Identifying communal rituals in the Paleolithic is of scientific importance, as it reflects the expression of collective identity and the maintenance of group cohesion. This study provides evidence indicating the practice of deep cave collective rituals in the Levant during the Early Upper Paleolithic (EUP) period. It is demonstrated that these gatherings occurred within a distinct ritual compound and were centered around an engraved object in the deepest part of Manot Cave, a pivotal EUP site in southwest Asia. The ritual compound, segregated from the living areas, encompasses a large gallery partitioned by a cluster of remarkable speleothems. Within this gallery, an engraved boulder stands out, displaying geometric signs suggesting a unique representation of a tortoise. Isotopic analysis of calcite crusts on the boulder’s grooves revealed alignment with values found in speleothems from the cave dated to ~37 to 35 ka BP. Additionally, meticulous shape analysis of the grooves’ cross-section and the discernible presence of microlinear scratches on the grooves’ walls confirmed their anthropogenic origin. Examination of stalagmite laminae (36 ka BP) near the engraved boulder revealed a significant presence of wood ash particles within. This finding provides evidence for using fire to illuminate the dark, deep part of the cave during rituals. Acoustic tests conducted in various cave areas indicate that the ritual compound was well suited for communal gatherings, facilitating conversations, speeches, and hearing. Our results underscore the critical role of collective practices centered around a symbolic object in fostering a functional social network within the regional EUP communities.

Objectives: To evaluate the outcome of treating deep overbite (OB) using anterior bite elevators concurrently with a pre-adjusted edgewise appliance.Materials and Methods: The Case Western Reserve University (CWRU) cephalometric analysis was used to isolate tipping movement of upper (TUI) and lower incisors (TLI), bodily tooth movement of upper (BUI), and lower incisors (BLI), as well as vertical skeletal changes in the anterior region of the maxilla (MXSK) and mandible (MNSK). Thirty treated subjects were examined at pretreatment (T1) and posttreatment (T2) and compared to an untreated control group matched on age, sex, and Angle malocclusion from the Bolton Brush Growth Study Collection (CWRU, Cleveland, Ohio).Results: Overbite (OB) in the treated group was decreased significantly (P < .001) (-5.6 mm) compared to controls. Statistically significant (P < .001) changes were found for BUI (-0.7 mm), TUI (0.9 mm), TLI (-1.4 mm), BLI (-1.1 mm), and MNSK (-1.6 mm). Most of the overbite correction was in the lower arch and included tipping and intrusion of the lower incisors along with an increase in lower vertical facial height.Conclusions: Deep OB correction was achieved efficiently using anterior bite elevators with pre adjusted edgewise appliance. Correction using bite turbos would be a treatment option for individuals presenting with decreased lower facial height and deep bite.

In this in-vitro experimental study, we assessed the physical and chemical properties of five different thermoplastic transparent aligner materials as follows: SmartTrack (ST), Zendura, Essix Ace (Ace), Essix C+ (C+), and Tru-Tain DX30-25 (DX30). Dissolution property, thermogravimetric analysis (TGA), nuclear magnetic resonance, and attenuated total reflectance-Fourier transform infrared spectroscopy were measured for chemical evaluation. Differential scanning calorimetry (DSC) and dynamic mechanical analysis (DMA) were measured for physical evaluation. We found that C+ was not soluble in any of the tested solvents. Ace and DX30 were soluble in chloroform. ST showed a two-stage degradation according to the TGA results. These results suggest that the core of ST, Ace, and DX30 are PETG or PCT type thermoplastics, while the skin of ST and Zendura are TPU. From the DSC studies, only C+ shows more crystalline characteristic, which is consistent with its lower transparency. The flexural moduli measured by DMA of all 5 aligners are between 0.9 and 1.7 GPa, with Zendura being the stiffest.

Background: The development of dental caries around orthodontic brackets is a common complication of orthodontic treatment. Objectives: This study aimed to compare the antibacterial efficacy of stainless steel (SS) brackets coated with copper oxide nanoparticles (CuO-NPs), titanium dioxide nanoparticles (TiO2-NPs), and hydroxyapatite silver nanoparticles (HA-SNPs) against Streptococcus mutans. Methods: In this in vitro, experimental study, 20 orthodontic brackets were assigned to four groups (n = 5, each group). One group served as the no-intervention control group, and the brackets in the remaining three groups underwent dip coating with CuO-NPs, TiO2-NPs, and HA-SNPs < 100 nm. The number of S. mutans colonies was counted after 24 h, one week, and one and three months. Data were analyzed using the Shapiro Wilk test, repeated measures ANOVA, and Bonferroni multiple comparisons test. Results: All three experimental groups exhibited similar antibacterial properties after 90 days of trial (P > 0.05). Moreover, CuO-NPs had a greater inhibitory effect than TiO2-NPs on S. mutans after 24 h (P = 0.007). However, the inhibitory effect of HA-SNPs was not significantly different from that of TiO2-NPs (P = 0.259) or CuO-NPs (P = 0.224). Conclusions: Considering the similar antibacterial properties of all three coatings in the long term, all three types of nanoparticles can be used to coat orthodontic brackets to prevent caries. However, due to the high cost and difficult preparation of HA-SNPs and the slightly higher efficacy of CuO-NPs in the short-term, the latter may be preferred for this purpose.

The aim of this chapter is to describe the basic aspects of the growth of the craniofacial complex in so much as they fall in the interest of children’s dentistry. The recognition of the changing features in a child’s growing face is important for the clinical practice. Τhe prenatal facial growth and development stages as well as the different concepts of the growth process are briefly described. The relationship of bone and cartilage and the difference between intramembranous and endochondral bone formation are analyzed. The neurocranium (calvaria and basicranium) is briefed, and focus is given on the nasomaxillary complex and the mandible, explaining the role of synchondroses and other anatomical features, such as the maxillary tuberosity, the ramus, the condyle, and others, in facial growth and development. Lastly, basics on the use of cephalometric radiographs and the normal variations in facial form and the anatomic basis for malocclusions are given.

Seldom in the course of a career in orthodontics does one come across a colleague who is truly inspiring in their approach to life. Professor Franco Magni of Genoa, Italy, was one of those rare individuals. Born in Genoa on January 7, 1938, he received his first graduate degree in Medicine from the University of Genoa in 1962. As was the tradition in Europe at that time, individuals wishing to study dentistry had to first complete medical training. Franco Magni, MD, then went on to study dentistry at the same university finishing that course of study in 1964. Still eager to learn more about the specialty of orthodontics, he matriculated at the Eastman Dental Hospital in London. On completion of his orthodontic training in 1966 under the direction of Professor Clifford Ballard, he earned a Diploma in Orthodontics and was recognized by the Royal College of Surgeons as a specialist in orthodontics. He returned to Genoa as 1 of only 2 Italian specialists in orthodontics trained abroad after the war. In 1971 he earned the title of “Libero Docente in Clinica Odontoiatrica” in Rome. When Paolo Falconi organized the first Italian Postgraduate Program in Orthodontics in 1973, Franco enrolled and became a member of the first class of Italian-trained specialists. His practice in Genoa grew steadily until it was one of the most prestigious in Northern Italy. Patients all over Europe sought out “The Professor” to treat the most challenging craniofacial conditions. A sign in his office read, “Since we often are called upon to treat the most challenging malocclusions we use techniques that are outside of the mainstream and could be considered experimental.” True to his love of our specialty, he continued to practice in Genoa with his daughter, Cinzia, until his untimely death on April 29th, 2021. Dr Magni was a lifelong leader in European orthodontics. On returning to Italy, he formed Gruppo Italiano Studio Ortodonzia, an Italian study group of orthodontists. In addition, in 1968, Dr Magni helped found the Italian Society of Orthodontists (SIDO). He would go on to become a SIDO board member in 1974 and president of the society in 1984. Always a leader in organized orthodontics, Franco was elected President of the European Begg Society in 1974 and President of the European Orthodontic Society in 1984. Using his leadership position along with his relationship with world leaders of orthodontic thought, he was able to bring inspirational continuing education to Europe. These courses included many of the most well-known names in our specialty: P.R. Begg, Karl Gugino, Norm Cetlin, Bob Issacson, Jim McNamara, Tom Graber, Delaire, Don Enlow, and Alexander Petrovic. He held the title “Probo viro” of SIDO and was a long-time editorial board member of the European Journal of Orthodontics. He contributed to the leading Italian textbook on orthodontics “Trattato di Ortodonzia” (Edizioni USES Firenze). Case Western Reserve University (CWRU) in Cleveland, Ohio, was Professor Magni's American home. In 1979 he was appointed as a visiting assistant professor and was mentored by the chair of the department, world expert in facial growth, Don Enlow. While at CWRU, Franco maintained his curious nature and began to integrate craniofacial biology into clinical orthodontics. Always the perpetual student, he traveled to California to study with Robert Ricketts and began to employ bio progressive principles in his daily treatment planning. His desire to share his expertise prompted him to invite his good friend Franco Poggio to Cleveland, where they gave a course on in-house fabrication of the bionator appliance. A prescient and timely contribution to the residents and faculty of CWRU because it demonstrated the “European Approach to Orthodontics” on the basis of the concept of functional modification to elicit structural change in growing patients. After returning to Italy in 1982, Franco maintained a clinical appointment at CWRU and held the title of clinical professor until his death. Dr Magni and his wife Gabriela were fluent in English, and this allowed them to build cultural and scientific bridges between the United States and Europe. Every year they would come to CWRU to give lectures to the residents on cutting edge treatment for severe mandibular prognathia or retrognathia, as well as temporomandibular joint disorders. These lectures were always followed by a wonderful dinner that included wine and a discussion of world events. He was a regular fixture at the Moyer's Craniofacial Biology Symposium in Ann Arbor, MI, where he often engaged in lively discussions on growth modification with the likes of Petrovic, Duterloo, and Behrents. In addition to his appointment at CWRU, Franco was an Adjunct Professor of orthodontics and craniomandibular dysfunctions at the Universities of Parma, Padua, Cagliari, and Naples (Federico Secondo). Franco celebrated life. He lived each day filled with love and the companionship of his wife Gabriela and his children Cinzia, Paola, and Toni. He enjoyed decaf espresso, barley coffee, and a good meal with friends and colleagues, driving his Alfa Romeo along the coast of Italy, swimming in the shadow of the temple of Poseidon, and exploring the world around him. Here's an anecdote as remembered by Rosemary Bray, which encapsulates his spirit well:At an AAO Annual Session (which happened to fall on my May birthday), in the midst of my lecture to a crowd of about 800, in walked from the back of the room, Dr Duane Grummons and Dr Franco Magni, who both know I am Italian. Up the center aisle they both marched, clearly distracting my focus and delivery. They came up the stairs to the podium. Duane introduced Franco on the mic and then in the loudest, most happy and Bocelli-like voice, Franco proceeded to blast out "Happy Birthday To You" in Italian. He brought the house down with his enthusiasm and that signature smile and of course everyone joined him in a final “Tanti Auguri a te”! I could only cry - and will never forget it. He will be missed by all who knew him. “Ciao Franco, Grazie Mille”

OBJECTIVES To examine the correlation between spheno-occipital synchondrosis fusion stages and the hand-wrist skeletal maturity index. MATERIALS AND METHODS Digital records of 164 individuals (77 males, 87 females) aged 10 to 18 years old were examined. Three-dimensional CBCT scans and hand-wrist two-dimensional radiographs were scored for the spheno-occipital synchondrosis fusion stages and hand-wrist skeletal maturity index, respectively. Statistical analyses were performed for associations using R software with a significance threshold of P< .01. RESULTS A significant positive relationship was demonstrated between spheno-occipital synchondrosis fusion stages and hand-wrist skeletal maturity in both sexes. The Kendall's rank correlation τ between hand-wrist skeletal maturity index and spheno-occipital synchondrosis fusion percentage were high and positive in males and females (r = .74 and r = .71, respectively). CONCLUSIONS The significant, positive relationship between the hand-wrist skeletal maturity index and spheno-occipital synchondrosis fusion stages support the idea of using spheno-occipital synchondrosis fusion as a biological indicator for craniofacial and mandibular growth spurt prediction.

The Board of Trustees of the American Association of Orthodontists asked a panel of medical and dental experts in sleep medicine and dental sleep medicine to create a document designed to offer guidance to practicing orthodontists on the suggested role of the specialty of orthodontics in the management of obstructive sleep apnea. This White Paper presents a summary of the Task Force's findings and recommendations.

This study presents the dental remains discovered at Manot Cave (MC), Western Galilee, Israel. The cave contains evidence for human occupation during the Early Upper Paleolithic period (46–33 ka) mainly of Early Ahmarian (∼46–42 ka) and Levantine Aurignacian (∼38–34 ka) cultural levels. Six teeth (three deciduous and three permanent) were found at the site, of which four could be thoroughly analyzed. The morphology of the teeth was qualitatively described and analyzed using traditional and geometric morphometric methods. A large comparative sample was used in order to assess the morphological affiliation of the Manot specimens with other Homo groups. The results provided equivocal signals: the upper first premolar (MC-9 P3) is probably modern human; the upper deciduous second molar (MC-10 dm2) and the upper second permanent molar (MC-8 M2) might be modern humans; the lower second deciduous molar (MC-7 dm2) might be Neanderthal. Owing to the small sample size and the almost total lack of distinctive characteristics, our outcome could not supply conclusive evidence to address the question of whether Manot Aurignacian population came from Europe or descended from the local Ahmarian population.

Introduction: Our objective was to evaluate the prevalence of high-risk factors for sleep disordered breathing (SDB) in an orthodontic population of children. SDB is a spectrum of breathing disorders ranging from primary snoring to obstructive sleep apnea. Methods: The sample included 303 healthy children between the ages of 9 and 17. High risk of SDB was assessed using the Pediatric Sleep Questionnaire, a validated instrument that consists of 22 questions, and high risk is defined as positive answers to 33% or more of the questions answered. Sixteen randomly selected patients repeated the questionnaire 1 month after the initial survey for reliability. Results: In this sample, high-risk status on the Pediatric Sleep Questionnaire was not associated with sex, age, or race. The percentage of patients who were screened as high risk was 7.3% (95% confidence interval, 4.7%-10.6%). Conclusions: The results of this study suggest that approximately 7% of adolescent orthodontic patients may be at a significant risk for some form of SDB.

Obstructive sleep apnea (OSA) is a common but still underrecognized disorder. A mandibular repositioning appliance (MRA) is used to treat OSA by advancing the mandible and thereby reducing the collapsibility of the upper airway. It has been found that an MRA increases the volume of the upper airway, especially the velopharyngeal area, in OSA patients. We hypothesize that this increase in the velopharyngeal volume is associated with an anterior displacement of the tongue, but likely not with a stretching of the soft tissue connecting the soft palate, lateral pharynx, palatopharyngeal arch, and mandible. Since the function and structure of the genioglossus and hypoglossal nerve are always abnormal in patients with OSA, the tongue does not always move simultaneously with the mandible when an MRA is being used. Oropharyngeal exercises, especially tongue exercises, can improve the quality of life of OSA patients, including reduction of daytime sleepiness and snoring, better quality of sleep, and partial decrease in the AHI. Further, in animal models, tongue exercise is also found to be effective in tongue function recovery and in the remodeling of the hypoglossal nucleus. We suggest that a combination of tongue exercises along with MRA is a promising approach for patients who do not respond to an MRA alone.

INTRODUCTION:The purpose of this study was to evaluate the effect of using the transverse analysis developed at Case Western Reserve University (CWRU) in Cleveland, Ohio. The hypotheses were based on the following: (1) Does following CWRU's transverse analysis improve the orthodontic results? (2) Does following CWRU's transverse analysis minimize the active treatment duration? METHODS:A retrospective cohort research study was conducted on a randomly selected sample of 100 subjects. The sample had CWRU's analysis performed retrospectively, and the sample was divided according to whether the subjects followed what CWRU's transverse analysis would have suggested. The American Board of Orthodontics discrepancy index was used to assess the pretreatment records, and quality of the result was evaluated using the American Board of Orthodontics cast/radiograph evaluation. The Mann-Whitney test was used for the comparison. RESULTS:CWRU's transverse analysis significantly improved the total cast/radiograph evaluation scores (P = 0.041), especially the buccolingual inclination component (P = 0.001). However, it did not significantly affect treatment duration (P = 0.106). CONCLUSIONS:CWRU's transverse analysis significantly improves the orthodontic results but does not have significant effects on treatment duration.

Introduction: Bone turnover associated with orthodontic tooth movement is evidenced by increased bone turnover markers in gingival crevicular fluid (GCF). Postmenopausal women have an increased concentration of serum bone turnover markers. The filtrate of this serum makes up GCF, but little is known of the bone turnover around teeth in this cohort. The objective of this investigation was to compare the GCF bone turnover markers in premenopausal vs postmenopausal women receiving orthodontic treatment at baseline and at orthodontic activation. Methods: Twenty-eight women were enrolled in the study and separated into 2 groups: premenopausal (16) and postmenopausal (12). Bone turnover was evaluated by GCF at baseline and 24 hours after orthodontic appliance activation. GCF concentrations of RANKL and OPN were measured using ELISA. Baseline and change in concentrations were compared between groups. Results: Baseline RANKL and OPN were significantly different between the premenopausal and postmenopausal groups (P <0.05). Both markers increased significantly from baseline to 24 hours after orthodontic appliance activation in both groups (P <0.05). However, the response to orthodontic activation was not significantly different between groups. Conclusions: Although postmenopausal women have a different bone turnover profile at baseline than do their premenopausal counterparts, there is no difference in their response to orthodontic activation. This confers a level of security associated with orthodontic activation. Future studies are warranted to construct biomarker curves throughout orthodontic therapy.

The recent uptick in do it yourself orthodontics (DIY), the outrageous claims by orthodontic company advertisements in our journals, and the explosion of misinformation about orthodontic services available via the Internet are three reasons to care about science. Science is based on evidence. Findings from carefully conducted experiments where the hypothesis, that is, This is what I think happens, is tested to see if in fact you are correct in your thinking. Now, we have all heard that orthodontics is art and science. What is not always clear is that science comes in two flavors. The first type, reductionist science, seeks to reduce the question to a simple hypothesis that has a yes or no answer, that is, a testable hypothesis. This is the type of science that we are most familiar because it is the type of science that is generally supported by the big funding agencies like the National Institute of Health. And it is the type of science we conducted as part of our training when we all were orthodontic residents. And make no mistake about it we need reductionist science. However, there is another type of scientific inquiry that is equally important. This is scientific synthesis. Here, the question we are asking has no simple answer. It is a complex question and requires a complex answer. A few examples of these questions outside of orthodontics are: Is global warming real? Did humans evolve from less complex species? These types of questions are answered not with one experiment; rather, they are answered by a preponderance of information suggesting the most likely answer based on what we know to be true. Most orthodontic treatment questions require scientific synthesis of the information available from a variety of sources including animal experimentation. This article describes some applications of such findings to clinical care. (C) 2017 Elsevier Inc. All rights reserved.

[This corrects the article DOI: 10.1371/journal.pone.0183305.].

The timing of archeological industries in the Levant is central for understanding the spread of modern humans with Upper Paleolithic traditions. We report a high-resolution radiocarbon chronology for Early Upper Paleolithic industries (Early Ahmarian and Levantine Aurignacian) from the newly excavated site of Manot Cave, Israel. The dates confirm that the Early Ahmarian industry was present by 46,000 calibrated years before the present (cal BP), and the Levantine Aurignacian occurred at least between 38,000 and 34,000 cal BP. This timing is consistent with proposed migrations or technological diffusions between the Near East and Europe. Specifically, the Ahmarian could have led to the development of the Protoaurignacian in Europe, and the Aurignacian in Europe could have spread back to the Near East as the Levantine Aurignacian.