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This study aims to introduce a new sagittal cephalometric measurement, the sagittal G-triangle analysis, to accurately and reproducibly assess the sagittal jaw relationship. Sagittal G-triangle analysis, which consists of angles AXK and BXK, is based on an equilateral triangle (Bo-X-K) constructed using 5 cephalometric landmarks (Ba, Bo, Po, Or, and G). To test the diagnostic efficiency of this analysis, pretreatment cephalometric radiographs of 120 female and 120 male Chinese patients were randomly selected. For each enlisted subject, angles SNA and SNB as well as angles AXK and BXK were measured and recorded. On the basis of the SNA and SNB results, subjects were categorized into 6 groups: maxillary retrognathism, normal maxilla, maxillary prognathism, mandibular retrognathism, normal mandible, and mandibular prognathism. The diagnostic efficiency of angles AXK and BXK were evaluated using various statistical tests. A high correlation was detected between angles SNA and AXK as well as between angles SNB and BXK. Female patients with angle AXK between -2.255° and 2.860° and male patients with angle AXK between -2.615° and 2.120° were considered to have a normal maxilla position. Female patients with angle BXK between -2.61° and 2.93° and male patients with angle BXK between -2.275° and 0.610° were considered to have a normal mandible position. In conclusion, sagittal G-triangle analysis could be used as an alternative method for the evaluation of the sagittal position of the maxilla and mandible in cephalometric analysis.

Background Although, the outcomes and changes in the maxillofacial complex after the application of intraoral bone anchored Class III elastics, have been reported by multiple clinical studies, there was no finite element study to assess and evaluate the stress pattern and displacement on maxillomandibular complex with bimaxillary anchorage. The present study aims to evaluate the biomechanical effects on maxillomandibular complex of Skeletally anchored Class III elastics with varying angulations using the 3D finite element analysis. Methodology Two 3-dimensional analytical models were developed using the Mimics 8.11 (Materialise: Leuven, Belgium) and ANSYS software Version 12.1 (ANSYS Inc, Canonsburg, PA, USA) from sequential computed tomography images taken from a Skeletal Class III subject. The models were meshed into 465,091 tetrahedral elements and 101,247 nodes. Intraoral mechanics for skeletally anchored maxillary protraction (I-SAMP) were applied on two models i.e. A and B (without and with maxillary expansion respectively) between miniplates on maxilla and mandible on both right and left sides with three different angulations of forces—10°, 20° and 30°). Results Although the craniomaxillary complex in both the models (A and B) displaced forward while demonstrating rotations in opposite directions, the displacements and rotations decreased gradually with the increase of the angle of load application from 10° to 30°. The mandible rotated clockwise in both the simulations, but the displacement of mandibular surface landmarks was higher in Simulation A. However, the antero-inferior displacement of the glenoid fossa was higher in Simulation B than in A. Conclusion Significant displacement of maxillofacial sutures and structures was witnessed with I-SAMP with maxillary expansion and Class III elastics for correction of Skeletal Class III with maxillary retrognathism. Thus, I-SAMP with maxillary expansion is a desired protocol for treatment of maxillary retrognathism. However, the prescribed angulation of the Class III elastics should be as low as possible to maximise the desired effects.

This case report describes the successful surgical treatment of a patient diagnosed with obstructive sleep apnea (OSA). A 55-year-old Caucasian male patient with a body mass index (BMI) of 25.6 kg/m2 sought treatment with a chief concern of excessive daytime sleepiness and fatigue. An initial polysomnography report showed moderate OSA with an apnea-hypopnea index (AHI) of 21.2 events/h, and Epworth Sleepiness Score (ESS) of 12/24. The patient was initially prescribed with CPAP treatment but was unable to tolerate treatment after a few months. Clinical and radiographic examination revealed a concave facial profile with maxillary retrognathism. Intraoral examination revealed generalized gingival recession, missing upper lateral incisors and lower first premolars, anterior crossbite, and maxillary transverse deficiency with bilateral posterior crossbite. The lateral cephalogram showed a narrow posterior airway space at the level of the base of the tongue. The patient was treated with maxillomandibular advancement (MMA) surgery to improve airway obstruction. Results showed balanced facial esthetic and stable occlusion with a complete resolution of the patient’s OSA and a post-operative improvement of AHI from 21.2 to 0.7 events/h and ESS from 12/24 to 3/24. The lowest oxyhemoglobin saturation during sleep was improved to 97%, and the BMI decreased from 25.6 to 25.2 kg/m2. These results suggest that MMA surgical procedure can be used as a definitive treatment for patients with maxillomandibular deficiency and OSA.

Two 8-week-old Finnish Lapphund dogs presented with pain on manipulation, abnormal long bone conformation, retrognathism, and stunted growth compared to their litter mates. Multiple long bone fractures were evident on radiographs. Clinical pathology showed an atypically normal serum alkaline phosphatase activity for dogs this age. Due to poor quality of life, the dogs were humanely euthanized and subjected to a complete necropsy. On necropsy, all bones were soft and easily broken. Histologic examination revealed that the secondary spongiosa was diminished with abnormal bony trabeculae embedded in abundant loose vascular stroma. No Haversian canals were observed and the cortices contained abundant woven bone separated by fibrovascular tissue consistent with the diagnosis of osteogenesis imperfecta (OI). Inbreeding of the sire and female offspring led to a suspicion of recessive inheritance and the particular genetic collagen disorder remains to be identified in this breed.

The orientation of the occlusal plane (OP) influences the functional and esthetic balance of the face. We report on two patients for which the careful consideration of OP angulation from diagnosis to treatment planning aided in achieving a superior esthetic correction and improved stability. In both surgical patients, adequate presurgical control of the OP facilitated the surgical correction with a rotation of the OP. The results showed a better esthetic outcome and improved orientation of the musculoskeletal relation. Therefore, in severe mandibular prognathism or retrognathism, adequate planning of the OP orientation is of high significance.

Introdu??o: A Apn?ia Obstrutiva do Sono (AOS) ? um dist?rbio do sono que atinge crian?as e adolescentes, com consequ?ncias na sa?de sist?mica e desenvolvimento craniofacial. Impacta diretamente na qualidade de vida do indiv?duo, assim como na economia. Identificar e tratar a apn?ia ? especialmente importante em crian?as, nas quais o complexo craniofacial est? em cont?nuo crescimento e desenvolvimento, momento oportuno para corre??es de altera??es dento-esquel?ticas. De origem multifatorial, deve ser tratada multidisciplinarmente. Anormalidades de crescimento, complica??es cardiovasculares, neurocomportamentais, inflamat?rias/metab?licas e comorbidades neurocognitivas s?o consequ?ncias da AOS. Os tratamentos, na inf?ncia, incluem adenotonsilectomia, farmacoterapia, terapia miofuncional e Press?o Positiva Cont?nua nas Vias A?reas (CPAP), todos com limita??es importantes, o que t?m levado ? busca de alternativas terap?uticas. Aparelhos orais t?m sido experimentados no tratamento da AOS em crian?as, especificamente os de Expans?o R?pida da Maxila e de Avan?o Mandibular, entre eles os Ortop?dicos Funcionais dos Maxilares. Estes visam remodela??o ?ssea e mudan?a da forma, redirecionando for?as naturais como erup??o/crescimento e mudan?a de postura de l?ngua e de mand?bula. S?o eficazes no tratamento de maloclus?es e reorientam o crescimento maxilomandibular. O uso dos aparelhos Ortop?dicos Funcionais dos Maxilares pode representar um tratamento eficaz, menos invasivo e melhor tolerado do que outras modalidades dispon?veis para pacientes com AOS e altera??es craniofaciais. Objetivo: Revisar sistematicamente na literatura, a efic?cia dos Aparelhos Ortop?dicos Funcionais dos Maxilares, no tratamento de crian?as e/ou adolescentes com AOS, em rela??o ? ?ndice de Apn?ia e Hipopn?ia (IAH) e Satura??o de Oxig?nio (SaO2) m?nima em porcentagem, na Polissonografia (PSG). Tamb?m a verifica??o de sintomas no question?rio validado Obstructive Sleep Apnea?18 (OSA-18), para avalia??o de Apn?ia em crian?as. A compara??o, relacionando pacientes do grupo de tratados, comparados ? pacientes sem tratamento ou, somente os tratados, intragrupo, pr? e p?s tratamento com Ortopedia Funcional dos Maxilares. M?todos: Esta revis?o sistem?tica e meta-an?lise seguiu as normas do PRISMA 2020 e tem o n?mero de protocolo CRD42021253341 como registro no PROSPERO. A busca na literatura aconteceu em Outubro de 2021 e foi atualizada at? maio de 2022, nas bases de dados: MEDLINE (via PubMed), BVS (LILACS e BBO), ISI of knowledge (via Web of Science), SciELO (via Web of Science), COCHRANE, EMBASE (Elsevier), SCOPUS, WHO e literatura cinzenta. Foram inclu?dos estudos com crian?as e adolescentes at? 16 anos de idade, portadores de S?ndrome da Apn?ia e Hipopneia Obstrutiva do Sono (SAHOS). Esta, diagnosticada por PSG. Tratamento com Aparelhos Ortop?dicos Funcionais (AOF). Compara??o entre grupo tratado com grupo controle (sem tratamento), ou mesmos pacientes antes e depois do tratamento (intragrupo). Desfecho prim?rio foi avalia??o do IAH por hora do sono vista na PSG. Secund?rios foram SaO2 m?nima, vista em porcentagem, tamb?m em PSG, al?m de avalia??o dos escores do question?rio validado OSA-18 (para diagn?stico e acompanhamento de crian?as com apn?ia). A sele??o dos estudos foi realizada por dois revisores independentes e, aplicado como an?lise de concord?ncia entre revisores, Teste Cohen Kappa. Estudos selecionados foram submetidos a uma an?lise mediante tabela de extra??o de dados. Ap?s dados extra?dos, a qualidade de ensaios Cl?nicos (ECs) foi avaliada por meio de Lista m?todo Delphi e as coortes por meio da Escala de Newcastle-Ottawa. Na sequ?ncia, foi analisado risco de vi?s e, para Ensaios Cl?nicos Randomizados, usada a ferramenta para Risco de Vi?s da Cochrane. Para os ensaios cl?nicos n?o randomizados, foi usado RoBANS e, para os estudos de coorte foi usada a ferramenta de Risco de vi?s para estudos observacionais da Cochrane. A meta-an?lise foi realizada no software ?R?, usando como medida de frequ?ncia a m?dia com desvio padr?o, cuja medida de associa??o foi a diferen?a de m?dia Standardized Mean Difference (SMD). A representa??o gr?fica foi por meio de gr?ficos forest plot. Para c?lculo de heterogeneidade dos estudos foi usada estat?stica I2. Foram usados Intervalo de confian?a (IC) de 95% e modelos de efeito fixo e aleat?rio. Resultados: dos 4860 artigos selecionados na busca, 34 ficaram para revis?o sistem?tica e destes, 9 foram usados em meta-an?lises, al?m de 90, que tiveram como fonte as refer?ncias dos artigos selecionados das buscas. Em modelo fixo, para IAH, as 4 meta-an?lises realizadas foram estatisticamente significativas (tratamento diminuiu IAH), e para aleat?rio, 2 destas. Para SaO2, no fixo, 1 das duas realizadas foi significativa (tratamento aumentou satura??o m?nima de oxig?nio em porcentagem) e, para o aleat?rio n?o houve signific?ncia. Para o escore do OSA-18 as duas meta-an?lises realizadas foram estatisticamente significativas (tratamento reduziu os escores de sintomas, para ambos os modelos, fixo e aleat?rio. Mas, mesmo as an?lises que n?o foram estatisticamente significativas, apresentaram o diamante deslocado para o lado que o tratamento favorece o referido desfecho. Em porcentagem de resposta, o IAH, em todas as combina??es/compara??es realizadas, respondeu ao tratamento com melhora (redu??o no IAH), que variou de 51,30% a 58,89% no grupo tratado e, no controle (sem tratamento), houve piora (aumento no IAH), que variou de 28,43% a 39,43%. Para o desfecho da Satura??o, houve melhora (aumento) que variou de 4% a 9,49% em tratados e, para o controle tamb?m houve aumento, de 1,18%, portanto, em menor propor??o do que o grupo de tratados. Para o question?rio, houve melhora (redu??o) dos escores em 20,11% para grupo de tratados, enquanto que para o controle houve piora (aumento), no mesmo per?odo de tempo. As heterogeneidades variaram e 0 a 98%, e, por este motivo foram usados os efeitos fixo e aleat?rio. A qualidade dos artigos foi boa, embora com pontua??es variadas. E, n?o houve risco de vi?s, embora as pontua??es tenham sido diferentes entre os estudos avaliados. Conclus?o: O tratamento com Aparelhos Ortop?dicos Funcionais, ? apropriado e eficaz para crian?as e adolescentes portadores de SAHOS, desde que estes pacientes sejam diagnosticados, como poss?vel etiologia desta doen?a, a defici?ncia no crescimento e desenvolvimento do complexo maxilomandibular. Isto porque estas particularidades tendem a deixar as vias a?reas com menores dimens?es, contribuindo para a SAHOS. A Ortopedia Funcional dos Maxilares (OFM), auxilia tratando forma e fun??o do sistema estomatogn?tico, e, por consequ?ncia, amplia a qualidade de vida destes pacientes. Introduction: Obstructive Sleep Apnea (OSA) is a sleep disorder that affects children and teenagers with consequences in systemic health and craniofacial development, having an impact on the quality of life of the individual, as well as in the economy. Identify and treat apnea is most importantly in children, whose facial skull is in continued growth and development, being this the opportune time for corrections of dentoskeletal alterations. Its origins come from various factors, thus it must be treated multi disciplinarily. growth abnormalities, cardiovascular complications, neurobehavioral, inflammatory/metabolic and neurocognitive comorbidities are consequences of OSA. Treatments during childhood include adenotonsillectomy, pharmacotherapy, myofunctional therapy and Continuous Positive Airway Pressure (CPAP), all with important limitations, which have led to a search for therapeutic alternatives. Oral appliances have been tested on the treatment of OSA in children, specifically Rapid Maxillary Expansion and Mandibular Advancement, among these the Functional Orthopaedics, in their turn, aim at bone remodeling and the change in shape through redirect of natural forces such as eruption/growth, jaw and tongue posture change. They are effective in the treatment of malocclusions and re orient maxillomandibular growth. The use of Functional Orthopaedic Oral appliances may represent an effectice treatment, less invasive and better tolerated than others available for patients with OSA and craniofacial alterations. Objective: Systematically review in the literature the efficiency of the Functional Orthopaedic Oral Appliances on the treatment of children and/or teenagers with Obstructive Sleep Apnea (OSA), in relation to Apnea and Hypopnea Index (AHI) and minimum percentage of Oxygen Saturation, in the polysomnography (PSG), as well as an assessment of symptoms in the Obstructive Sleep Apnea-18 (OSA-18) validated questionnaire, for Apnea assessment in children, when compared to patients without treatment or only the treated patients, intra-group, before and after the treatment with Maxillary Functional Orthopaedic. Methods: This systematic review and meta-analysis outlined herein followed the standards of PRISMA 2020 and have the protocol number CRD42021253341 as registration in PROSPERO. Search in the literature took place in October 2021 and it was updated until May 2022, on the databases: MEDLINE (via PubMed), BVS (LILACS and BBO), ISI of knowledge (via Web of Science), SciELO (via Web of Science), COCHRANE, EMBASE (Elsevier), SCOPUS, WHO and grey literature. They were included studies with children and teenagers of up to 16 years of age bearer of the obstructive sleep apnea and hypopnea syndrome (OSAHS), diagnosed by polysomnography (PSG), treated with Functional Orthopaedic Oral Appliances and, compared the treated group with control group (without treatment) or same patients before and after treatment (intra-group). Primary outcome was the assessment of Apnea and Hypopnea Index (AHI) per sleep hour and, secondary, it was Minimum Oxygen Saturation (SaO2), seen in percentage, also in PSG, as well as scores assessment of the OSA-18 validated questionnaire (for diagnosis and follow up of children with apnea). The selection of the studies has been made by two independent assessors and, applied as analysis agreement between the assessors, Cohen Kappa Test. Selected studies have been submitted to an analysis through a data extraction table. After the extraction of data, the quaility of clinical tests (ECs) was assessed by means of List Method Delphi and the cohort studies by means of the Newcastle-Ottawa Scale. Subsequently, it was analysed bias risk and, for Random Clinical Tests, it was used the Cochrane tool for Bias Risk; for the non-random clinical tests, it was used RoBANS and, for the cohort studies it was used the Cochrane?s bias risk for observational studies tool. The meta-analysis was carried out in the ?R? software, using as frequency measurement the average with standard deviation, in which measurement of association was the difference of average Standardized Mean Difference (SMD), with graphic representation by means of forest plot graphs. For heterogeneity calculations of the studies, it was used I2 statistics. The outcomes were AHI, SaO2 and the OSA-18 questionnaire. It was used Confidence Interval of 95% and fixed and random effect models. Results: Of the 4860 selected articles in the Search, 34 were left for systematic review ando f those, 9 were used in meta-analyses, in addition to 90, whose purpose were the references of the articles selected in the searches. In the fixed model, for AHI, the four meta-analysis carried out were statistically significant (the treatment reduced AHI), and in the random model, two of them. For SaO2, in the fixed model, one of the two carried out was significant (the treatment increased minimum oxygen saturation in percentage) and for the random there has been no significance. For the OSA-18 score the two meta-analysis carried out were statistically significant (the treatment reduced the scores of symptoms for both fixed and random models). However, even the analysis which were not statistically significant, they showed the results of statistics (diamond) significantly more displaced to the side that the treatment favours the aforementioned outcome. In percentage of response, the AHI in all combinations / comparisons carried out responded to the treatment with an improvement (reduction in AHI) that varied from 51,30% to 58,89% in the treated group and, in the control group (without treatmet) there was a worsening (increase in AHI) that varied from 28,43% to 39,43%. For the outcome of the Saturation, there has been improvement (increase) that varied from 4% to 9,49% in the treated and for the control group there has also been increase of 1,18% so in a smaller proportion than the treated group. For the questionnaire, there has been improvement (reduction) on the scores in 20,11% in the treated group, whereas in the control group there has been worsening (increase) in the same period of time. Heterogeneities varied bewteen 0 to 98% and for this reason, it has been used the fixed and random effects. The quality of the articles was good, although with varied scoring. There has been no risk of bias, although the scores have been different between the studies assessed. Conclusion: Treatment with Functional Orthopaedic Oral Appliances is appropriate and effective for children and teenagers bearer of the Obstructive Sleep Apnea and Hypopnea Syndrome (OSAHS), as long as these patients are diagnosed, as a possible etiology of the OSAHS, the deficiency on the development and growth of the maxillomandibular complex, such particularities that tend to leave the airways smaller, this way contributing to OSAHS. The Functional Orthopaedics aids treating the shape and function of stomatognathic system and, as a result, expanding the quality of life of these patients. Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES

BACKGROUND The myosin 1H (MYO1H) gene, located on chromosome 12, encodes the unconventional MYO1H protein, which is involved in the intracellular movement and morphology of chondrocytes, and plays a vital role in the prognathism or retrognathism of the mandible. OBJECTIVES The objective of this study was to assess the relationship between the polymorphisms of the MYO1H gene and mandibular prognathism in the Iranian population. MATERIAL AND METHODS The current project evaluated 64 patients with mandibular prognathism requiring orthognathic surgery and 60 controls with skeletal class I occlusion. Genome amplification was performed using specific primer pairs to assess the rs10850110 and rs11611277 polymorphisms of the MYO1H gene through the polymerase chain reaction (PCR). The restriction fragment length polymorphism (RFLP) technique was used to detect single-nucleotide polymorphisms. The data was analyzed using the χ2 test. RESULTS The patient and control groups were not significantly different in terms of age or gender (p > 0.05). In all, 3.1% of patients and 6.7% of controls had the rs10850110 polymorphism (p = 0.680), and 1.6% of patients and 5% of controls had the rs11611277 polymorphism (p = 0.602). CONCLUSIONS No significant correlation was noted between the rs10850110 and rs11611277 polymorphisms of the MYO1H gene and mandibular prognathism in the Iranian population. However, the lower frequency of these polymorphisms in the patient group suggests a possible association with mandibular retrognathism, which needs to be investigated with a larger sample size.

Introducción: En la maloclusión clase III con mordida cruzada anterior existe una alteración en la relación máxilo-mandibular: retrognatismo maxilar, prognatismo mandibular o combinada, esta desarmonía puede alterar la estética facial. Si se interviene a una edad temprana se puede lograr la normalidad de la funciones y armonía en la relación de los maxilares, llevando a mejorar la estética del paciente. Es importante tener en cuenta el factor etiológico para establecer un adecuado plan de tratamiento y lograr estabilidad a largo plazo. La etiología es multifactorial; hereditaria y ambiental (hábitos, agrandamiento de las amígdalas y postura mandibular). Existen varias opciones de tratamiento dependiendo de la edad como ortopedia maxilar, ortodoncia y cirugía ortognática. Caso clínico: se presenta una paciente de 9 años y 7 meses de edad, género femenino, con estrabismo, cuya madre consulta porque “se le está saliendo la mandíbula”; los hallazgos clínicos y cefalométricos determinan una maloclusión clase III con retrognatismo maxilar, mordida cruzada anterior, crecimiento vertical, respiración mixta con predominio nasal, deglución atípica y sigmatismo. El tratamiento que se realizó en este paciente fue en 2 fases: en la primera ortopedia mecánica con Hyrax y máscara facial de Delaire por 11 meses y en la segunda fase aparato de ortopedia funcional SN3 (pequeñas aletas inferiores). Conclusión: Los cambios obtenidos con máscara facial de Delaire se evidencian a nivel facial, dental y esquelético, sin comprometer la alteración de estrabismo que la paciente presenta y maneja con gafas.

Summary Class III malocclusion can be varied in presentation and progression. This report describes the presentation, course of treatment and long-term follow-up of two siblings with Class III malocclusion. Two cases discussed in this report were different in their presentation. Sibling 1, a 19-year-old male patient had developed skeletal Class III malocclusion with severe maxillomandibular discrepancy, showing both components of maxillary hypoplasia and mandibular prognathism & asymmetry with average growth pattern. Sibling 2, a 13-year-old male patient had developed a Class III malocclusion with maxillary retrognathism with vertical growth pattern. An insight into the similarities and dissimilarities in the presentation, course of treatment and long-term follow-up of the two cases is provided. The two cases were successfully managed with entirely different treatment approaches. Sibling 1 underwent maxillary advancement with Le Fort I surgery and mandibular set back and rotation with bilateral sagittal split osteotomy which was preceded by pre-surgical orthodontic treatment with extraction of upper first premolars for orthodontic decompensation. Sibling 2 was treated with skeletally anchored facemask therapy followed by fixed mechanotherapy. Acceptable clinical outcome with long-term stability of the treatment results was observed in the two siblings. Orthognathic surgery may be completely avoided later if early orthopaedic treatment to advance the maxilla is initiated at an appropriate age.

The aim of this retrospective study was to evaluate the skeletal, dental, and soft tissue effects of the alternating rapid maxillary expansions and constrictions (Alt-RAMEC) protocol combined with a facemask in prepubertal patients.The study group (mean age 9.74 ± 1.46 years) consisted of 20 patients with class III malocclusion characterized by maxillary retrognathism. They were treated with a facemask for 7 months following a 9‑week Alt-RAMEC protocol. Cone-beam computed tomography (CBCT) records and three-dimensional (3D) photographs taken before (T0) and after the protraction and retention period (T1) were evaluated. The study group was compared with a well-matched control group of 16 untreated patients (mean age 9.44 ± 0.79 years) with the same malocclusion. The records for the control group included cephalometric radiographs and 3D photographs.In the study group, significant forward movements of A point (3.49 mm), nasal (2.91 mm) and zygomatic bones were achieved. Intermolar, internasal, and interzygomatic widths increased. Soft tissue points followed the hard tissue movements, apart from b and pog. In the control group, A (0.97 mm), B (1.69 mm), Pog, and b points presented forward movement. Significant differences were found regarding the forward movement of the maxilla between the groups.The Alt-RAMEC/facemask protocol was effective not only in the maxillary region but also in the midface.ZWECK: Ziel dieser retrospektiven Studie war es, die skelettalen, dentalen und weichgewebigen Auswirkungen der alternierenden schnellen Gaumennahterweiterung und -konstriktion (Alt-RAMEC-Protokoll) in Kombination mit einer Gesichtsmaske bei präpubertären Patienten zu untersuchen.Die Studiengruppe (mittleres Alter 9,74 ± 1,46 Jahre) bestand aus 20 Patienten mit Klasse-III-Malokklusion mit retrognathem Oberkiefer. Sie wurden nach einem 9‑wöchigen Alt-RAMEC-Protokoll 7 Monate lang mit einer Gesichtsmaske behandelt. Digitale Volumentomographien (CBCT) und dreidimensionale (3D) Fotografien, die vor (T0) und nach der Protraktions- und Retentionszeit (T1) aufgenommen worden waren, wurden ausgewertet. Die Studiengruppe wurde mit einer gut abgestimmten Kontrollgruppe von 16 unbehandelten Patienten (Durchschnittsalter 9,44 ± 0,79 Jahre) mit der gleichen Malokklusion verglichen. Die Aufzeichnungen für die Kontrollgruppe umfassten kephalometrische Röntgenaufnahmen und 3D-Fotografien.In der Studiengruppe wurden signifikante Vorwärtsbewegungen von A‑Punkt (3,49 mm) sowie Nasen- (2,91 mm) und Jochbein erzielt. Die intermolaren, internasalen und interzygomatischen Abstände nahmen zu. Weichteilpunkte folgten den Hartgewebebewegungen, abgesehen von b und pog. In der Kontrollgruppe zeigten die Punkte A (0,97 mm), B (1,69 mm), Pog und b eine Vorwärtsbewegung. Bezüglich der Vorwärtsbewegung des Oberkiefers wurden signifikante Unterschiede zwischen den Gruppen festgestellt.Das Alt-RAMEC-Gesichtsmaske-Protokoll war nicht nur im Oberkieferbereich, sondern auch im Mittelgesicht wirksam.

This case report describes the successful treatment of a 25-year-old male with maxillary retrognathism, skeletal and dental Class III malocclusion, anterior and posterior crossbite, negative overjet and overbite, mild mandibular crowding, and lower midline deviation. The nonextraction treatment plan included: (1) maxillary and mandibular arch fixed appliance and (2) Le Fort 1 maxillary osteotomy and postsurgical orthodontic treatment. The orthodontic treatment was initiated with 0.022” preadjusted brackets bonded to all the teeth except the maxillary second molars, 2 days before the surgery without any archwires. Two weeks after the surgery, maxillary and mandibular arch alignment along with the occlusal adjustments was started with the use of 0.018” NiTi wires, in both arches. Optimum esthetic and functional results were achieved in 10 weeks after the surgery, with the cooperation of two specialties and the use of surgery first approach.

Introduction A skeletal Class III malocclusion is one of the most difficult anomalies to treat. Class III malocclusion with retruded maxilla can be orthopedically corrected with facemask in deciduous or mixed dentition in mild to moderate cases. The treatment should be carried out as early as possible before the malocclusion becomes severe. Cases’ report These are two case reports of successful treatment of developing skeletal class III malocclusion, on a 7-year-old female patient in early mixed dentition and on a 9-year-old female patient in mixed dentition. Both present a skeletal Class III due to a deficient maxilla. The treatment plan included protraction of the maxilla by a reverse pull Delaire type facemask. The post treatment results showed significant improvement in Class III skeletal relationship and the facial profile, with the correction of the overjet. Discussion The purpose of early orthodontic treatment of Class III is to intercept the developing malocclusion and redirect it to physiological development. Cases that show skeletal maxillary retrognathism are cases opt for treatment with facemask. The latter acts by promoting maxillary growth while restricting mandibular growth. Thus, it improves the skeletal relationships, minimizes excessive dental compensation and improves occlusal function. It also provides more pleasing facial aesthetics and may eliminate the necessity for orthognathic surgery treatment in some cases. Conclusion Early Class III treatment can be done successfully when proper diagnosis and proper treatment plan are carried out carefully.

Purpose: Genioplasty is a surgical procedure that is used to enhance the shape and appearance of the chin. It can be performed alone or in combination with other jaw-related surgeries either for medical or cosmetic purposes. Recently many studies have been reported for mandibular reconstruction with distraction osteogenesis. However, these distractors can cause some complications such as incorrect prolongation of hard tissues due to the lack of guiding section. The purpose of this study is to manufacture a novel genioplasty distractor and measure its biomechanical stability and reliability for different activation lengths in mandibular bone. Methods: The modified genioplasty distractor was manufactured from grade 2 and grade 5 (Ti6AI4V) titanium alpha + beta alloy which was biocompatible and adequately rigid for possible in situ application in the future and a sample holder was manufactured for compressive strength testing. Results: Test results showed that our modified genioplasty distractors withstood 300 N compression force for activation lengths from 0 to 11 mm. Recorded stress values were in the range of 0.110 MPa to 0.389 MPa. Conclusion: The modified genioplasty distractor developed and tested here is a promising surgical tool that has the potential to reduce genioplasty related complications especially in demanding cases. (C) 2021 Published by Elsevier Masson SAS.

In the dental industry, it seem no one has entertained the thought that if a dislocated mandible, in a Class II Skeletal relation could occlude or block the blood flow in in the STA.* Therefore stopping or impeding blood flow to the vertex of the head and therefor causing balding. Taking into consideration that in a healthy Class I Skeletal relation the clearance between the base of the skull and the eminence of the condyle is only 3.5mm.Pic 1 Orthodontic experience tells us that mandibles 3.5mm retrognathic and more are very common. The intent of this paper is to expose the facts and evidence that show the Class II Skeletal mandible is the cause of balding by blocking blood flow through the S.T.A. Balding of vertex can be avoided. A large array of research has been, and continues to be conducted to determine the causative agent for hair loss. Traditionally such investigation has focused on a number of varying topics, including but not limited to chromosome composition, genotype, and subsequent phenotype expression. However, little or no investigation has been conducted to deduce what effect the skeletal relationship has upon the initial development of hair loss. Through a series of observational case studies, it is evident that there is a relationship between malocclusion and hair loss. Specifically, through analysis of dental records, cephalometric radiographs, and visual observation of patients, there appears to be a correlation between Class II Skeletal malocclusion and subsequent hair loss. Further investigation yields that vascular anatomical differences between different skeletal schemes is associated with the development of hair loss. Keywords: Craniofacial Anomalies, Pediatric Dentistry, Orthodontics, Hair Loss, Baldness

Importance. The choice of management and orthodontic appliance construction is fundamental in planning and treatment of patients with mandibular micrognathia and/ or retrognathism. The aim ― is evaluation of treatment effectiveness of patients with mandibular micrognathia and/ or retrognathism in incompleted facial skeleton growth period. Methodoloty. Base of the research was Children dentistry and orthodontics department of E.A. Vagner Perm State Medical University. The object of the research is 98 patients aged from 5,5 to 16 (42 girls and 56 boys) with distal occlusion and mandibular micrognathia and/ or retrognathism. Data for study were lateral cephalograms, profile images, clinical study results before and after orthodontic treatment. Results. It was determined that the largest increase in mandible size and its position normalization is observed in the treatment of patients with CS2, CS3 cervical vertebral maturation stages. In patients with CS5 cervical vertebral maturation stage and overjet more than 6 mm we use a symptomatic treatment principle for distal occlusion correction. Results application area ― orthodontists practice. Conclusions. This data may be used in prognosis of orthodontic treatment outcome and retentional period in patients with distal occlusion.

La maloclusión Clase III se caracteriza por una deficiencia en el creci-miento de la maxila (retrognatismo maxilar) o un crecimiento inadecua-do de la mandíbula (prognatismo mandibular) o una combinación de ambos. Las interrogantes más frecuentes respecto al tratamiento de la Clase III son; el momento adecuado en el cual se debe llevar a cabo y cual aparato es el más adecuado, ya que actualmente se cuenta con una diversidad de aparatos, sin embargo hay poca evidencia disponible respecto a la efectividad. Evidencia moderada demuestra que el tratamiento temprano con más-cara facial resulta en mejoras sustanciales así como también se resalta que el momento del tratamiento temprano es crucial para un resultado exitoso. El objetivo de esta revisión de literatura es evaluar la efectividad de la máscara facial en el tratamiento temprano de la maloclusión de Clase III.

Obstructive sleep apnea is a medical syndrome with multifactorial pathophysiology. Surgery can be the primary treatment option when anatomic factors are identified with narrowing at specific or general levels of pharyngeal airway. The surgeries are directed to the etiologic anatomic structure to achieve greatest effectiveness. Body weight, Mallampati scale, and tonsil grade are key evaluations to select effective surgical procedures. Surgical weight reduction, maxillomandibular advancement, and pharyngeal soft tissue surgeries are considered for the patient with obesity, maxillomandibular retrognathism, and tonsillar hypertrophy, respectively. Tailored surgical planning can meet the patients needs for airway, esthetics, and normal Angle's occlusion.

Objective. The aim of this study is to clarify the postsurgical stability of temporomandibular joints in skeletal class III patients treated with 2-jaw orthognathic surgery which was performed utilizing computer-aided three-dimensional simulation and navigation in orthognathic surgery (CASNOS) protocol. Materials and Methods. 23 consecutive nongrowing skeletal class III patients with mandibular prognathism associated with maxillary retrognathism treated with 2-jaw orthognathic surgery between 2018 and 2019 were enrolled in this study. The surgery was planned according to the standardized protocol of CASNOS (computer-aided three-dimensional simulation and navigation in orthognathic surgery). Computed tomography (CT) scans were performed in all patients 3 weeks presurgically and 6 months postsurgically. ITKSNAP and 3D Slicer software were used to reconstruct three-dimensional facial skeletal images, to carry out image segmentation, and to superimpose and quantify the TMJ position changes before and after surgery. Amount of displacement of the most medial and lateral points of the condyles and the change of intercondylar angles were measured to evaluate the postsurgical stability of TMJ. Results. A total amount of 23 skeletal class III patients female : male = 12 : 11 with age ranged from 20.3 to 33.5 years (mean: 24.39 ± 4.8 years old ) underwent Le Fort I maxillary advancement and BSSO setback of the mandible. The surgical outcome revealed the satisfactory correction of their skeletal deformities. The mean displacement of the right most lateral condylar point (RL-RL ′ ) was 1.04 ± 0.42 mm and the mean displacement of the left most lateral condylar point (LL-LL ′ ) was 1.19 ± 0.41 mm . The mean displacement of the right most medial condylar point (RM-RM ′ ) was 1.03 ± 0.39 mm and the left most medial condylar point (LM-LM ′ ) was 0.96 ± 0.39 mm . The mean intercondylar angle was 161.61 ± 5.08 ° presurgically and 159.28 ± 4.92 ° postsurgically. Conclusion. The postsurgical position of TM joint condyles in our study only presented a mild change with all the landmark displacement within a range of 1.2 mm. This indicates the bimaxillary orthognathic surgery via 3D CASNOS protocol can achieve a desired and stable result of TMJ position in treating skeletal class III adult patients with retrognathic maxilla and prognathic mandible.