Thai Journal of Orthodontics

Evaluation of Midpalatal Suture Maturation Stages among Adolescents and Adults using Cone Beam Computed Tomography

2023-10-26T11:12:46+07:00

Background: Transverse maxillary constriction is commonly found in skeletal discrepancies. Growth of the maxilla in the transverse plane is reflected by midpalatal suture maturation status. Previous studies attempted to assess the midpalatal suture maturation. However, literature of the evaluation of MPS maturation using cone beam computed tomography (CBCT) still was limited. Objective: The purpose of the study was to evaluate the different maturation stages of midpalatal suture among adolescents and adults using CBCT. Materials and methods: The sample comprised 200 CBCT reports of subjects. The images were exported to 3D imaging software, where axial sections were used for the suture maturation stages evaluation. The investigators interpreted the images to establish the staging of suture maturation according to the morphologic characteristics in five maturational stages (A to E). The statistical analysis was performed (P < 0.05). Results: The most frequently observed maturational stage in midpalatal suture was stage D (52 %), followed by stage C (22.50 %) and stage E (22.50 %) in mixed age samples. Males showed a higher occurrence of stage D (56.31 %) compared to females (43.69 %). Conclusion: Stage D was the most common maturation stage observed. The common occurrence of stage D in the study group indicates a greater likelihood of open midpalatal suture in adolescents and young adults.

Comparison of Anterior Maxillary Root Surface Areas in Patients with Normal Overjet and Large Overjet using Cone Beam Computed Tomography

2024-02-16T13:48:48+07:00

Background: Root surface area is related to orthodontic force magnitude used to induce alveolar bone remodeling with minimize periodontal damage. These detriments are highly concerned especially in anterior teeth that often needed to be retracted. Objective: To compare root surface area of maxillary anterior teeth between patients with normal overjet and large overjet. Materials and methods: Twelve cone beam computed tomography (CBCT) images of each group were used. Three-dimensional construction of each tooth was created using Mimics software. The surface area apical to cemento-enamel junction was measured and calculated as root surface area using 3-Matic software. The data was analyzed with descriptive analysis. Results: Mean age of the patients was 19.75 ± 2.25 years. Mean root surface area of maxillary anterior teeth ranged from 181.32 to 282.16 mm.² The mean root surface area of maxillary central incisor, lateral incisor, and canine in normal overjet patients were 199, 181 and 249 mm²respectively. While the mean root surfaces in large overjet patients were 210, 197, 282 mm² respectively. Conclusion: The root surface areas of maxillary lateral incisor and canine in large overjet patients were significantly greater than in normal overjet patients. However, there was no significant difference in maxillary central incisor. These findings presented that the difference overjet pattern might associated with the root surface area of maxillary lateral and canine.

The Change of Occlusal Bite Force during Clear Aligner Treatment and Squeezing Exercise

2024-03-13T08:37:53+07:00

Background: No studies revealed the change of occlusal bite force during clear aligner treatment combined with the squeezing exercise. Objective: To study the change of occlusal bite force during anterior open bite treatment with clear aligners and squeezing exercise. Materials and methods: Twenty-two adults with anterior open bite were treated with customized clear aligners. Anterior open bite was corrected using clear aligners combined with squeezing exercise. Squeezing exercise was done by clenching on the clear aligner with submaximal bite force around 80 %. Occlusal bite force was collected at pretreatment (T0), 1 month (T1), 2 months (T2), 3 months (T3), 4 months (T4), 5 months (T5), and 6 months of treatment (T6). Parametric tests were used for statistical analysis. Results: After commencement the treatment, the maximum bite force was significantly higher than the squeezing bite force at all time intervals. Both maximum and squeezing bite force substantially increased from T0 to T2, gradually increased from T2 to T4, and remained stable from T4 to T6. Conclusions: Clear aligner treatment combined with squeezing exercises enhanced both maximum and squeezing bite force during a 6-month observation period.

Relationship between Obstructive Sleep Apnea and Extraction Teeth in Orthodontic Treatment

2023-09-25T13:43:14+07:00

Obstructive sleep apnea is a common upper airway disorder that, if left untreated, could occur complications including physical, mental, and psychosocial problems. Dentists should be knowledgeable with obstructive sleep apnea and screen patients for the condition by completing an oral examination and administering a questionnaire that includes Berlin questionnaire, Epworth sleepiness scale, and STOP-Bang questionnaire. Additionally, lateral cephalometric radiographs or cone beam computed tomography were examined. Mandibular micrognathism, a hyperdivergent pattern, midface hypoplasia, a decrease in the thyromental distance, and a low hyoid position are all characteristics that are frequently seen in patient with obstructive sleep apnea. Currently, the role of obstructive sleep apnea in orthodontic treatment is more recognized. Both orthodontic treatment combined with tooth extraction and orthodontic treatment combined with mandibular setback surgery require an appropriate treatment. The tooth extraction and mandibular setback will decrease the tongue’s surface area. The tongue is positioned more backward. As a result, the upper airway becomes smaller due to an increase in the contact distance between the soft palate and the tongue. This may lead to the development of obstructive sleep apnea. However, it is unclear from previous studies that orthodontic treatment combined with tooth extraction and orthodontic treatment combined with mandibular setback surgery directly contributes to obstructive sleep apnea. Most of the previous studies may focused on changes in the upper airway spaces without sleep test, a gold standard diagnostic test for diagnosing and describing the severity of obstructive sleep apnea. Therefore, this article presents an overview for orthodontists to realize the importance of obstructive sleep apnea and develop appropriate treatment plans.

Risk Factors Related to Obstructive Sleep Apnea Syndrome in Children with Repaired Cleft Lip and Palate

2023-09-11T15:45:20+07:00

Obstructive sleep apnea syndrome (OSAS) is a common sleep-related breathing disorder frequently detected in children, especially when a craniofacial condition such as cleft lip and palate (CLP) plays a role. Their distinct craniofacial alterations, marked by a diminished midface and a retrusive maxilla compared to non-cleft children, increase the susceptibility of children with CLP to OSAS. These anatomical changes result in a decreased cross-sectional airway volume, increasing the likelihood of OSAS development in children with CLP. Medical procedures like palatoplasty, commonly utilized to address anatomical irregularities, can inadvertently lead to upper airway obstruction. Additionally, various risk factors influence OSAS in children with CLP, making it a multifactorial condition. The ability to identify OSAS in children with CLP is essential because if left untreated it can cause cognitive deficits, behavioral problems, impaired growth, and cardiovascular complications. To minimize the underdiagnosis of OSAS, the related risk factors related to OSAS in children with CLP should be considered. This review article aims to investigate those risk factors in children with repaired CLP to enable early detection, which can prevent unexpected complications through proper interventions.

Distraction Osteogenesis in Cleidocranial Dysostosis: A Case Report

2023-08-02T13:26:57+07:00

Cleidocranial dysostosis is one of the congenital deformities that involved both teeth and their bone support. The deformities often present with complexity of disorder in the multiple regions. Base on the clinical evidence, the result of orthodontic treatment providing in the younger age groups revealed better outcome than in the older age patient groups. In addition, the treatment protocols are varied depend on the severity of deformities, age, developmental stage of the permanent dentition, periodontal status and budgets of treatment due to the long and multiple surgical operations. The orthodontic treatment protocol of cleidocranial dysplasia in the growing age could be started with the selected serial extraction of the deciduous teeth and removed the supernumerary teeth. This performance stimulates the spontaneous eruption of related permanent teeth to erupt in the alveolar bone with the proper position. The unerupted permanent teeth could only be achieved by artificial orthodontic force. The permanent dentition then will be aligned to get the optimal occlusion. Nevertheless, the surgical operation of jaw bones may be needed especially in patients with severe discrepancy of bony structures that beyond the orthodontic compensation. These guidelines of treatment provided the satisfied outcome of occlusion, masticatory function and facial esthetics in cleidocranial dysostosis patients.