene was evaluated in 15-week-old male Wistar rats, 8 in each group (Control, Raloxifene, Raloxifene + 7-day relapse, Raloxifene + 14-day relapse) for a total of 42 days. All animals had 14 days of orthodontic tooth movement with a closed nickel-titanium coil spring tied from incisors to right first molar applying 5-8 gm of force. On the day of appliance removal, impression was taken with silicon material and the distance between first molar and second molar was filled with light-cured adhesive resin cement for retention phase. Raloxifene Retention, Raloxifene Retention + 7D, Raloxifene Retention + 14D groups received 14 daily doses of raloxifene (2.0 mg/kg/day) subcutaneously after orthodontic tooth movement during retention. After 14 days of retention, the retainer was removed and right first molar was allowed to relapse for a period of 14 days. Raloxifene injection continued for the Raloxifene + 14-day relapse group during relapse phase too. Control group received saline injections during retention. Animals were euthanized by CO2 inhalation. The outcome measure included percentage of relapse, bone volume fraction, tissue density, and histology analysis using tartrate-resistant acid phosphatase staining and determining receptor activator of nuclear factor-кB-ligand (RANKL) and osteoprotegerin expression. RESULTS Raloxifene Retention + 14D group had significantly less (P < 0.05) orthodontic relapse when compared with other groups. There was a significant increase (P < 0.05) in bone volume fraction and tissue density in the Raloxifene Retention + 14D group when compared with other groups. Similarly, there was significant decrease in number of osteoclasts and RANKL expression in Raloxifene Retention + 14D group when compared with Raloxifene Retention + 7D group (P < 0.05). CONCLUSION Raloxifene could decrease post-orthodontic treatment relapse by decreasing bone resorption and indirectly enhancing bone formation.

OBJECTIVES:To evaluate the amount of external apical root resorption (EARR) secondary to orthodontic treatment in patients with Short Root Anomaly (SRA) compared to patients with average root lengths using Cone Beam Computed Tomography (CBCT).SETTINGS AND SAMPLE POPULATION:Cone beam computed tomography scans of 23 SRA and 26 control patients were selected from 232 pretreatment scans from a single private practice.MATERIALS AND METHODS:Cone beam computed tomography scans before (T1) and after orthodontic treatment (T2) were evaluated for differences in the change in tooth and root length of the maxillary incisors between both groups. Gender, treatment duration and age were examined as covariates.RESULTS:The mean values for root and tooth length of the maxillary incisors decreased by a range of 0.6 to 1.3 mm after orthodontic treatment. There was no significant difference between the groups for the majority of the measurements although there was a trend for less EARR in the SRA group. The maxillary left central incisor had significantly less proportional and non-proportional loss in tooth length in the SRA group. Age, gender and treatment duration were not associated with change in the proportional and non-proportional lengths for both groups.CONCLUSION:Patients with SRA did not exhibit a significant difference in the proportional and non-proportional change of length after orthodontic treatment when compared to the controls for most measurements. Only tooth length for the maxillary left central incisor had significantly less reduction after orthodontic treatment for both the proportional and non-proportional measurements in the SRA group compared to the control group.

Background and purpose: Unusual enlargement of nose and pharyngeal (nasopharynx) can disrupt the flow of air through the nose. The aim of this study was to investigate the cephalometric parameters in the upper airways. Materials and methods: A retrospective descriptive study was performed using the digital lateral cephalometric radiographs of 32 adults with class I (CL I) malocclusion and no history of night apnea. The radiographs were obtained from the archives in Qazvin Orthodontics Department of Dentistry School and private clinics. Coefficient of variations and Pearson correlation were calculated in SPSS. Results: There was positive Significant correlation (r= 0.761) between tongue length and tongue height, length of the soft palate, and maximum thickness of the soft palate but negative significant correlation was found between tongue length and hypo pharnzhyal air space (r= -0.422) (P= 0.01). There was positive significant correlation (r= 0.444) between tongue height and length of the soft palate and maximum thickness of the soft palate. Also, there was positive significant correlation between over pharyngeal air space and hypo pharyngeal air space and posterior air space (r= 0.551) (P= 0.014). There was positive significant correlation between hypo pharyngeal air space and posterior air space, vertical position of vallecula, and horizontal position of vallecula (P= 0.017). Posterior air space had a positive significant correlation with horizontal position of vallecula but had a negative significant correlation with length of the soft palate. There was positive significant correlation between length of the soft palate and maximum thickness of the soft palate, and vertical position of vallecula and horizontal position of vallecula. Conclusion: There was no significant difference in cephalometric parameters of the upper air ways in adults in Qazvin with CL I malocclusion. Genetic and environmental effects are the most important factors in these cases.

Costochondral graft (CCG) is a common treatment modality for temporomandibular joint (TMJ) ankylosis. One of disadvantages of CCG is unpredictability of growth pattern and risk of overgrowth. This report illustrates management of a patient with CCG overgrowth. The patient was a girl, aged 7 years with severe facial asymmetry and TMJ ankylosis. The treatment comprised releasing of ankylotic mass and use of CCG for TMJ reconstruction. Four years later, the patient underwent overgrowth of the grafted side. Following clinical examination and scintigraphy, the grafted side was shaved to prevent more growth and the patient left to pass adolescent growth spurt. Ultimately, remnant deviation may be compensated by mild genioplasty and fat injection

Introduction: To correct dentofacial deformities, a combination of orthodontic treatment and orthognathic surgery is needed. Prediction software packages are beneficial in treatment planning and achieving improved outcomes, but before using any software, its reliability and reproducibility must be assessed. The aim of this study was to evaluate the accuracy of 2-dimensional Dolphin (version 10; Dolphin Imaging & Management Solutions, Chatsworth, Calif) and 3-dimensional Maxilim (Medicim, Sint-Niklaas, Belgium) softwares in predicting the soft-tissue profiles of patients who had Le Fort I osteotomies. Methods: The presurgical and postsurgical cone-beam computed tomography synthesized lateral cephalograms of 13 patients were collected. Using the Dolphin and Maxilim softwares, the postsurgical profiles were predicted. The positions of the soft-tissue landmarks in profile views were compared with landmarks in the postsurgical photographs. The data were analyzed with the coefficient of reliability and paired-sample t tests. Results: The alpha values of the interclass correlations for each landmark in the x and y planes were between 0.96 and 0.99, except for stomion superior in Maxilim (0.83). The 95% confidence interval and the absolute mean of the error showed that errors in the Dolphin software were greater than those in the Maxilim software, but the differences were not significant (P>0.05), except for soft-tissue A-point. The greatest errors were seen in the chin region. The prediction errors of the nasolabial and mentolabial angles were greater; the prediction error in the Dolphin software was 9 degrees, which has clinical significance. Conclusions: The Dolphin and Maxilim softwares are both appropriate for clinical use. Their inaccuracies in the prediction of the chin region should be considered in complicated surgical planning.