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Background This prospective randomized clinical trial aimed to evaluate the immediate and short-term skeletal, dentoalveolar, and periodontal effects of rapid palatal expansion (RPE) and miniscrew-assisted RPE (MARPE) in adolescent and young adult patients. Methods This study followed a two-arm, parallel, randomized clinical trial design that recruited patients with transverse maxillary deficiency in a 1:1 allocation ratio. Forty patients (14 men and 26 women) requiring maxillary expansion were randomly allocated to the RPE (n = 20, age = 14.0 ± 4.5) or MARPE (n = 20, age = 14.1 ± 4.2) groups. The assignment was performed via computer-generated block randomization, with a block size of four. Upon identical (35 turns) amount of expansion, low-dose cone-beam computed tomography images were taken before treatment (T0), immediately after expansion (T1), and after a 3-month consolidation period (T2). The primary outcome of this study comprised the assessment of midpalatal suture separation. Secondary outcomes included, skeletal, dentoalveolar, and periodontal measurements, which were performed at each time point. Results The frequency of midpalatal suture separation was 90% (18/20) and 95% (19/20) for the RPE and MARPE groups, respectively. A greater increase in nasal width in the molar region (M-NW) and greater palatine foramen (GPF) was observed immediately after the expansion (T1-T0) and consolidation periods (T2-T0) in the MARPE group compared to the RPE group (P P P Conclusions Midpalatal suture separation was observed in 90% and 95% of patients in the RPE and MARPE groups, respectively. Both RPE and MARPE groups exhibited significant triangular basal bone expansion and skeletal relapse during consolidation. Under identical amounts of expansion, the MARPE group showed lower decrease in the skeletal, dentoalveolar and periodontal variables after consolidation. The reinforcement of RPE with miniscrews contributes to the maintenance of the basal bone during consolidation period. Trial registration WHO Institutional Clinical Trials Registry Platform (IRB No. KCT0006871 / Registration date 27/12/2021).

This study evaluates the accuracy and efficiency of automatic tooth segmentation in digital dental models using deep learning. We developed a dynamic graph convolutional neural network (DGCNN)-based algorithm for automatic tooth segmentation and classification using 516 digital dental models. We segmented 30 digital dental models using three methods for comparison: (1) automatic tooth segmentation (AS) using the DGCNN-based algorithm from LaonSetup software, (2) landmark-based tooth segmentation (LS) using OrthoAnalyzer software, and (3) tooth designation and segmentation (DS) using Autolign software. We evaluated the segmentation success rate, mesiodistal (MD) width, clinical crown height (CCH), and segmentation time. For the AS, LS, and DS, the tooth segmentation success rates were 97.26%, 97.14%, and 87.86%, respectively (p DS), the means of MD widths were 8.51, 8.28, and 8.63 mm, respectively (p AS > LS), the means of CCHs were 7.58, 7.65, and 7.52 mm, respectively (p DS, AS), and the means of segmentation times were 57.73, 424.17, and 150.73 s, respectively (p

Carboxybetaine methacrylate (CBMA), which has anti-biofouling properties, was incorporated into poly(methyl methacrylate) (PMMA) to prevent multi-species biofilm formation without impairing the critical mechanical properties of the PMMA. The incorporation of 2-methacryloyloxyethyl phosphorylcholine (MPC, 3 wt%) was used as a positive control. PMMA wettability was found to increase with increasing CBMA content. The addition of CBMA resulted in decreased mechanical properties of PMMA. The incorporation of 3% CBMA into PMMA resulted in considerable long-term anti-biofouling effects that reduce adhesion of various fungi, bacteria (Candida albicans, Actinomyces naeslundii, and Veillonella parvula), and a human saliva-derived biofilm. The anti-biofouling effect of CBMA-incorporated PMMA surpassed that of the positive control. By calculating the intensity of the collective band using Raman spectroscopy, CBMA was proven to form the most stable hydration layer. Neither CBMA nor MPC groups showed cytotoxicity. Occlusal splints fabricated using 3% CBMA showed clinically acceptable aesthetic properties with slight turbidity. Despite a limitation in terms of deteriorations of the mechanical properties, the addition of an appropriate amount of CBMA to PMMA inhibited the attachment of fungi and bacteria and suppressed multi-species biofilm growth. The aesthetic properties of CBMA-incorporated PMMA are acceptable for clinical practice.

Objective This study aimed to evaluate the differences in cephalometric characteristics and skeletal maturation in girls with central precocious puberty (CPP) via lateral and hand-wrist radiographs. We also aimed to identify the indicators that are most effective for determining skeletal maturity in these patients. Methods The study included 70 Korean girls (mean age, 8.5 ± 0.5 years) diagnosed with CPP at the Department of Pediatrics, and 48 normal healthy age-matched girls who visited the Department of Orthodontics and had no history of hormone treatment or growth problems. Skeletal maturation was evaluated using lateral cephalometric and hand-wrist radiographs using cervical vertebrae maturation indicators (CVMI) and skeletal maturity indicators (SMI). Results The mean mandibular plane angle was smaller in the CPP group than in the control group (35.8° ± 4.9° vs. 39.0° ± 6.5°), resulting in greater posterior facial height (p = 0.003). SMI was significantly greater in the CPP group (3.5 ± 1.4 vs. 2.0 ± 1.0) than in the control group (p = 0.001) and was significantly associated with CPP (r = 0.492; p = 0.001), whereas CVMI was not. Conclusions In comparison with the control group, the CPP group exhibited a smaller mandibular plane angle, greater posterior facial height, and greater skeletal maturation. SMI may be more suitable than CVMI for determining skeletal maturation in CPP. Hand-wrist radiography is recommended in addition to lateral cephalogram for predicting growth in girls with CPP.

Simple, fast, and accurate analytical techniques for verifying the accuracy of label declarations for marine oil dietary supplements containing eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are required because of the increased consumption of these products. We recently developed broad-based partial least squares regression (PLS-R) models to quantify six fatty acids (FAs) and FA classes by using the spectroscopic data from a portable Fourier transform infrared (FTIR) device and a benchtop Fourier transform near infrared (FT-NIR) spectrometer. We developed an improved quantification method for these FAs and FA classes by incorporating a nonlinear calibration approach based on the machine learning technique support vector machines. For the two spectroscopic methods, high accuracy in prediction was indicated by low root mean square error of prediction and by correlation coefficients (R2) close to 1, indicating excellent model performance. The percent accuracy of the support vector regression (SV-R) model predicted values for EPA and DHA in the reference material was 90 to 110%. In comparison to PLS-R, SV-R accuracy for prediction of FA and FA class concentrations was up to 2.4 times higher for both ATR-FTIR and FT-NIR spectroscopic data. The SV-R models also provided closer agreement with the certified and reference values for the prediction of EPA and DHA in the reference standard. Based on our findings, the SV-R methods had superior accuracy and predictive quality for predicting the FA concentrations in marine oil dietary supplements. The combination of SV-R with ATR-FTIR and/or FT-NIR spectroscopic data can potentially be applied for the rapid screening of marine oil products to verify the accuracy of label declarations. HIGHLIGHTS

Technologies that can overcome the poor mechanical properties of the coatings with bacterial anti-adhesion effect based on super-wetting properties are still challenging. In this study, we developed a durable superhydrophilic nanocomposite coatings composed of polysaccharide matrix and organosilicate (OS) compound filler. In brief, carboxymethylcellulose (CMC) and chitosan (CS)-based multilayer films were fabricated via Layer-by-layer (LbL) assembly then crosslinking for the films was performed to improve inner stability and induce superhydrophilicity. As second step, we synthesized a biocompatible and robust organosilicate compound via sol-gel reaction and incorporate it as reinforcing filler into the superhydrophilic films. Consequently, durable hybrid superhydrophilic nanocomposites were coated on the substrate, and various chemical analysis and performance evaluations of the coatings were performed. The mechanical properties of the composite coatings were significantly improved due to the OS acting as a reinforcing filler in the multilayer films. Furthermore, the coatings exhibited excellent biocompatibility and transparency and exerted antibacterial effect based on superhydrophilic property. This study presents a practical strategy to solve the poor durability, the limitation of super-wetting coatings widely applied in various fields.

In the medical industry, zwitterionic brushes have received significant attention owing to their antifouling effect that arose from their hydration ability. However, sufficient understanding of the hydration dynamics of zwitterionic brushes is required to fabricate the precisely controlled antifouling medical devices. In this paper, we successfully show that hydration, the interaction between water molecules and zwitterionic brushes, and its dynamics can be evaluated logically and quantitatively using (i) water contact angle, (ii) molecular dynamics simulation, and (iii) Raman spectroscopy. Based on the intuitive results on hydration, we precisely optimized the antifouling property of the model medical device, a removable orthodontic retainer, with various grafting efficiencies of 2-methacryloyloxyethyl phosphate choline. As a result, the model device reduced nonspecific adsorption of proteins and bacteria, indicating an improved antifouling effect, and also inhibited the formation of a biofilm. Furthermore, the device showed excellent physical properties desirable for application in the orthodontic field, meaning the balance between the antibacterial property and mechanical strength.

We incorporated zwitterionic materials into light-curable fluoride varnish (LCFV) in order to inhibit biofilm accumulation and prevent dental caries, and the properties of LCFV with three different zwitterionic materials, namely, 2-methacryloyloxyethyl phosphorylcholine (MPC), carboxybetaine methacrylate (CBMA), and sulfobetaine methacrylate (SBMA) polymers (each at a weight percentage of 3%), were compared; unmodified LCFV without any zwitterionic material was used as a control. Material properties including film thickness and degree of conversion (DC) of each type of LCFV were evaluated. In addition, protein-repellent effects and inhibitory effects on Streptococcus mutans adhesion and saliva-derived biofilm accumulation of LCFV were estimated. Finally, the preventive effect of LCFV on enamel demineralization was assessed in vitro on extracted human teeth specimens stored in S. mutans-containing medium. The film thickness of LCFV significantly decreased with the incorporation of zwitterionic materials compared to the control LCFV, whereas there were no significant differences in the DC among all of the LCFV groups. Furthermore, the amount of adsorbed protein, adherent S. mutans colony-forming unit (CFU) counts, and saliva-derived biofilm thickness and biomass were all significantly lower for LCFV with incorporated zwitterionic materials compared with the control. All LCFV groups including the control showed certain preventive effects against enamel demineralization during a 14-day immersion in the medium with S. mutans and sucrose, and the depth of demineralization was significantly lower in LCFV with zwitterionic materials than in the control. Thus, the incorporation of zwitterionic materials such as MPC, CBMA, and SBMA appears to confer superior antifouling effects to LCFV.

This study evaluated the synergetic effect between surface pre-reacted glass-ionomer (SPRG) filler and 2-methacryloyloxyethyl phosphorylcholine (MPC), for inhibiting multi-species biofilm formation, while maintaining or even improving the original beneficial features of SPRG-filled resin-based composite (RBC).MPC (1.5-10wt%) was incorporated into commercial SPRG-filled RBC. Then, the inherent properties of RBC, and ion release and acid-neutralising properties associated with SPRG were investigated. Further, protein adsorptions and bacterial adhesion and viability on the SPRG-filled RBC surfaces were studied using four kinds of oral bacteria; Streptococcus mutans, Actinomyces naeslundii, Veillonella parvula, and Porphyromonas gingivalis. Finally, the thickness and biomass of the human saliva-derived biofilm model cultured on test and control samples were analysed.Addition of MPC content resulted in decreased flexural strength and wettability of SPRG-filled RBC. SPRG-filled RBC released significantly higher amounts of multiple ions as contents of MPC increased. Meanwhile, SPRG-filled RBC with 5-wt% MPC significantly improved acid-neutralising properties than those of other test and control samples (P0.001). SPRG-filled RBC with 3wt% MPC significantly reduced the amount of adsorbed bovine serum albumin and proteins from the brain heart infusion medium as compared to the control (P0.01). A similar trend was observed in the attachment of four types of bacteria and multi-species biofilm (P0.01).Despite limitation in terms of deteriorations of some physical properties, addition of 3% MPC to SPRG-filled RBC leads to inhibition of the attachment of multi-species bacteria on its surface, as well as inhibition of biofilm growth. Moreover, the original important bioactive features of SPRG-filled RBC such as ion release and acid neutralisations are either maintained or improved upon adding MPC.

The aim of this study is to investigate the resistance of various fluoride-releasing restorative materials against the demineralization and remineralization of enamel surfaces, including those that have been recently introduced to the market. Three different fluoride-releasing restorative materials were considered: glass ionomer (FI), resin-modified glass ionomer (RL), and an alkasite restorative material (CN). The acid neutralization ability was investigated using pH measurement, and the concentrations of released fluoride and calcium ions were measured. Finally, the demineralization resistance and remineralization effects of enamel were observed using a microhardness tester and SEM. CN showed an initial substantial increase in pH followed by a steady increase, with values higher than those of the other groups (p &lt, 0.05). All three groups released fluoride ions, and the CN group released more calcium ions than the other groups (p &lt, 0.05). In the acid resistance test, from the microhardness and SEM images, the CN group showed effective resistance to demineralization. In the remineralization test, the microhardness results showed that the FI and CN groups recovered the microhardness from the values of the demineralized enamel surface (p &lt, 0.05). This was confirmed by the SEM images from remineralization tests, the CN group showed a recovered demineralized surface when immersed in artificial saliva for 7 days. In conclusion, alkasite restorative material can be an effective material when used in cariogenic environments.

In this study, we aimed to evaluate and compare the bracket positioning accuracy of the indirect bonding (IDB) transfer tray fabricated in-clinic using the tray printing (TP) and marker-model printing methods (MP).The TP group was further divided into 2 groups (single-tray printing [STP] and multiple-tray printing [MTP]) depending on the presence of a tray split created using the 3-dimensional (3D) software. Five duplicated plaster models were used for each of the 3 experimental groups, and a total of 180 artificial teeth, except the second molar, were evaluated in the experiment. The dental model was scanned using a model scanner (E3; 3Shape Dental Systems, Copenhagen, Denmark). Virtual brackets were placed on facial axis points, and the IDB trays were designed and fabricated using a 3D printer (VIDA; EnvisionTEC, Mich). The accuracy of bracket positioning was evaluated by comparing the planned bracket positions and the actual bracket positions using 3D analysis on inspection software. The main effects and first-order interaction effects were analyzed together by analysis for the analysis of variance.The mean distance and height errors were significantly lower in the STP group than those in the MP and MTP groups (P 0.05). The mean distance error was 0.06 mm in the STP group and 0.09 mm in the MP and MTP groups. The mean height error was 0.10 mm in the STP group and 0.15 mm and 0.18 mm in MP and MTP groups, respectively. However, no significant differences were observed in the angular errors among the 3 groups.The in-office-fabricated IDB system with computer-aided design and 3D printer is clinically applicable after considering the linear and angular errors. We recommend IDB trays fabricated using the STP method owing to the lower frequency of bracket positioning errors and ease of fabrication.

Objective This study compared soft tissue changes after extraction of the four premolars followed by maximum retraction of the anterior teeth according to the type of anterior teeth movement tipping and translation. Methods Patients who had undergone orthodontic treatment involving the extraction of four premolars were retrospectively selected and divided into either the tipping (n = 27) or translation (n = 26) groups based on the retraction of the incisor root apex and the axis changes of the incisors during the treatment period. Lateral pre- and post-treatment cephalograms were analyzed. Results There were no significant differences between the tipping and translation groups before treatment. The retraction amounts of the root apex of the upper and lower incisors in the tipping group were 0.33 and 0.26 mm, respectively, and 5.02 and 5.31 mm, respectively, in the translation group (p < 0.001). The posterior movements of soft tissue points A and B in the tipping group were 0.61 and 1.25 mm, respectively, and 1.10 and 3.25 mm, respectively, in the translation group (p < 0.01). The mentolabial sulcus angle increased by 5.89° in the tipping group, whereas it decreased by 8.13° in the translation group (p < 0.001). Conclusions An increased amount of retraction of the incisor root apex led to the increased posterior movement of soft tissue points A and B, and this appeared more distinct in cases involving the lower incisor and lower lip.

To elucidate genetic factors affecting orthodontic treatment duration, we employed targeted next-generation sequencing on DNA from the saliva of 117 patients undergoing orthodontic treatment after premolar extraction. The clinical characteristics of patients were summarized, and the association of clinical variables with treatment duration was assessed. Patients whose treatment duration deviated from the average were classified into an extreme long group or an extreme short group. We identified single nucleotide polymorphisms (SNPs) significantly enriched in the two groups via targeted sequencing. Nine SNPs (six genes) were significantly enriched in both groups. In the extreme long group, the frequency of the CC genotypes of WNT3A, SPP1 (rs4754, rs9138), and TNFSF11, the TT genotype of SPP1 (rs1126616), as well as the GG genotype of SFRP2 was significantly higher than in the short group. In the extreme short group, the TC genotype of SPP1, the AA genotype of P2RX7, the CT genotype of TNFSF11, and the AG genotype of TNFRSF11A tended to exhibit higher frequency than in the long group. Taken together, we identified genetic polymorphisms related to treatment duration in Korean orthodontic patients undergoing premolar extraction. Accurate prediction of the treatment period through further research will be of great aid to patients as well as orthodontists.

The properties of underlying substrates influence the quality of an intraoral scan, but few studies have compared the outcomes using common restorative materials. In this study, we aimed to compare the accuracy of digital and conventional impressions recorded for four different dental materials as the substrates. Experimental crowns were produced with a metallic surface (gold or cobalt-chromium alloy (Co-Cr)) or without a metallic surface (zirconia or PMMA (polymethyl methacrylate)). A conventional impression was made in the conventional group (CON group), and gypsum models were subsequently scanned with a tabletop scanner. An intraoral scanner was used to scan the crowns either after applying a powder spray to reduce the surface reflectivity (IOS-P group) or without the powder spray (IOS group). The scans were assessed in three dimensions for precision and trueness. The accuracy did not differ between the CON and IOS groups for the non-metallic crowns. However, it was statistically different for the Co-Cr metallic crown, reducing trueness observed between groups as CON &gt, IOS &gt, IOS-P. The study evidences the differences in outer surface accuracy observed with a change in the substrate material to be imaged using an oral scanner and with the impression method. These findings suggest that the restoration material present in the oral cavity should be considered when selecting an impression-taking method.

Zwitterionic polymers have extraordinary properties, that is, significant hydration and the so-called antipolyelectrolyte effect, which make them suitable for biomedical applications. The hydration induces an antifouling effect, and this has been investigated significantly. The antipolyelectrolyte effect refers to the extraordinary ion-responsive behavior of particular polymers that swell and hydrate considerably in physiological solutions. This actuation begins to attract attention to achieve

Adult cleft lip and/or palate (CL/P) patients with a maxillomandibular skeletal discrepancy and missing teeth require an interdisciplinary approach for esthetic satisfaction. The prosthetic and orthodontic treatments for two unilateral CL/P patients with 2 different prostheses and orthodontic interventions are described. A 20-year-old woman with a skeletal Class II, anterior open bite, and the missing teeth was treated with zirconia-based fixed dental prostheses after orthodontic treatment with the intrusion of the maxillary molars using miniscrews. A 34-year-old man with a skeletal Class III, anterior crossbite, chronic generalized moderate periodontitis, and the defected area was treated with a dental implant, and zirconia-based fixed dental prostheses after periodontal treatment and bimaxillary surgery. These clinical reports demonstrate that prosthetic treatment combined with nonsurgical or surgical orthodontic treatment can be effective for adult patients with unilateral CL/P and missing teeth. The therapeutic approaches resulted in improvements in the patients’ facial appearances and satisfaction.

The increased demand for marine oil dietary supplements requires rapid and accurate screening to verify product quality and accuracy of label declarations. Simple and rapid procedures, based on spectra from a portable Fourier-transform infrared (FTIR) device and a benchtop FT-near infrared (FT-NIR) spectrometer combined with chemometrics, were developed to: (1) differentiate sources of omega-3 polyunsaturated fatty acids (PUFA) in their natural triacylglycerol (TAG) or concentrated ethyl ester (EE) forms, and (2) quantify six main fatty acids (FA)/FA classes. A partial least squares discriminant analysis (PLS-DA) model developed for ATR-FTIR data was successfully used to classify a large number of representative products (n = 95) as belonging to the TAG or EE classes, or as mixtures of such. Broad-based partial least squares regression (PLSR) models for each of six fatty acid (FA)/FA classes were successfully validated by cross-validation and by using an independent validation test set. For both complementary procedures, PLSR model predictions showed good linear correlations with a reference gas chromatographic method (R2 > 0.91) and excellent predictive qualities for eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). These simple, rapid, and nondestructive spectroscopic procedures have the potential for differentiating between natural and concentrated forms of omega-3 PUFA and verifying the accuracy of label declarations.

Objectives: To determine whether the success rate and primary stability of surface-treated miniscrews differ from those of nontreated miniscrews. Materials and Methods: Patients who required one or more miniscrews for the same reason in each quadrant were recruited into a single-blinded, split-mouth, randomized, controlled trial with a 1:1 allocation ratio. Self-drilling miniscrews with two surface types were used: those with no surface treatment, and those with an acid-etched surface treatment. The cumulative success rate and primary stability of each type of miniscrew were examined, and factors potentially affecting the success and failure of miniscrews were investigated. Results: Forty patients were included in the study, with a total of 98 orthodontic miniscrews. The overall success rate was 88.8%, and the respective success rates for acid-etched and machined surface miniscrews were 91.8% and 85.7%. The respective mean insertion torques were 13.62 ± 5.95 N·cm and 13.38 ± 4 N·cm, and periotest values measured immediately after insertion were −0.50 ± 2.77 for acid-etched miniscrews and −0.28 ± 3.36 for machined surface miniscrews. There was no significant difference in the mean insertion torques and periotest values according to surface treatment and jaw. Conclusions: Neither the success rate nor the primary stability of acid-etched surface miniscrews and machined surface miniscrews differed significantly. There is a high possibility that miniscrews will fall out in patients who have an open bite or those who require total distalization.

This study investigated the association of changes in cementum protein-1 (CEMP-1), dentine phosphoprotein (DPP), and c-terminal cross-linked telopeptide of type I collagen (CTX-I) levels in human gingival crevicular fluid (GCF) under constant load with external root resorption volume and amount of tooth movement. In total, 11 healthy adult patients (mean age, 23.5 years [range, 18.3–37.7]; four men and seven women) were enrolled. GCF samples were obtained from premolars at T0, T1 (1 day), T2 (1 week), T3 (2 weeks), T4 (4 weeks), and T5 (8 weeks) under constant 100-gm buccal tipping force. Opposite premolars were used as controls. Teeth were extracted at T5, followed by quantification of external root resorption volume and histological analysis. In the test group, T5/T0 ratios of CEMP-1 and DPP levels, differential CEMP-1 levels between T5 and T0, and differential DPP levels between T2 and T0 correlated positively with root resorption volume (r = 0.734, 0.730, 0.627, and 0.612, respectively, all p < 0.05). CEMP-1 levels at T0 and T3 correlated negatively with root resorption volume (r = −0.603 and −0.706; all p < 0.05). CTX-I levels at T5 correlated positively with the amount of tooth movement (r = 0.848, p < 0.01). Alterations in CEMP-1 and DPP levels in human GCF at specific timepoints during orthodontic treatment may be associated with different degrees of external root resorption. This study demonstrates that changes in the levels of tissue-specific biomarkers in GCF may facilitate early detection of external root resorption during orthodontic tooth movement.

Becker’s nevus is a relatively common skin lesion with brown hyperpigmentation and hypertrichosis. It may be expressed simultaneously with other cutaneous, muscular, or skeletal defects, such as hypoplasia of the breast or scoliosis, for which the term “Becker’s nevus syndrome” has been proposed. An 8-year-old boy presented with a Becker’s nevus on the right cheek, chin, and upper neck with alveolar bone hypertrophy in the anterior mandible, which led to an anterior crossbite and severe canting of the mandibular anterior teeth. Through orthopedic treatment using a face mask, the anteroposterior jaw relationship was improved. In phase 2 treatment, we corrected the canting of the mandibular anterior teeth with a segmental intrusion of the mandibular anterior right teeth into the hypertrophic alveolar bone area. The facial profile was improved along with acceptable occlusion, and the treatment result was stable at 1 year after the end of the treatment, without any periodontal attachment loss, root resorption of mandibular anterior teeth, or increase in the size of the hypertrophic region. This case report describes the successful comprehensive treatment of a growing patient with skeletal Class III malocclusion and multiple characteristics of Becker’s nevus syndrome.

Objectives To date, the clinical stability of dual-thread orthodontic miniscrews has not been studied. This study aimed to compare the primary stability and long-term clinical success rate of dual-thread and cylindrical orthodontic miniscrews and to examine the association between various clinical factors and the success rate of miniscrews. Materials and Methods A total of 145 cylindrical and 135 dual-thread miniscrews were inserted in the maxillary and mandibular buccal alveolar areas of 142 patients. The torque and Periotest (Siemens, Bensheim, Germany) values were recorded during insertion and removal. The effect of clinical variables such as sex, age, screw design, jaw, side of placement, root proximity, and site of placement on the success rate was examined using logistic regression analysis. Results There was no statistically significant difference (P = .595) in the overall clinical success rate between the two designs, with an overall success rate of 82.1% and 84.4% for the cylindrical and dual-thread miniscrews, respectively. Age and screw-root proximity were significantly associated with failure (P < .05). Conclusions The dual-thread miniscrews did not show superior long-term stability and clinical success rate as compared with the cylindrical miniscrews. The results of this study suggest that patient age and screw-root proximity influence the clinical success rate of miniscrews.

This study sought to test the feasibility of a newly developed plane called computed modified absolute mandibular midsagittal plane (cmAMP) based on the similarity index (SI) for evaluating the stereoscopical symmetry of the mandible by comparison with other proposed midsagittal planes. This study involved 29 adult patients (15 men, 14 women, average age, 23.1 &plusmn, 6.9 years) with skeletal Class III facial asymmetry who underwent bimaxillary orthognathic surgery. Using cone-beam computed tomography images taken before and 1 year after surgery, cmAMP with the highest SI value between the two anterior segments of the hemi-mandible was set by a computer algorithm. Results show that the SI using cmAMP had the highest value (0.83 &plusmn, 0.04) before surgery compared to the other midsagittal planes, and was not significantly different from the SI (0.80 &plusmn, 0.05) using a facial midsagittal plane (MSP) after surgery. The distance (1.15 &plusmn, 0.74 mm) and angle (2.02 &plusmn, 0.82&deg, ) between MSP and cmAMP after surgery were significantly smaller than those between MSP and other midsagittal planes. In conclusion, the cmAMP plane best matches the two anterior segments of hemi-mandible symmetrically and is the closest to MSP after orthognathic surgery in skeletal Class III patients with facial asymmetry.

The plane formed by the intersection of bilateral porions (PoR and PoL) and left orbitale (OrL) is conventionally defined as the Frankfort horizontal (FH) plane. We aim to test the influence of the FH plane definition on a 3D cephalometric assessment. We selected 38 adult patients (20 males, 18 females, average age: 22.87 &plusmn, 5.17 years) without any gross asymmetry from retrospective records and traced and analyzed their cone-beam computed tomographic images. The findings were categorized into the following four groups: FH1: conventional, FH2: PoR, PoL, right orbitale (OrR), FH3: OrR, OrL, PoL, FH4: OrR, OrL, PoR. The average menton (Me) deviation from the MSP was statistically significant for the FH1 group (0.56 &plusmn, 0.27 mm, p &lt, 0.001), compared to the FH3 (1.37 &plusmn, 1.23 mm) and FH4 (1.33 &plusmn, 1.16 mm) groups. The spatial orientation level (SOL) of the FH plane showed a marked difference (p &lt, 0.05) between the FH2 (0.602&deg, &plusmn, 0.503&deg, ) and FH4 (0.944&deg, 0.778&deg, ) groups. The SOL of the MSP was comparatively small (p &lt, 0.001) for FH2 (0.015&deg, 0.023&deg, ) in comparison to both FH 3 (0.644&deg, 0.546&deg, ) and FH 4 (0.627&deg, 0.516&deg, ). Therefore, the FH plane definition can significantly influence the interpretation of cephalometric findings. Future studies should focus on standardization to improve the reliability and reproducibility of 3D cephalometry.

Flowable resins used for dental restoration are subject to biofilm formation. Zinc has antibacterial properties. Thus, we prepared a zinc-doped phosphate-based glass (Zn-PBG) to dope a flowable resin and evaluated the antibacterial activity of the composite against Streptococcus mutans (S. mutans) to extrapolate the preventative effect toward secondary caries. The composites were prepared having 0 (control), 1.9, 3.8, and 5.4 wt.% Zn-PBG. The flexural strength, elastic modulus, microhardness, depth of cure, ion release, inhibition zone size, and number of colony-forming units were evaluated and analyzed using ANOVA. The flexural strength of the control was significantly higher than those of Zn-PBG samples (p &lt, 0.05). However, all samples meet the International Standard, ISO 4049. The microhardness was not significantly different for the control group and 1.9 and 3.8 wt.% groups, but the 5.4 wt.% Zn-PBG group had a significantly lower microhardness (p &lt, 0.05). Further, the composite resins increasingly released P, Ca, Na, and Zn ions with an increase in Zn-PBG content (p &lt, 0.05). The colony-forming unit count revealed a significant reduction in S. mutans viability (p &lt, 0.05) with increase in Zn-PBG content. Therefore, the addition of Zn-PBG to flowable composite resins enhances antibacterial activity and could aid the prevention of secondary caries.

Since pits and fissures are the areas most commonly affected by caries due to their structural irregularity, bioactive resin-based sealant (RBS) may contribute to the prevention of secondary caries. This study aims to investigate the mechanical, physical, ion-release, enamel remineralisation, and antibacterial capabilities of the novel RBS with bioactive glass (BAG) and 2-methacryloyloxyethyl phosphorylcholine (MPC). For the synthesis, 12.5 wt% BAG and 3 wt% MPC were incorporated into RBS. The contact angle, flexural strength, water sorption, solubility, and viscosity were investigated. The release of multiple ions relating to enamel remineralisation was investigated. Further, the attachments of bovine serum albumin, brain heart infusion broth, and Streptococcus mutans on RBS were studied. Finally, the thickness and biomass of a human saliva-derived microsm biofilm model were analysed before aging, with static immersion aging and with thermocycling aging. In comparison to commercial RBS, BAG+MPC increased the wettability, water sorption, solubility, viscosity, and release of multiple ions, while the flexural strength did not significantly differ. Furthermore, RBS with MPC and BAG+MPC significantly reduced protein and bacteria adhesion and suppressed multi-species biofilm attachment regardless of the existence of aging and its type. The novel RBS has great potential to facilitate enamel remineralisation and suppress biofilm adhesion, which could prevent secondary dental caries.

The surface molecular chemistry, such as amine functionality, of biomaterials plays a crucial role in the osteogenic activity of relevant cells and tissues during hard tissue regeneration. Here, we examined the possibilities of creating amine functionalities on the surface of titanium by using the nonthermal atmospheric pressure plasma jet (NTAPPJ) method with humidified ammonia, and the effects on human mesenchymal stem cell (hMSC) were investigated. Titanium samples were subjected to NTAPPJ treatments using nitrogen (N-P), air (A-P), or humidified ammonia (NA-P) as the plasma gas, while control (C-P) samples were not subjected to plasma treatment. After plasma exposure, all treatment groups showed increased hydrophilicity and had more attached cells than the C-P. Among the plasma-treated samples, the A-P and NA-P showed surface oxygen functionalities and exhibited greater cell proliferation than the C-P and N-P. The NA-P additionally showed surface amine-related functionalities and exhibited a higher level of alkaline phosphatase activity and osteocalcin expression than the other samples. The results can be explained by increases in fibronectin absorption and focal adhesion kinase gene expression on the NA-P samples. These findings suggest that NTAPPJ technology with humidified ammonia as a gas source has clinical potential for hard tissue generation.

This study aims to compare the torque values for various lengths of the titanium-based orthodontic anchor screw (OAS), different anchorage methods and varying artificial bone densities after predrilling. Furthermore, the effects of these parameters on bone stability are evaluated. A total of 144 OASs were prepared with a diameter of 1.6 mm and heights of 6, 8 and 10 mm. Artificial bones were selected according to their density, corresponding to Grades 50, 40 and 30. Torque values for the automatic device and manual anchorage methods exhibited a statistically significant difference for the same-sized OAS, according to the bone density of the artificial bones (p &lt, 0.05). However, when insertion torque was at the maximum rotations, there was no significant difference in the torque values for the Grade 30 artificial bone (p &gt, 0.05). When the torque values of both anchorage methods were statistically compared with the mean difference for each group, the results of the manual anchorage method were significantly higher than those of the automatic device anchorage method (p &lt, 0.05). A statistically significant difference was observed in the bone stability resulting from different OAS anchorage methods and artificial bone lengths. These findings suggest that the automatic anchorage method should be used when fixing the OAS.

Prevention of dental caries is a key research area, and improvement of the pit and fissure sealants used for caries prevention has been of particular interest. This report describes results of incorporating a zwitterion, sulfobetaine methacrylate (SB), into photo-polymerized resin-based sealants to enhance resistance to cariogenic bacteria and protein adhesion. Varying amounts (1.5&ndash, 5 wt%) of SB were incorporated into a resin-based sealant, and the flexural strength, wettability, depth of cure, protein adhesion, bacterial viability, and cell cytotoxicity of the resultant sealants were evaluated. The flexural strength decreased with the increasing SB content, but this decrease was statistically significant only for sealants containing &ge, 3 wt% SB. Incorporating a zwitterion led to a significant reduction in the water contact angle and protein adhesion. The colony-forming unit count showed a significant reduction in the bacterial viability of S. mutans, which was confirmed with microscopic imaging. Moreover, cell cytotoxicity analysis of SB-modified sealants using an L929 fibroblast showed a cytotoxicity comparable to that of an unmodified control, suggesting no adverse effects on the cellular metabolism upon SB introduction. Hence, we conclude that the addition of 1.5&ndash, 3 wt% SB can significantly enhance the inherent ability of sealants to resist S. mutans adhesion and prevent dental caries.

It is essential for 3D-printed intra-oral appliances to be able to withstand the mechanical and microbial insult existent in the harsh environment of the oral cavity. Poly(methyl methacrylate) (PMMA)-based appliances are widely used in dentistry. Hence, the present study aimed to evaluate the role of nanodiamonds (NDs) as fillers to enhance the resistance to friction and wear. Using a solution-based mixing technique, 0.1 wt% ND was incorporated into the PMMA, and specimens were 3D-printed for tribological and bacterial analysis. The control specimens without ND fillers were tested against specimens with both amine-functionalized NDs (A-ND) and pure non-functionalized NDs (ND). The surface hardness test revealed a statistically significant increase in the Vickers micro-hardness (p 0.001) in the nanocomposite groups. There was a significant reduction in the coefficient of friction (COF) (p 0.01) in both the ND and A-ND nanocomposites compared to the stainless steel (SS) counter surfaces. However, for titanium (Ti)-based specimens, the COF of the control group was similar to that of A-ND but lower than that of ND. The wear resistance evaluation revealed that both the ND and A-ND groups displayed enhanced resistance to surface loss in comparison to the controls for both SS and Ti counter-surfaces (p 0.001). Furthermore, both A-ND and ND exhibited significantly enhanced resistance to the formation of Streptococcus mutans biofilms after 48 h (p 0.01) compared to the control group. Hence, we concluded that the addition of 0.1 wt% ND in the PMMA-based resin for 3D printing resulted in significant improvement in properties such as COF, wear resistance, and resistance to S. mutans, without any notable impact associated with the functionalization of the NDs.

Purpose The aim of the present study was to compare the long-term stability of bimaxillary surgery using an intraoral vertical ramus osteotomy (IVRO) with and without presurgical orthodontic treatment. Materials and Methods The present retrospective study included 31 consecutive patients with skeletal Class III malocclusions who had undergone bimaxillary surgery (Le Fort I osteotomy and bilateral IVRO). Patients were divided into 2 groups based on treatment type: pre-orthodontic orthognathic surgery (POGS; n = 17) and conventional surgery with presurgical orthodontic treatment (CS; n = 14). Lateral cephalograms were obtained before surgery, 1 day after surgery, 1 month after surgery, 1 year after surgery, and 2 years after surgery to evaluate skeletal and soft tissue changes between the 2 groups. Data were analyzed using χ2 tests, Mann-Whitney U tests, repeated-measures analyses of variance, and independent t tests. Results There was no significant difference in skeletal or soft tissue measurements—with the exception of the angle between the sella-and-nasion plane and the occlusal plane (SN-OP; P Conclusions These findings suggest that POGS and CS have similar long-term stability in patients with skeletal Class III malocclusion.

Herein we evaluate the effect of nanodiamond (ND) incorporation on the mechanical properties of poly(methyl methacrylate) (PMMA) nanocomposite. Three quantities of ND (0.1, 0.3, and 0.5 wt.%) were tested against the control and zirconium oxide nanoparticles (ZrO). Flexural strength and elastic modulus were measured using a three-point bending test, surface hardness was evaluated using the Vickers hardness test, and surface roughness was evaluated using atomic force microscopy (AFM), while fungal adhesion and viability were studied using Candida albicans. Samples were also analyzed for biofilm thickness and biomass in a saliva-derived biofilm model. All groups of ND-PMMA nanocomposites had significantly greater mean flexural strengths and statistically improved elastic modulus, compared to the control and ZrO groups (P &lt, 0.001). The Vickers hardness values significantly increased compared to the control group (P &lt, 0.001) with 0.3% and 0.5% ND. ND addition also gave significant reduction in fungal adhesion and viability (P &lt, 0.001) compared to the control group. Finally, salivary biofilm formation was markedly reduced compared to the ZrO group. Hence, the incorporation of 0.1&ndash, 0.5 wt.% ND with auto- polymerized PMMA resin significantly improved the flexural strength, elastic modulus, and surface hardness, and provided considerable fungal resistance.

Objective The aim of this study was to evaluate the stress distribution and displacement of various craniofacial structures after nonsurgical rapid palatal expansion (RPE) with conventional (C-RPE), bone-borne (B-RPE), and miniscrew-assisted (MARPE) expanders for young adults using three-dimensional finite element analysis (3D FEA). Methods Conventional, bone-borne, and miniscrew-assisted palatal expanders were designed to simulate expansion in a 3D FE model created from a 20-year-old human dry skull. Stress distribution and the displacement pattern for each circumaxillary suture and anchor tooth were calculated. Results The results showed that C-RPE induced the greatest stress along the frontal process of the maxilla and around the anchor teeth, followed by the suture area, whereas B-RPE generated the greatest stress around the miniscrew, although the area was limited within the suture. Compared with the other appliances, MARPE caused relatively even stress distribution, decreased the stress on the buccal plate of the anchor teeth, and reduced tipping of the anchor teeth. Conclusions The findings of this study suggest that the incorporation of miniscrews in RPE devices may contribute to force delivery to the sutures and a decrease in excessive stress on the buccal plate. Thus, MARPE may serve as an effective modality for the nonsurgical treatment of transverse maxillary deficiency in young adults.

This retrospective observational study aimed to examine the correlation and correspondence between skeletal maturation indicators (SMI), cervical vertebral maturation indicators (CVMI), and radius-ulna-short bones (RUS) skeletal maturity scores in Korean adolescents, and to determine whether easily obtainable SMI or CVMI can replace the RUS skeletal maturity score. A total of 1017 participants were included with both hand-wrist radiograph and lateral cephalogram acquired concurrently. From the lateral cephalogram, CVMI was determined, through the hand-wrist radiograph, SMI was categorized, and the RUS skeletal maturity score was evaluated as well. Associations were examined using the Mann–Whitney U test, Spearman’s rank-order correlation analysis, and multiple correspondence analysis. There was no statistically significant difference in chronological age between males and females, however, the SMI, CVMI, and RUS skeletal maturity scores were significantly higher in females. The SMI, CVMI, and RUS skeletal maturity scores showed a statistically significant strong degree of both positive correlation and correspondence. However, a precisely corresponding RUS skeletal maturity score was difficult to obtain for a specific CVMI and SMI stage, implying the absence of a quantitative correlation. In conclusion, detailed evaluation should be conducted using the RUS skeletal maturity score, preferably in cases that require bone age determination or residual growth estimation.

Summary Assessing changes in patient's psychological health and oral health-related quality of life (OHRQoL) over time during orthodontic treatment may help clinicians to treat patients more carefully. To evaluate changes in mental health, self-reported masticatory ability and OHRQoL during orthodontic treatment in adults, this prospective study included 66 adults (30 men, 36 women; mean age, 24·2 ± 5·2 years). Each patient completed the Korean versions of the State–Trait Anxiety Inventory, Zung Self-Rating Depression Scale, Rosenberg self-esteem scale, key subjective food intake ability (KFIA) test for five key foods and Oral Health Impact Profile-14 (OHIP-14K) at baseline (T0), 12 months after treatment initiation (T1) and debonding (T2). All variables changed with time. Self-esteem and the total OHIP-14K score significantly decreased and increased, respectively, at T1, with a particular increase in the psychological and social disabilities scores. There were no significant differences in any questionnaire scores before and after treatment. The total OHIP-14K score was positively correlated with trait anxiety and depression, and negatively correlated with self-esteem and KFIA at T0, regardless of the treatment duration. Older patients showed a significant increase in the total OHIP-14K score at T1 and T2. OHRQoL worsened with an increase in the treatment duration. Our results suggest that OHRQoL temporarily deteriorates, with the development of psychological and social disabilities, during orthodontic treatment. This is related to the baseline age, psychological health and self-reported masticatory function. However, patients recover once the treatment is complete.

OBJECTIVE The purpose of this study was to compare the changes induced in the pharyngeal airway space by orthodontic treatment with bodily retraction of the mandibular incisors and mandibular setback surgery without extraction. METHODS This retrospective study included 63 adult patients (32 men and 31 women). Thirty-three patients who had been treated via four-bicuspid extraction and bodily retraction of the mandibular incisors (incisor retraction, IR group) were compared with 30 patients who had been treated via mandibular setback surgery (MS group) without extraction. Lateral cephalograms were acquired and analyzed before (T1) and after treatment (T2). RESULTS The superior pharyngeal airway space did not change significantly in either group during treatment. The middle pharyngeal airway space decreased by 1.15 ± 1.17 mm and 1.25 ± 1.35 mm after treatment in the IR and MS groups, respectively, and the decrease was comparable between the two groups. In the MS group, the inferior pharyngeal airway space (E-IPW) decreased by 0.88 ± 1.67 mm after treatment (p < 0.01). The E-IPW was larger in the MS group than in IR group at T1, but it did not differ significantly between the two groups at T2. No significant correlation was observed between changes in the pharyngeal airway space and the skeletal and dental variables in each group. CONCLUSIONS The middle pharyngeal airway space decreased because of the posterior displacement of the mandibular incisors and/or the mandibular body. The E-IPW decreased only in the MS group because of the posterior displacement of only the mandibular body.

The application of 3D imaging is at its cusp in craniofacial diagnosis and treatment planning. However, most applications are limited to simple subjective superimposition-based analysis. As the diagnostic accuracy dictates the precision in operability, we propose a novel method that enables objective clinical decision making for patients with mandibular asymmetry. We analyzed cone-beam computed tomography (CBCT) scans of 34 patients who underwent surgical correction for mandibular asymmetry using a high-throughput computing algorithm. Radiomic segmentation of quantitative features of surface and volume followed by exploration resulted in identification of a computed modified absolute mandibular midsagittal plane (cmAMP). Tomographic similarity scan (ToSS) curves were generated via bilateral equidistant scanning in an antero-posterior direction with cmAMP as the reference. ToSS comprised of a comprehensive similarity index (SI) score curve and a segment-wise volume curve. The SI score was computed using the Sørensen-Dice similarity coefficient ranging from 0 to 1. The volumetric analysis was represented as the non-overlapping volume (NOV) and overlapping volume (OV) for each segment, with two segmentation lines, at the mental foramen anteriorly and the intraoral vertical ramus osteotomy region posteriorly. Statistical analysis showed strong negative correlation between the NOV and SI scores for the anterior, middle, and total mandible (P 0.001). Additionally, a significant correlation was observed between the change in the SI scores for anterior (P = 0.044) and middle segments (P 0.001) to the total mandible when comparing the data before and after the surgery. This work demonstrated the potential of incorporating ToSS curves in surgical simulation software to improve precision in the clinical decision-making process.