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Rutili V, Souki BQ, Nieri M, Carlos ALFM, Pavoni C, Cozza P, McNamara JA, Giuntini V, Franchi L. Long-term effects produced by early treatment of Class III malocclusion with rapid maxillary expansion and facemask followed by fixed appliances: A multicentre retro-prospective controlled study. Orthod Craniofac Res 2024; 27:429-438. [PMID: 38146808 DOI: 10.1111/ocr.12748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 11/11/2023] [Accepted: 12/14/2023] [Indexed: 12/27/2023]
Abstract
OBJECTIVE To assess the short- and long-term dentoskeletal effects of early Class III treatment with rapid maxillary expansion and facemask (RME/FM) followed by fixed appliances. MATERIALS AND METHODS A total of 44 patients (27 females, 17 males) treated consecutively with RME/FM were included from the archives of 3 centres. Three lateral cephalograms were available: T0 (before the start of RME/FM therapy, mean age 8.1 ± 1.8 years), T1 (immediately after RME/FM, mean age 9.8 ± 1.6 years), and T2 (long-term observation, mean age 19.5 ± 1.6 years). A control group of 17 untreated Class III subjects (12 females and 5 males) also was selected. Between-group statistical comparisons were performed with ANCOVA. RESULTS No statistically significant differences for any of the cephalometric variables were found at T0. In the short term, the treated group showed significant improvements in ANB (+2.9°), Wits appraisal (+2.7 mm), SNA (+1.8°) and SNB (-1.1°). A significant closure of CoGoMe angle (-1.3°) associated with smaller increments along Co-Gn (-2.4 mm) also was found together with a significant increase in intermaxillary divergence (+1.3°). In the long-term, significant improvements in ANB (+2.6°), Wits appraisal (+2.7 mm) and SNB (-1.7°) were recorded together with a significant closure of the CoGoMe angle (-2.9°). No significant long-term changes in vertical skeletal relationships were found. CONCLUSIONS RME/FM therapy was effective in improving Class III dentoskeletal relationships in the short term. These changes remained stable in the long-term due mainly to favourable mandibular changes.
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Affiliation(s)
- Valentina Rutili
- Graduate Orthodontic Program, Department of Experimental and Clinical Medicine, The University of Florence, Florence, Italy
| | - Bernardo Quiroga Souki
- Graduate Orthodontic Program, Pontifical Catholic University of Minas Gerais, Belo Horizonte, Brazil
| | - Michele Nieri
- Graduate Orthodontic Program, Department of Experimental and Clinical Medicine, The University of Florence, Florence, Italy
| | | | - Chiara Pavoni
- Department of Faculty of Medicine and Surgery, UniCamillus, International Medical University, Rome, Italy
| | - Paola Cozza
- Department of Faculty of Medicine and Surgery, UniCamillus, International Medical University, Rome, Italy
| | - James A McNamara
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry and Center for Human Growth and Development, The University of Michigan, Ann Arbor, Michigan, USA
| | - Veronica Giuntini
- Graduate Orthodontic Program, Department of Experimental and Clinical Medicine, The University of Florence, Florence, Italy
| | - Lorenzo Franchi
- Graduate Orthodontic Program, Department of Experimental and Clinical Medicine, The University of Florence, Florence, Italy
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Biggs EV, Benavides E, McNamara JA, Cevidanes LHS, Copello F, Lints RR, Lints JP, Ruellas ACO. Authors' response. Am J Orthod Dentofacial Orthop 2024; 165:380-381. [PMID: 38555168 DOI: 10.1016/j.ajodo.2024.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 01/18/2024] [Indexed: 04/02/2024]
Affiliation(s)
- Elizabeth V Biggs
- Novi, Ann Arbor, and Traverse City, Mich, and Rio de Janeiro, Brazil
| | - Erika Benavides
- Novi, Ann Arbor, and Traverse City, Mich, and Rio de Janeiro, Brazil
| | - James A McNamara
- Novi, Ann Arbor, and Traverse City, Mich, and Rio de Janeiro, Brazil
| | | | - Flavio Copello
- Novi, Ann Arbor, and Traverse City, Mich, and Rio de Janeiro, Brazil
| | - Ronald R Lints
- Novi, Ann Arbor, and Traverse City, Mich, and Rio de Janeiro, Brazil
| | - Joel P Lints
- Novi, Ann Arbor, and Traverse City, Mich, and Rio de Janeiro, Brazil
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Marino Merlo M, Quiroga Souki B, Nieri M, Bonanno A, Giuntini V, McNamara JA, Franchi L. Comparison of the effects on facial soft tissues produced by rapid and slow maxillary expansion using stereophotogrammetry: a randomized clinical trial. Prog Orthod 2024; 25:1. [PMID: 38168740 PMCID: PMC10761642 DOI: 10.1186/s40510-023-00498-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 09/28/2023] [Indexed: 01/05/2024] Open
Abstract
OBJECTIVE To compare the effects on facial soft tissues produced by maxillary expansion generated by rapid maxillary expansion (RME) versus slow maxillary expansion (SME). MATERIALS AND METHODS Patients in the mixed dentition were included with a transverse discrepancy between the two arches of at least 3 mm. A conventional RME screw was compared to a new expansion screw (Leaf expander) designed to produce SME. Both screws were incorporated in a fixed expander. The primary outcome was the difference of the facial tissue changes in the nasal area measured on facial 3D images captured immediately before application of the expander (T0) and after one year of retention, immediately after the expander removal (T1). Secondary outcomes were soft tissue changes of other facial regions (mouth, lips, and chin). Analysis of covariance was used for statistical analysis. RESULTS Fourteen patients were allocated to the RME group, and 14 patients were allocated to the SME group. There were no dropouts. Nasal width change showed a difference between the two groups (1.3 mm greater in the RME group, 95% CI from 0.4 to 2.2, P = 0.005). Also, intercanthal width showed a difference between treatments (0.7 mm greater in the RME group, 95% CI from 0.0 to 1.3, P = 0.044). Nasal columella width, mouth width, nasal tip angle, upper lip angle, and lower lip angle did not show any statistically significant differences. The Y-axis (anterior-posterior) components of the nasal landmark showed a statistically significant difference between the two groups (0.5 mm of forward displacement greater in the RME group, 95% CI from 0.0 to 1.2, P = 0.040). Also, Z-axis (superior-inferior) components of the lower lip landmark was statistically significant (0.9 mm of downward displacement in favor of the RME group, 95% CI from 0.1 to 1.7, P = 0.027). All the other comparisons of the three-dimensional assessments were not statistically significant. CONCLUSIONS RME produced significant facial soft tissue changes when compared to SME. RME induced greater increases in both nasal and intercanthal widths (1.3 mm and 0.7 mm, respectively). These findings, though statistically significant, probably are not clinically relevant. Trial registration ISRCTN, ISRCTN18263886. Registered 8 November 2016, https://www.isrctn.com/ISRCTN18263886?q=Franchi&filters=&sort=&offset=2&totalResults=2&page=1&pageSize=10.
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Affiliation(s)
- Matilde Marino Merlo
- Graduate Orthodontic Program, Department of Experimental and Clinical Medicine, The University of Florence, Florence, Italy
| | - Bernardo Quiroga Souki
- Graduate Orthodontic Program, Pontifical Catholic University of Minas Gerais, Belo Horizonte, Brazil
| | - Michele Nieri
- Department of Experimental and Clinical Medicine, Orthodontics, The University of Florence, Florence, Italy
| | - Agnese Bonanno
- Graduate Orthodontic Program, Department of Experimental and Clinical Medicine, The University of Florence, Florence, Italy
| | - Veronica Giuntini
- Graduate Orthodontic Program, Department of Experimental and Clinical Medicine, The University of Florence, Florence, Italy
| | - James A McNamara
- Thomas M. and Doris Graber Endowed Professor of Dentistry Emeritus, Department of Orthodontics and Pediatric Dentistry, School of Dentistry, The University of Michigan, Ann Arbor, MI, USA
- Professor Emeritus of Cell and Developmental Biology, School of Medicine, The University of Michigan, Ann Arbor, MI, USA
- Center for Human Growth and Development, The University of Michigan, Ann Arbor, MI, USA
| | - Lorenzo Franchi
- Graduate Orthodontic Program, Department of Experimental and Clinical Medicine, The University of Florence, Florence, Italy.
- Thomas M. Graber Visiting Scholar, Department of Orthodontics and Pediatric Dentistry, School of Dentistry, The University of Michigan, Ann Arbor, USA.
- Director of the Division of Dentistry, University Hospital of Careggi, Via del Ponte di Mezzo, 46-48, 50127, Florence, Italy.
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Biggs EV, Benavides E, McNamara JA, Cevidanes LHS, Copello F, Lints RR, Lints JP, Ruellas ACO. Three-dimensional Evaluation of the Carriere Motion 3D Appliance in the treatment of Class II malocclusion. Am J Orthod Dentofacial Orthop 2023; 164:824-836. [PMID: 37598337 DOI: 10.1016/j.ajodo.2023.05.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 05/01/2023] [Accepted: 05/01/2023] [Indexed: 08/21/2023]
Abstract
INTRODUCTION This study aimed to quantify the outcomes of adolescent patients with Class II malocclusion treated with the Carriere Motion 3D Appliance (CMA) combined with full fixed appliances. METHODS Cone-beam computed tomography scans of 22 patients were available before orthodontic treatment (T1), at removal of the CMA (T2), and posttreatment (T3). The average age of the patients was 13.5 ± 1.6 years at T1, 14.1 ± 0.2 years at T2, and 15.6 ± 0.5 years at T3. The 3-dimensional image analysis procedures were performed using ITK-SNAP (version 3.6.0; www.itksnap.org, Hatfield, Pa) and SlicerCMF (version 4.11.0; http://www.slicer.org, Cambridge, Mass); skeletal and dentoalveolar changes relative to cranial base, maxillary, and mandibular regional superimpositions were evaluated. RESULTS Changes were analyzed with 1 sample t tests using the mean differences during the CMA phase (T1 to T2) and total treatment time (T1 to T3). Significant skeletal changes included a slight reduction of ANB from T1 to T3, mandibular growth (Co-Gn increment of 1.2 mm and 3.3 mm from T1 to T2 and T1 to T3, respectively), inferior displacement of point A, and anterior and inferior displacement of point B. The mandibular plane did not change significantly during treatment. During the CMA treatment, posterior tipping and distal rotation of the maxillary molars, tip back and inferior displacement of the maxillary canines, significant mesial rotation, and superior displacement of the mandibular molars were observed. These movements rebounded during the full fixed appliance phase except for the molar and canine vertical displacements. Clinically significant dental changes during treatment included a reduction in overjet and overbite, Class II correction of the molar and canine relationship, and proclination of the mandibular incisors. CONCLUSIONS The CMA is an effective treatment modality for Class II correction in growing patients because of a combination of mesial movement of the mandibular molar, distal rotation of the maxillary molar, and anterior displacement of the mandible.
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Affiliation(s)
- Elizabeth V Biggs
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Mich; Private practice, Novi, Mich
| | - Erika Benavides
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Mich
| | - James A McNamara
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Mich
| | - Lucia H S Cevidanes
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Mich
| | - Flavio Copello
- Department of Orthodontics, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil; Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Maryland, Baltimore, Md
| | | | | | - Antonio C O Ruellas
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Mich; Department of Orthodontics, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil.
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Rutili V, Quiroga Souki B, Nieri M, Farnese Morais Carlos AL, Pavoni C, Cozza P, McNamara JA, Giuntini V, Franchi L. Long-Term Assessment of Treatment Timing for Rapid Maxillary Expansion and Facemask Therapy Followed by Fixed Appliances: A Multicenter Retro-Prospective Study. J Clin Med 2023; 12:6930. [PMID: 37959395 PMCID: PMC10649687 DOI: 10.3390/jcm12216930] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 10/15/2023] [Accepted: 10/27/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND to determine the role of treatment timing in the long-term effects produced by rapid maxillary expansion and facemask therapy (RME/FM) in Class III patients. METHODS This study compared two sample groups treated with RME/FM followed by fixed appliances: the early prepubertal group (EPG) (17 patients; mean age before treatment (T0), 5.8 ± 0.7 years; range, 4.3-6.9 years) and the late prepubertal group (LPG) (17 patients; mean age at T0, 10.1 ± 0.8 years; range, 9.0-11.1 years). Lateral cephalograms for the two groups were examined before treatment (T0) and at a long-term observation (T1) (EPG, 19.8 ± 1.0 years; LPG, 21.0 ± 2.1 years). Independent sample t-tests were performed to compare the two groups at T0 and T1. RESULTS No statistically significant differences were found for any of the cephalometric variables at T0, except for the total mandibular length, overjet, and inclination of the maxillary incisors to the palatal plane, which were greater in the LPG. At T1, no statistically significant differences were detected for any of the cephalometric variables. CONCLUSIONS There were no significant long-term differences when treating Class III patients with RME/FM, either during an early prepubertal phase (≤7 years of age) or during a late prepubertal phase (≥9 years of age).
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Affiliation(s)
- Valentina Rutili
- Graduate Orthodontic Program, Department of Experimental and Clinical Medicine, The University of Florence, 50121 Florence, Italy; (V.R.); (M.N.); (V.G.)
| | - Bernardo Quiroga Souki
- Graduate Orthodontic Program, Pontifical Catholic University of Minas Gerais, Belo Horizonte 30535-610, Brazil; (B.Q.S.); (A.L.F.M.C.)
| | - Michele Nieri
- Graduate Orthodontic Program, Department of Experimental and Clinical Medicine, The University of Florence, 50121 Florence, Italy; (V.R.); (M.N.); (V.G.)
| | - Ana Luiza Farnese Morais Carlos
- Graduate Orthodontic Program, Pontifical Catholic University of Minas Gerais, Belo Horizonte 30535-610, Brazil; (B.Q.S.); (A.L.F.M.C.)
| | - Chiara Pavoni
- Department of Faculty of Medicine and Surgery, UniCamillus, International Medical University, 00131 Rome, Italy; (C.P.); (P.C.)
| | - Paola Cozza
- Department of Faculty of Medicine and Surgery, UniCamillus, International Medical University, 00131 Rome, Italy; (C.P.); (P.C.)
| | - James A. McNamara
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry and Center for Human Growth and Development, The University of Michigan, Ann Arbor, MI 48109, USA;
| | - Veronica Giuntini
- Graduate Orthodontic Program, Department of Experimental and Clinical Medicine, The University of Florence, 50121 Florence, Italy; (V.R.); (M.N.); (V.G.)
| | - Lorenzo Franchi
- Graduate Orthodontic Program, Department of Experimental and Clinical Medicine, The University of Florence, 50121 Florence, Italy; (V.R.); (M.N.); (V.G.)
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Bazzani M, Cevidanes LHS, Al Turkestani NN, Annarumma F, McMullen C, Ruellas ACO, Massaro C, Rego MVNN, Yatabe MS, Kim-Berman H, McNamara JA, Franchi L, Ngan P, He H, Angelieri F, Aghazada H, Migliorati M. Three-dimensional comparison of bone-borne and tooth-bone-borne maxillary expansion in young adults with maxillary skeletal deficiency. Orthod Craniofac Res 2023; 26:151-162. [PMID: 35737876 PMCID: PMC10257795 DOI: 10.1111/ocr.12595] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 06/01/2022] [Accepted: 06/04/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To compare the transverse dental and skeletal changes in patients treated with bone-anchored palatal expander (bone-borne, BB) compared to patients treated with tooth and bone-anchored palatal expanders (tooth-bone-borne, TBB) using cone-beam computer tomography (CBCT) and 3D image analysis. METHODS The sample comprised 30 patients with transverse maxillary discrepancy treated with two different types of appliances: bone-borne (Group BB) and tooth-bone-borne (Group TBB) expanders. CBCT scans were acquired before (T1) and after completion of maxillary expansion (T2); the interval was 5.4 ± 3.4 and 6.2 ± 2.1 months between the T1 and the T2 scans of Group TBB (tooth-bone-borne) and Group BB (bone-borne), respectively. Transverse, anteroposterior and vertical linear and angular three-dimensional dentoskeletal changes were assessed after cranial base superimposition. RESULTS Both groups displayed marked transverse skeletal expansion with a greater ratio of skeletal to dental changes. Greater changes at the nasal cavity, zygoma and orbital levels were found in Group BB. A relatively parallel sutural opening in an anterior-posterior direction was observed in Group TBB; however, the Group BB presented a somewhat triangular (V-shaped) opening of the suture that was wider anteriorly. Small downward-forward displacements were observed in both groups. Asymmetric expansion occurred in approximately 50% of the patients in both groups. CONCLUSION Greater skeletal vs dental expansion ratio and expansion of the circummaxillary regions were found in Group BB, the group in which a bone-borne expander was used. Both groups presented skeletal and dental changes, with a similar amount of posterior palate expansion. Asymmetric expansion was observed in both groups.
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Affiliation(s)
| | - Lucia H S Cevidanes
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
| | - Najla N Al Turkestani
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
- Department of Restorative and Aesthetic Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | | | - Craig McMullen
- Private Practice of Orthodontics, Brighton, Michigan, USA
| | - Antonio C O Ruellas
- Department of Orthodontics, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Camila Massaro
- Department of Orthodontics, Bauru Dental School, University of São Paulo, São Paulo, Brazil
| | - Marcus V N N Rego
- Department of Orthodontics, Centero Universitário Uninovafapi, Teresina, Brazil
| | - Marilia S Yatabe
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
| | - Hera Kim-Berman
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
| | - James A McNamara
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
| | - Lorenzo Franchi
- Department of Surgery and Translational Medicine, University of Florence, Florence, Italy
| | - Peter Ngan
- Department of Orthodontics, West Virginia University School of Dentistry, Morgantown, West Virginia, USA
| | - Hong He
- Department of Orthodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Fernanda Angelieri
- Department of Orthodontics, Methodist University of São Paulo, São Paulo, Brazil
| | | | - Marco Migliorati
- Department of Orthodontics, Genoa University School of Dentistry, Genoa, Italy
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Gurgel ML, de Oliveira Ruellas AC, Bianchi J, McNamara JA, Tai S, Franchi L, Deleat-Besson R, Le C, Logan C, Turkestani NA, Massaro C, Del Castillo AA, Arruda KEM, Benavides E, Yatabe M, Cevidanes L. Clear aligner mandibular advancement in growing patients with Class II malocclusion. AJO DO Clin Companion 2023; 3:93-109. [PMID: 37636594 PMCID: PMC10454533 DOI: 10.1016/j.xaor.2023.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
Abstract
Treatment effects occurring during Class II malocclusion treatment with the clear aligner mandibular advancement protocol were evaluated in two growing patients: one male (12 years, 3 months) and one female (11 years, 9 months). Both patients presented with full cusp Class II molar and canine relationships. Intraoral scans and cone-beam computed tomography were acquired before treatment and after mandibular advancement. Three-dimensional skeletal and dental long-axis changes were quantified, in which the dental long axis was determined by registering the dental crowns obtained from intraoral scans to the root canals in cone-beam computed tomography scans obtained at the same time points. Class II correction was achieved by a combination of mandibular skeletal and dental changes. A similar direction of skeletal and dental changes was observed in both patients, with downward and forward displacement of the mandible resulting from the growth of the mandibular condyle and ramus. Dental changes in both patients included mesialization of the mandibular posterior teeth with flaring of mandibular anterior teeth. In these two patients, clear aligner mandibular advancement was an effective treatment modality for Class II malocclusion correction with skeletal and dental effects and facial profile improvement.
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Affiliation(s)
- Marcela Lima Gurgel
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Mich
| | - Antonio Carlos de Oliveira Ruellas
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Mich
- Department of Orthodontics, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Jonas Bianchi
- Department of Orthodontics, University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, Calif
| | - James A. McNamara
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Mich
| | - Sandra Tai
- Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Lorenzo Franchi
- Department of Experimental and Clinical Medicine, School of Dentistry, University of Florence, Florence, Tuscany, Italy
| | - Romain Deleat-Besson
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Mich
| | - Celia Le
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Mich
| | - Candice Logan
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Mich
| | - Najla Al Turkestani
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Mich
- Department of Restorative and Aesthetic Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah, Makkah, Saudi Arabia
| | - Camila Massaro
- Department of Orthodontics, School of Dentistry, Federal University of Goiás, Goiânia, Goiás, Brazil
| | - Aron Aliaga Del Castillo
- Department of Orthodontics, Bauru Dental School, University of São Paulo, Bauru, São Paulo, Brazil
| | | | - Erika Benavides
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Mich
| | - Marilia Yatabe
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Mich
| | - Lucia Cevidanes
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Mich
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McMullen C, Al Turkestani NN, Ruellas ACO, Massaro C, Rego MVNN, Yatabe MS, Kim-Berman H, McNamara JA, Angelieri F, Franchi L, Ngan P, He H, Cevidanes LHS. Authors' response. Am J Orthod Dentofacial Orthop 2022; 162:587-589. [PMID: 37830528 DOI: 10.1016/j.ajodo.2022.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 08/12/2022] [Indexed: 11/15/2022]
Affiliation(s)
- Craig McMullen
- Ann Arbor, Mich, Jeddah, Saudi Arabia, Rio de Janeiro, São Paulo, and Teresina, Brazil, Florence, Italy, Morgantown, W Va, and Wuhan, China
| | - Najla N Al Turkestani
- Ann Arbor, Mich, Jeddah, Saudi Arabia, Rio de Janeiro, São Paulo, and Teresina, Brazil, Florence, Italy, Morgantown, W Va, and Wuhan, China
| | - Antonio C O Ruellas
- Ann Arbor, Mich, Jeddah, Saudi Arabia, Rio de Janeiro, São Paulo, and Teresina, Brazil, Florence, Italy, Morgantown, W Va, and Wuhan, China
| | - Camila Massaro
- Ann Arbor, Mich, Jeddah, Saudi Arabia, Rio de Janeiro, São Paulo, and Teresina, Brazil, Florence, Italy, Morgantown, W Va, and Wuhan, China
| | - Marcus V N N Rego
- Ann Arbor, Mich, Jeddah, Saudi Arabia, Rio de Janeiro, São Paulo, and Teresina, Brazil, Florence, Italy, Morgantown, W Va, and Wuhan, China
| | - Marilia S Yatabe
- Ann Arbor, Mich, Jeddah, Saudi Arabia, Rio de Janeiro, São Paulo, and Teresina, Brazil, Florence, Italy, Morgantown, W Va, and Wuhan, China
| | - Hera Kim-Berman
- Ann Arbor, Mich, Jeddah, Saudi Arabia, Rio de Janeiro, São Paulo, and Teresina, Brazil, Florence, Italy, Morgantown, W Va, and Wuhan, China
| | - James A McNamara
- Ann Arbor, Mich, Jeddah, Saudi Arabia, Rio de Janeiro, São Paulo, and Teresina, Brazil, Florence, Italy, Morgantown, W Va, and Wuhan, China
| | - Fernanda Angelieri
- Ann Arbor, Mich, Jeddah, Saudi Arabia, Rio de Janeiro, São Paulo, and Teresina, Brazil, Florence, Italy, Morgantown, W Va, and Wuhan, China
| | - Lorenzo Franchi
- Ann Arbor, Mich, Jeddah, Saudi Arabia, Rio de Janeiro, São Paulo, and Teresina, Brazil, Florence, Italy, Morgantown, W Va, and Wuhan, China
| | - Peter Ngan
- Ann Arbor, Mich, Jeddah, Saudi Arabia, Rio de Janeiro, São Paulo, and Teresina, Brazil, Florence, Italy, Morgantown, W Va, and Wuhan, China
| | - Hong He
- Ann Arbor, Mich, Jeddah, Saudi Arabia, Rio de Janeiro, São Paulo, and Teresina, Brazil, Florence, Italy, Morgantown, W Va, and Wuhan, China
| | - Lucia H S Cevidanes
- Ann Arbor, Mich, Jeddah, Saudi Arabia, Rio de Janeiro, São Paulo, and Teresina, Brazil, Florence, Italy, Morgantown, W Va, and Wuhan, China
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McMullen C, Al Turkestani NN, Ruellas ACO, Massaro C, Rego MVNN, Yatabe MS, Kim-Berman H, McNamara JA, Angelieri F, Franchi L, Ngan P, He H, Cevidanes LHS. Three-dimensional evaluation of skeletal and dental effects of treatment with maxillary skeletal expansion. Am J Orthod Dentofacial Orthop 2022; 161:666-678. [PMID: 34980520 PMCID: PMC9050833 DOI: 10.1016/j.ajodo.2020.12.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 12/01/2020] [Accepted: 12/01/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION The objective was to determine the skeletal and dental changes with microimplant assisted rapid palatal expansion (MARPE) appliances in growing (GR) and nongrowing (NG) patients using cone-beam computed tomography and 3-dimensional imaging analysis. METHODS The sample consisted of 25 patients with transverse maxillary discrepancy treated with a maxillary skeletal expander, a type of MARPE appliance. Cone-beam computed tomography scans were taken before and after maxillary expansion; the interval was 6.0 ± 4.3 months. The sample was divided into GR and NG groups using cervical vertebral and midpalatal suture maturation. Linear and angular 3-dimensional dentoskeletal changes were assessed after cranial base superimposition. Groups were compared with independent-samples t test (P <0.05). RESULTS Both groups displayed marked transverse changes with a similar ratio of skeletal to dental transverse changes and parallel sutural opening from the posterior nasal spine-anterior nasal spine; a similar amount of expansion occurred in the anterior and the posterior regions of the maxilla. The maxilla expanded skeletally without rotational displacements in both groups. The small downward-forward displacements were similar in both groups, except that the GR group had a significantly greater vertical displacement of the canines (GR, 1.7 ±1.0 mm; NG, 0.6 ± 0.8 mm; P = 0.02) and anterior nasal spine (GR, 1.1 ± 0.6 mm; NG, 0.5 ± 0.5 mm; P = 0.004). CONCLUSIONS Treatment of patients with MARPE appliance is effective in GR and NG patients. Although greater skeletal and dental changes were observed in GR patients, a similar ratio of skeletal to dental transverse changes was observed in both groups.
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Affiliation(s)
- Craig McMullen
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Mich
| | - Najla N Al Turkestani
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Mich; Department of Restorative and Aesthetic Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia.
| | - Antonio C O Ruellas
- Department of Orthodontics, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Camila Massaro
- Department of Orthodontics, Bauru Dental School, University of São Paulo, São Paulo, Brazil
| | - Marcus V N N Rego
- Department of Orthodontics, Centero Universitário Uninovafapi, Teresina, Brazil
| | - Marilia S Yatabe
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Mich
| | - Hera Kim-Berman
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Mich
| | - James A McNamara
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Mich
| | - Fernanda Angelieri
- Department of Orthodontics, Methodist University of São Paulo, São Paulo, Brazil
| | - Lorenzo Franchi
- Department of Surgery and Translational Medicine, University of Florence, Florence, Italy
| | - Peter Ngan
- Department of Orthodontics, West Virginia University School of Dentistry, Morgantown, W Va
| | - Hong He
- Department of Orthodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Lucia H S Cevidanes
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Mich
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10
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Giuntini V, Nieri M, Goracci C, Ruellas AC, McNamara JA, Franchi L. Variations in maxillary second molar position of untreated subjects with normal occlusions: A long-term observational study. Orthod Craniofac Res 2021; 25:168-173. [PMID: 34310067 DOI: 10.1111/ocr.12522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Accepted: 07/22/2021] [Indexed: 11/27/2022]
Abstract
INTRODUCTION The purpose of the present study was to evaluate the long-term variations in maxillary second molar position in untreated subjects with normal occlusion. SETTING AND SAMPLE POPULATION A sample of 39 subjects (18 females and 21 males) selected from the University of Michigan Growth Study (UMGS) was followed longitudinally with digital dental casts at 3 observation times: T1, when the maxillary permanent second molars were fully erupted, T2, last observation available in the longitudinal series (38 subjects), and T3, at least 20 years after T2 (12 subjects). MATERIALS AND METHODS Digital measurements were recorded with an open-source software. Outcome variables were sagittal and transverse inclinations of the upper second molars. Two mixed-effect models were performed. RESULTS The maxillary second molars had a distolingual inclination at T1, T2 and T3. Sagittal and transverse inclination showed progressive significant uprighting from T1 through T3 (P < .001). From T1 to T2, the adjusted difference in sagittal crown inclination was 8.0° (95% CI from 6.5° to 9.6°; P < .001). From T2 to T3, the adjusted difference was 5.5° (95% CI from 3.0° to 8.1°; P < .001). From T1 to T2, the adjusted difference in transverse crown inclination was 1.9° (95% CI from 0.4° to 3.5°; P = .011). From T2 to T3, the adjusted difference was 6.0° (95% CI from 3.4° to 8.5°; P < .001). CONCLUSIONS Along with age, maxillary second molars showed a progressive significant uprighting with a decrease in the distal and lingual inclinations.
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Affiliation(s)
- Veronica Giuntini
- Department of Experimental and Clinical Medicine, The University of Florence, Florence, Italy
| | - Michele Nieri
- Department of Experimental and Clinical Medicine, The University of Florence, Florence, Italy
| | - Cecilia Goracci
- Department of Medical Biotechnologies, University of Siena, Policlinico Le Scotte, Siena, Italy
| | - Antonio C Ruellas
- Department of Orthodontics and Pediatric Dentistry, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - James A McNamara
- Department of Orthodontics and Pediatric Dentistry, University of Michigan School of Dentistry, Ann Arbor, MI, USA.,Cell and Developmental Biology, School of Medicine, The University of Michigan, Ann Arbor, MI, USA.,Private practice of orthodontics, Ann Arbor, MI, USA
| | - Lorenzo Franchi
- Department of Experimental and Clinical Medicine, The University of Florence, Florence, Italy
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11
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Perillo L, Auconi P, d'Apuzzo F, Grassia V, Scazzocchio M, Nucci L, McNamara JA, Franchi L. Machine learning in the prognostic appraisal of Class III growth. Semin Orthod 2021. [DOI: 10.1053/j.sodo.2021.05.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Franchi L, Nieri M, Lomonaco I, McNamara JA, Giuntini V. Predicting the mandibular growth spurt. Angle Orthod 2021; 91:307-312. [PMID: 33909876 DOI: 10.2319/080220-676.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 11/01/2020] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES To develop a prediction model that combined information derived from chronological age, sex, and the cervical vertebral maturation (CVM) method to predict the pubertal spurt in mandibular growth. MATERIALS AND METHODS A total of 50 subjects (29 females, 21 males) were selected from the American Association of Orthodontists Foundation Craniofacial Growth Legacy Collection, the University of Michigan Growth Study, and the Denver Child Growth study. A total of 456 lateral cephalograms were analyzed, and a multilevel logistic model was applied. The outcome variable was the presence or absence of the mandibular pubertal growth peak. The predictive variables were chronological age up to the third order, sex, presence or absence of CS 3 interactions between age and sex, age and CS 3, sex and CS 3. RESULTS The mean age ± standard deviation (SD) at the first cephalogram was 8.2 ± 0.5 years, whereas the mean age at the last cephalogram was 16.5 ± 1.1 years. The mean interval ± SD between two consecutive cephalograms was 1.0 ± 0.1 years. The mean age ± SD at the lateral cephalogram obtained immediately before the mandibular pubertal growth peak was 12.1 ± 1.1 years for females and 13.2 ± 0.8 years for males. The greatest increase in mandibular length occurred after CS 3 in 78% of the subjects. The presence of CS 3, age, second-order age, sex, and the interaction between age and sex were all statistically significant predictors of the mandibular pubertal growth spurt. CONCLUSIONS CS 3, chronological age, and sex can be used jointly to predict the pubertal peak in mandibular growth.
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McNamara JA, Franchi L, McClatchey LM, Kowalski SE, Cheeseman CC. Evaluation of adolescent and adult patients treated with the Carriere Motion Class III appliance followed by fixed appliances. Angle Orthod 2021; 91:149-156. [PMID: 33434285 DOI: 10.2319/073120-669.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 11/01/2020] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To determine dentoalveolar and skeletal effects produced in mature patients by the Carriere Motion Class III (CM3) appliance followed by fixed appliances. MATERIALS AND METHODS This retrospective study evaluated 32 patients at three time points: T1 (initial), T2 (removal of CM3), and T3 (posttreatment). Serial cephalograms were traced and digitized, and best-fit regional superimpositions were constructed. Eleven linear and 7 angular variables were measured. The starting forms of the CM3 patients were compared with a sample of untreated subjects with normal occlusions and well-balanced faces. RESULTS The CM3 phase lasted 6.3 months, followed by a phase of fixed appliances lasting 12.9 months; the total duration of treatment was 19.2 months. Minimal skeletal changes were measured sagittally, with only a slight increase in lower anterior facial height observed during treatment. Most treatment changes were dentoalveolar in nature. Wits appraisal increased 4.0 mm during treatment. The molar relationship improved by 6.0 mm during phase I, a value that rebounded slightly during phase II, resulting in an improvement toward Class I of 4.8 mm. Best-fit regional superimpositions revealed anterior movement of upper molars relative to the maxilla and posterior movement of lower molars relative to the mandible. CONCLUSIONS The Carriere Motion Class III appliance is an effective and efficient method of resolving occlusal problems in minimally growing Class III patients. Primary treatment effects are dentoalveolar in nature with minimal skeletal alterations.
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14
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Auconi P, Ottaviani E, Barelli E, Giuntini V, McNamara JA, Franchi L. Prognostic approach to Class III malocclusion through case-based reasoning. Orthod Craniofac Res 2021; 24 Suppl 2:163-171. [PMID: 33417750 DOI: 10.1111/ocr.12466] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 12/10/2020] [Accepted: 12/29/2020] [Indexed: 01/04/2023]
Abstract
OBJECTIVE This investigation evaluates the evidence of case-based reasoning (CBR) in providing additional information on the prediction of future Class III craniofacial growth. SETTINGS AND SAMPLE POPULATION The craniofacial characteristics of 104 untreated Class III subjects (7-17 years of age), monitored with two lateral cephalograms obtained during the growth process, were evaluated. MATERIALS AND METHODS Data were compared with the skeletal characteristics of subjects who showed a high degree of skeletal imbalance ('prototypes') obtained from a large data set of 1263 Class III cross-sectional subjects (7-17 years of age). RESULTS The degree of similarity of longitudinal subjects with the most unbalanced prototypes allowed the identification of subjects who would develop a subsequent unfavourable skeletal growth (accuracy: 81%). The angle between the palatal plane and the sella-nasion line (PP-SN angle) and the Wits appraisal were two additional craniofacial features involved in the early prediction of the adverse progression of the Class III skeletal imbalance. CONCLUSIONS Case-based reasoning methodology, which uses a personalized inference method, may bring additional information to approximate the skeletal progression of Class III malocclusion.
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Affiliation(s)
| | - Ennio Ottaviani
- Department of Mathematics, Università degli Studi di Genova, Genoa, Italy.,OnAIR Ltd, Genoa, Italy
| | | | - Veronica Giuntini
- Department of Experimental and Clinical Medicine, Orthodontics, Università degli Studi di Firenze, Florence, Italy
| | - James A McNamara
- Thomas M and Doris Graber Endowed Professor Emeritus, Department of Orthodontics and Pediatric Dentistry School of Dentistry, University of Michigan, Ann Arbor, MI, USA.,Professor Emeritus of Cell and Developmental Biology, School of Medicine, Research Professor Emeritus, Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, USA
| | - Lorenzo Franchi
- Department of Experimental and Clinical Medicine, Orthodontics, Università degli Studi di Firenze, Florence, Italy.,Thomas M. Graber Visiting Scholar, Department of Orthodontics and Pediatric Dentistry, University of Michigan, Ann Arbor, MI, USA
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15
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Franchi L, Nieri M, McNamara JA, Giuntini V. Predicting mandibular growth based on CVM stage and gender and with chronological age as a curvilinear variable. Orthod Craniofac Res 2020; 24:414-420. [PMID: 33305453 DOI: 10.1111/ocr.12457] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 10/10/2020] [Accepted: 12/04/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The aim of this study was to develop a prediction model that combines the information derived from chronological age (analysed as a curvilinear variable), gender and the CVM method to predict mandibular growth. SETTINGS AND SAMPLE POPULATION 50 participants (29 females, 21 males) were selected from the AAOF Craniofacial Growth Legacy Collection, the Michigan Growth Study and the Denver Child Growth study. MATERIALS AND METHODS In this investigation, 456 lateral cephalograms were analysed by applying a mixed effect model. The outcome variable was the annualized increment in total mandibular length (Co-Gn) during the year following the lateral cephalogram on which the cervical stage and chronological age were evaluated. The predictive variables were chronological age up to the fifth order, gender, stage of cervical vertebral maturation, as well as interactions between age and gender, age and cervical stage, and gender and cervical stage. RESULTS Cervical stage, chronological age up to the fourth order, gender, and the interaction between age and gender were significant predictors of annualized increments in mandibular length. The annualized increment in Co-Gn was significantly greater for CS 3 when compared to all other cervical stages. Further, annualized increments in Co-Gn for CS 1 and CS 2 were significantly greater when compared to CS 5. CONCLUSIONS Cervical stage, chronological age and gender can be used jointly to predict the annualized increment in mandibular growth. Cervical stage 3 exhibited the greatest annualized increase in mandibular length.
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Affiliation(s)
- Lorenzo Franchi
- Department of Experimental and Clinical Medicine, Orthodontics, The University of Florence, Florence, Italy.,Department of Orthodontics and Pediatric Dentistry, School of Dentistry, The University of Michigan, Ann Arbor, MI, USA
| | - Michele Nieri
- Department of Experimental and Clinical Medicine, Orthodontics, The University of Florence, Florence, Italy
| | - James A McNamara
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, The University of Michigan, Ann Arbor, MI, USA.,School of Medicine, The University of Michigan, Ann Arbor, MI, USA.,Center for Human Growth and Development, The University of Michigan, Ann Arbor, MI, USA.,Private Practice of Orthodontics, Ann Arbor, MI, USA
| | - Veronica Giuntini
- Department of Experimental and Clinical Medicine, Orthodontics, The University of Florence, Florence, Italy
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16
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Aristizábal JF, González APP, McNamara JA. Improving shear bond strength of metallic brackets after whitening. Dental Press J Orthod 2020; 25:38-43. [PMID: 33206827 PMCID: PMC7668060 DOI: 10.1590/2177-6709.25.5.038-043.oar] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Accepted: 03/29/2020] [Indexed: 11/22/2022] Open
Abstract
Objective: To evaluate a protocol for bonding metallic brackets after bleaching with hydrogen peroxide (HP). Methods: 60 extracted maxillary premolar were randomly divided into an unbleached control group and two groups bleached with a solution of 35% hydrogen peroxide prior to bonding. The teeth in one of the treated groups were bonded immediately after bleaching; while the other group was treated with 10% sodium ascorbate immediately after bleaching and before bonding. The teeth in all groups were stored in an artificial saliva solution for 7 days after bonding. The shear bond strength data was measured in megapascals (MPa) and the fail attempts were verified. The significance level was established at p< 0.05. Results: The unbleached group, in which brackets were bonded to untreated enamel, had the highest bond strength values (11.0 ± 5.7MPa) in comparison to the bleached group (7.14 ± 40MPa), in which brackets were bonded to recently bleached enamel. Slightly improved bond strength was observed in the antioxidant group (8.13 ± 5.4MPa), in which the teeth were bleached and then the antioxidant was applied to the teeth before bonding. Unbleached and bleached groups showed statistically significant difference for shear bond strength (p=0.03) and load strength (p=0.03); no significant differences were noted between unbleached and antioxidant groups (p=0.52). Conclusion: The antioxidant treatment applied immediately after bleaching was effective in reversing the reduction in shear bond strength of brackets after tooth bleaching.
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Affiliation(s)
| | | | - James A McNamara
- University of Michigan, Department of Orthodontics and Pediatric Dentistry, School of Dentistry (Ann Arbor/MI, USA)
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Auconi P, McNamara JA, Franchi L. Computer-aided heuristics in orthodontics. Am J Orthod Dentofacial Orthop 2020; 158:856-867. [PMID: 33008708 DOI: 10.1016/j.ajodo.2019.10.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 10/01/2019] [Accepted: 10/01/2019] [Indexed: 11/28/2022]
Abstract
INTRODUCTION During the decision-making process, physicians rely on heuristics that consist of simple, useful procedures for solving problems, intuitive shortcuts that produce reliable decisions based on limited information. In clinical situations characterized by a high degree of uncertainty such as those encountered in orthodontics, cognitive biases and judgment errors related to heuristics are not uncommon. This study aimed at promoting trust in the effective interface between the intuitive reasoning of the orthodontic practitioner and the computational heuristics emerging from simple statistical models. METHODS We propose an integrative model based on the interaction between clinical reasoning and 2 computational tools, cluster analysis and fast-and-frugal trees, to extract a structured craniofacial representation of untreated subjects with Class III malocclusion and to forecast the worsening of the malocclusion over time. RESULTS Cluster analysis of cephalometric values from 144 growing subjects with Class III malocclusion followed longitudinally (T1: mean age, 10.2 ± 1.9 years; T2: mean age, 13.8 ± 2.7 years) produced 3 morphologic subgroups with predominant sagittal, vertical, and slight maxillomandibular imbalances. Fast-and-frugal trees applied to different subgroups extracted heuristics that improved the prediction of key features associated with adverse craniofacial growth. CONCLUSIONS Provided that cephalometric values are placed in the appropriate framework, the matching between simple and fast computational approaches and clinical reasoning could help the intuitive logic, perception, and cognitive inferences of orthodontic practitioners on the outcome of patients affected by Class III disharmony, decreasing errors associated with flawed judgments and improving the accuracy of decision making.
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Affiliation(s)
| | - James A McNamara
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, and Cell and Developmental Biology, School of Medicine, Center for Human Growth and Development, University of Michigan, and Private practice, Ann Arbor, Mich
| | - Lorenzo Franchi
- Department of Experimental and Clinical Medicine, Section of Dentistry (Orthodontics), University of Florence, Florence, Italy, and Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Mich.
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Oliveira PM, Cheib-Vilefort PL, de Pársia Gontijo H, Souki BQ, Melgaço CA, Franchi L, McNamara JA. Authors' response. Am J Orthod Dentofacial Orthop 2020; 158:6-7. [PMID: 32448567 DOI: 10.1016/j.ajodo.2020.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 03/09/2020] [Accepted: 03/11/2020] [Indexed: 11/25/2022]
Affiliation(s)
| | | | | | | | | | - Lorenzo Franchi
- Belo Horizonte, Minas Gerai, Brazil, Florence, Italy, and Ann Arbor, Mich
| | - James A McNamara
- Belo Horizonte, Minas Gerai, Brazil, Florence, Italy, and Ann Arbor, Mich
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Alves ACDM, Janson G, McNamara JA, Lauris JRP, Garib DG. Authors' response. Am J Orthod Dentofacial Orthop 2020; 157:733-734. [PMID: 32487297 DOI: 10.1016/j.ajodo.2020.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 03/05/2020] [Accepted: 03/06/2020] [Indexed: 10/24/2022]
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20
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Stern S, Finke H, Strosinski M, Mueller-Hagedorn S, McNamara JA, Stahl F. Longitudinal changes in the dental arches and soft tissue profile of untreated subjects with normal occlusion. J Orofac Orthop 2020; 81:192-208. [PMID: 32253459 PMCID: PMC7186246 DOI: 10.1007/s00056-020-00221-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 11/21/2019] [Indexed: 02/07/2023]
Abstract
Aim The aim of this study was to analyze dental and soft tissue profile development in children with normal occlusions to establish age- and gender-specific reference intervals for German children during their active growth period. Subjects and methods The study group consisted of a sample of 31 untreated Caucasian subjects with normal occlusions. Dental casts were analyzed at four different stages of dentitional development. Extraoral profile photographs were available for 19 subjects at stages T2–T4. In these subjects 11 angular measurements and 14 indices were analyzed. Statistical comparisons of gender-specific differences were performed by Mann–Whitney U tests (p ≤ 0.05). Results Upper and lower posterior and total arch perimeters were recorded to be significantly larger in male subjects until the late mixed dentition. Subsequently, there was a tendency toward larger dimensions in males for those parameters. Upper and lower intercanine, interpremolar and intermolar widths were significantly larger in males throughout the entire observation period. There were no statistically significant gender differences with regard to most angular measurements in the dental arches, including molar rotation, palatal volume, overbite, overjet and molar relationship at later dental stages. Conclusion In untreated subjects with normal occlusion, dental arch and soft tissue parameters can be considered age-dependent. For some dental parameters, gender-specific differences were found that should be taken into consideration during diagnosis and treatment planning of growing children. The obtained longitudinal data of untreated children provide useful information for orthodontic diagnosis, treatment planning and future research projects.
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Affiliation(s)
- Sarah Stern
- Department of Orthodontics, University Dental School, Strempelstraße 13, 18057, Rostock, Germany
| | - Hannah Finke
- Department of Orthodontics, University Dental School, Strempelstraße 13, 18057, Rostock, Germany
| | - Marlon Strosinski
- Department of Orthodontics, University Dental School, Strempelstraße 13, 18057, Rostock, Germany
| | - Silvia Mueller-Hagedorn
- Department of Orthodontics, University Dental School, Strempelstraße 13, 18057, Rostock, Germany
| | - James A McNamara
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - Franka Stahl
- Department of Orthodontics, University Dental School, Strempelstraße 13, 18057, Rostock, Germany.
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21
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Oliveira PM, Cheib-Vilefort PL, de Pársia Gontijo H, Melgaço CA, Franchi L, McNamara JA, Souki BQ. Three-dimensional changes of the upper airway in patients with Class II malocclusion treated with the Herbst appliance: A cone-beam computed tomography study. Am J Orthod Dentofacial Orthop 2020; 157:205-211. [PMID: 32005472 DOI: 10.1016/j.ajodo.2019.03.021] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Revised: 03/01/2019] [Accepted: 03/01/2019] [Indexed: 11/17/2022]
Abstract
INTRODUCTION This study aimed to determine the volumetric effects on the upper airways of growing patients with Class II malocclusion treated with the Herbst appliance (HA). METHODS Volumetric measurements of the upper airways of 42 skeletal Class II malocclusion patients (mean age: 13.8 ± 1.2 years; ranging from 12.0 to 16.9 years) were assessed using cone-beam computed tomography scans acquired before treatment (T0) and approximately 1 year later (T1). The sample comprised a Herbst appliance group (HA group [HAG]; n = 24), and a comparison group (comparison group [CG]; n = 18) of orthodontic patients who had received dental treatments other than mandibular advancement with dentofacial orthopedics. RESULTS In CG, nasopharynx and oropharynx volumes decreased slightly during the observation period (9% and 3%, respectively), whereas the nasal cavity volume increased significantly (12%; P = 0.046). In HAG, there was an increase in the volume of all regions (nasal cavity, 5.5%; nasopharynx, 11.7%; and oropharynx, 29.7%). However, only the oropharynx showed a statistically significant increase (P = 0.003), presenting significant volumetric changes along the time (T1-T0) in HAG. CONCLUSION Mandibular advancement with the HA significantly increased the volume of the oropharynx, but no significant volumetric modifications were observed in the nasal cavity and nasopharynx.
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Affiliation(s)
- Paula Moreira Oliveira
- Graduate Program in Orthodontics, Pontifical Catholic University of Minas Gerais, Belo Horizonte, Brazil
| | | | | | - Camilo Aquino Melgaço
- School of Dentistry, Pontifical Catholic University of Minas Gerais, Belo Horizonte, Brazil
| | - Lorenzo Franchi
- Department of Surgery and Translational Medicine, Section of Dentistry, The University of Florence, Florence, Italy; Department of Orthodontics and Pediatric Dentistry, School of Dentistry, The University of Michigan, Ann Arbor, Mich
| | - James A McNamara
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, The University of Michigan, Ann Arbor, Mich; Cell and Developmental Biology, School of Medicine, Center for Human Growth and Development, The University of Michigan; and Private practice, Ann Arbor, Mich
| | - Bernardo Quiroga Souki
- Graduate Program in Orthodontics, Pontifical Catholic University of Minas Gerais, Belo Horizonte, Brazil.
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Rutili V, Nieri M, Giuntini V, McNamara JA, Franchi L. A multilevel analysis of craniofacial growth in subjects with untreated Class III malocclusion. Orthod Craniofac Res 2019; 23:181-191. [PMID: 31677327 DOI: 10.1111/ocr.12356] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 10/28/2019] [Accepted: 10/30/2019] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To analyse the craniofacial growth of a long-term semi-longitudinal sample of Caucasian subjects with untreated Class III malocclusion. SETTING AND SAMPLE POPULATION A total of 144 Caucasian subjects (of North American and Italian origin) with untreated Class III malocclusion. MATERIALS AND METHODS Subjects aged 2 years and 9 months up to 21 years and 7 months were selected. A multilevel model was used to calculate growth curves for ten variables for both each individual subject and for the whole sample. RESULTS There was a statistically significant increase for total mandibular length (Co-Gn. T2-T1 = 8.4 mm), midfacial length (Co-A. T2-T1 = 3.4 mm) and lower anterior facial height (ANS-Me. T2-T1 = 3.8 mm). The multilevel analysis showed two points of acceleration of growth (about 3-5 years of age and 11-15 years of age) for seven out of ten variables. For Co-Gn and Co-A variables, males presented points of maximum growth delayed by 1 year in comparison with females, with a greater duration (1 year longer) and a greater total growth of about 5 mm. Active mandibular growth continued for a long time after the pubertal spurt: increases in mandibular length ended at about 17 years of age in females and at 21 years and 7 months in males. CONCLUSIONS Untreated Class III malocclusion showed a specific growth curve, especially for the mandible, whose excesses added up over time. In males, the amounts of mandibular and midfacial growth during the whole observation time were greater and lasted longer than in females.
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Affiliation(s)
- Valentina Rutili
- Section of Dentistry (Orthodontics), Department of Experimental and Clinical Medicine, The University of Florence, Italy
| | - Michele Nieri
- Section of Dentistry (Orthodontics), Department of Experimental and Clinical Medicine, The University of Florence, Italy
| | - Veronica Giuntini
- Section of Dentistry (Orthodontics), Department of Experimental and Clinical Medicine, The University of Florence, Italy
| | - James A McNamara
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, The University of Michigan, Ann Arbor, Michigan.,Emeritus of Cell and Developmental Biology, School of Medicine, The University of Michigan, Ann Arbor, Michigan.,Center for Human Growth and Development, The University of Michigan, Ann Arbor, Michigan.,Private Practice of Orthodontics, Ann Arbor, Michigan
| | - Lorenzo Franchi
- Section of Dentistry (Orthodontics), Department of Experimental and Clinical Medicine, The University of Florence, Italy.,Department of Orthodontics and Pediatric Dentistry, School of Dentistry, The University of Michigan, Ann Arbor, Michigan
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Cheib Vilefort PL, Farah LO, Gontijo HP, Moro A, Ruellas ACDO, Cevidanes LHS, Nguyen T, Franchi L, McNamara JA, Souki BQ. Condyle-glenoid fossa relationship after Herbst appliance treatment during two stages of craniofacial skeletal maturation: A retrospective study. Orthod Craniofac Res 2019; 22:345-353. [PMID: 31419375 DOI: 10.1111/ocr.12338] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Revised: 08/08/2019] [Accepted: 08/10/2019] [Indexed: 12/15/2022]
Abstract
OBJECTIVES To perform a three-dimensional evaluation of the position of the condyles in patients treated with Herbst appliance (HA) in two stages of cervical vertebral maturation. SETTING AND SAMPLE POPULATION Retrospective case-control study. Pubertal Herbst group (PHG; n = 24, mean age 14.5 years, CS 3 and CS 4) and pre-pubertal Herbst group (PPHG; n = 17, mean age 9.9 years, CS 1 and CS 2) were contrasted with comparison groups of non-orthopaedically treated Class II patients in pubertal (PCG; n = 17, mean age 13.9 years) and pre-pubertal maturational stages (PPCG; n = 18, mean age 10.6 years). MATERIALS AND METHODS Cone-beam computer tomography scans were taken before treatment (T0) and at T1 after 8 to 12 months. Point-to-point measurements of the displacement of the condyles between T0 and T1, relative to the glenoid fossae, were performed in the X, Y, Z and 3D perspectives. Qualitative assessments using semi-transparent overlays and colour mapping also were produced. RESULTS The displacement of the condyles within the glenoid fossae in the treated groups was small (<0.75 mm; P > .05). Relative to the glenoid fossa, condylar position at T1 was similar to T0 in pre-pubertal and pubertal groups (P > .05). Similar condylar rotations from T0 to T1 were observed in Herbst and comparison groups, and no significant difference was found between pre-pubertal and pubertal patients. CONCLUSIONS Regardless the stage of skeletal maturation, HA treatment did not change the condyle-glenoid fossa relationship.
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Affiliation(s)
| | | | - Henrique Pársia Gontijo
- Graduate Program in Dentistry, Pontifical Catholic University of Minas Gerais, Belo Horizonte, Brazil
| | - Alexandre Moro
- Graduate Program in Dentistry, University Positivo, Curitiba, Brazil
| | | | | | - Tung Nguyen
- Department of Orthodontics, School of Dentistry, University of North Carolina, Chapel Hill, NC, USA
| | - Lorenzo Franchi
- School of Dentistry, University of Florence, Florence, Italy
| | - James A McNamara
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - Bernardo Quiroga Souki
- Graduate Program in Dentistry, Pontifical Catholic University of Minas Gerais, Belo Horizonte, Brazil
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24
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Behrents RG, Shelgikar AV, Conley RS, Flores-Mir C, Hans M, Levine M, McNamara JA, Palomo JM, Pliska B, Stockstill JW, Wise J, Murphy S, Nagel NJ, Hittner J. Obstructive sleep apnea and orthodontics: An American Association of Orthodontists White Paper. Am J Orthod Dentofacial Orthop 2019; 156:13-28.e1. [DOI: 10.1016/j.ajodo.2019.04.009] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 04/01/2019] [Accepted: 04/01/2019] [Indexed: 10/26/2022]
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Kim-Berman H, McNamara JA, Lints JP, McMullen C, Franchi L. Treatment effects of the Carriere ® Motion 3D™ appliance for the correction of Class II malocclusion in adolescents. Angle Orthod 2019; 89:839-846. [PMID: 31232602 DOI: 10.2319/121418-872.1] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To determine the treatment effects produced in Class II patients by the Carriere® Motion 3D™ appliance (CMA) followed by full fixed appliances (FFA). MATERIALS AND METHODS This retrospective study evaluated 34 adolescents at three time points: T1 (pretreatment), T2 (removal of CMA), and T3 (posttreatment). The comparison group comprised 22 untreated Class II subjects analyzed at T1 and T3. Serial cephalograms were traced and digitized, and 12 skeletal and 6 dentoalveolar measures were compared. RESULTS Phase I with CMA lasted 5.2 ± 2.8 months; phase II with FFA lasted 13.0 ± 4.2 months. CMA treatment restricted the forward movement of the maxilla at point A. There was minimal effect on the sagittal position of the chin at pogonion. The Wits appraisal improved toward Class I by 2.1 mm during the CMA phase but not during FFA. Lower anterior facial height increased twice as much in the treatment group as in controls. A clockwise rotation (3.9°) of the functional occlusal plane in the treatment group occurred during phase I; a substantial rebound (-3.6°) occurred during phase II. Overjet and overbite improved during treatment, as did molar relationship; the lower incisors proclined (4.2°). CONCLUSIONS The CMA appliance is an efficient and effective way of correcting Class II malocclusion. The changes were mainly dentoalveolar in nature, but some skeletal changes also occurred, particularly in the sagittal position of the maxilla and in the vertical dimension.
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Garib D, Miranda F, Yatabe MS, Lauris JRP, Massaro C, McNamara JA, Kim-Berman H, Janson G, Behrents RG, Cevidanes LHS, de Oliveira Ruellas AC. Superimposition of maxillary digital models using the palatal rugae: Does ageing affect the reliability? Orthod Craniofac Res 2019; 22:183-193. [PMID: 30844126 DOI: 10.1111/ocr.12309] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 02/27/2019] [Accepted: 02/28/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate the reliability of 3-dimensional maxillary dental changes using two methods of digital model superimposition. SETTING AND SAMPLE POPULATION The Department of Orthodontics of Bauru Dental School, University of São Paulo and University of Michigan Craniofacial Growth Center. Fifteen subjects with normal occlusion. MATERIAL & METHODS The sample was composed of digital study models of 15 normal occlusion subjects taken at 13 (T1), 18 (T2) and 60 years of age (T3). Using the software SlicerCMF 3.1, superimposition (registration) was conducted using 9 landmarks placed on the incisive papilla, second and third palatal rugae and 10 mm distal to the third palatal rugae. Two registration methods were compared: landmarks (LA) and regions of interest (ROI). Three-dimensional changes of landmarks on the buccal cusp tip of posterior teeth bilaterally and the incisal edge of the right central incisor were measured by three examiners. Intraclass correlation coefficients and Bland-Altman method evaluated intra- and inter-examiner agreements. RESULTS Good or excellent intra-examiner agreement was found for T1-T2 and T2-T3 measurements using both registration methods. Inter-examiner agreements were good to excellent for T1-T2 measurements and poor to fair for most T2-T3 measurements. Mean T1-T2 differences were less than 0.5 mm for most measurements. CONCLUSION Maxillary digital dental models of patients with normal occlusion superimposed on palatal rugae showed an adequate reliability for a 5-year interval comparison using landmarks or regions of interest. Lower than acceptable reproducibility using both superimposition methods was found for a 40-year interval comparison.
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Affiliation(s)
- Daniela Garib
- Department of Orthodontics, Bauru Dental School and Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, Brazil
| | - Felicia Miranda
- Department of Orthodontics, Bauru Dental School, University of São Paulo, Bauru, Brazil
| | - Marilia S Yatabe
- Department of Orthodontics and Pediatric Dentistry, School of Dental Medicine, University of Michigan, Ann Arbor, MI, USA
| | | | - Camila Massaro
- Department of Orthodontics, Bauru Dental School, University of São Paulo, Bauru, Brazil
| | - James A McNamara
- Department of Orthodontics and Pediatric Dentistry, School of Dental Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Hera Kim-Berman
- Department of Orthodontics and Pediatric Dentistry, School of Dental Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Guilherme Janson
- Department of Orthodontics, Bauru Dental School, University of São Paulo, Bauru, Brazil
| | - Rolf G Behrents
- Orthodontic Program at the Center for Advanced Dental Education of Saint Louis University, Saint Louis, MO, USA
| | - Lucia H S Cevidanes
- Department of Orthodontics and Pediatric Dentistry, School of Dental Medicine, University of Michigan, Ann Arbor, MI, USA
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28
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Fischer B, Masucci C, Ruellas A, Cevidanes L, Giuntini V, Nieri M, Nardi C, Franchi L, McNamara JA, Defraia E. Three-dimensional evaluation of the maxillary effects of two orthopaedic protocols for the treatment of Class III malocclusion: A prospective study. Orthod Craniofac Res 2018; 21:248-257. [DOI: 10.1111/ocr.12247] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 08/28/2018] [Accepted: 09/12/2018] [Indexed: 12/19/2022]
Affiliation(s)
| | - Caterina Masucci
- Sous-section Orthopédie Dento-Faciale; Faculté de Chirurgie dentaire; Université de Nice Sophia Antipolis; Nice France
- Department of Surgery and Translational Medicine; Orthodontics; University of Florence; Florence Italy
| | - Antonio Ruellas
- Department of Orthodontics and Pediatric Dentistry School of Dentistry; University of Rio de Janeiro; Rio de Janeiro RJ Brazil
- Department of Orthodontics and Pediatric Dentistry School of Dentistry; University of Michigan; Ann Arbor Michigan
| | - Lucia Cevidanes
- Department of Orthodontics and Pediatric Dentistry School of Dentistry; University of Michigan; Ann Arbor Michigan
| | - Veronica Giuntini
- Department of Surgery and Translational Medicine; Orthodontics; University of Florence; Florence Italy
| | - Michele Nieri
- Department of Surgery and Translational Medicine; Orthodontics; University of Florence; Florence Italy
| | - Cosimo Nardi
- Department of Experimental and Clinical Biomedical Sciences; Radiodiagnostic Unit n. 2; University of Florence; Florence Italy
| | - Lorenzo Franchi
- Department of Surgery and Translational Medicine; Orthodontics; University of Florence; Florence Italy
- Department of Orthodontics and Pediatric Dentistry; University of Michigan; Ann Arbor Michigan
| | - James A. McNamara
- Department of Orthodontics and Pediatric Dentistry School of Dentistry; University of Michigan; Ann Arbor Michigan
- School of Medicine; University of Michigan; Ann Arbor Michigan
- Center for Human Growth and Development; University of Michigan; Ann Arbor Michigan
| | - Efisio Defraia
- Department of Surgery and Translational Medicine; Orthodontics; University of Florence; Florence Italy
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29
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Franchi L, Nieri M, McNamara JA. Diagnostic reliability of the objective cervical vertebral maturation method for the mandibular growth peak. Eur J Orthod 2018; 40:452-453. [PMID: 29924307 DOI: 10.1093/ejo/cjy032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Lorenzo Franchi
- Department of Surgery and Translational Medicine, Orthodontics, University of Florence, Florence, Italy
| | - Michele Nieri
- Department of Surgery and Translational Medicine, Orthodontics, University of Florence, Florence, Italy
| | - James A McNamara
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry.,Department of Cell and Developmental Biology, School of Medicine.,Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, USA
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30
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Okano KS, Cevidanes LHS, Cheib PL, de Oliveira Ruellas AC, Yatabe M, Nguyen T, Franchi L, McNamara JA, Souki BQ. Three-dimensional assessment of the middle cranial fossa and central skull base following Herbst appliance treatment. Angle Orthod 2018; 88:757-764. [PMID: 30004786 DOI: 10.2319/101517-694.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES: The purpose of this three-dimensional (3D) study was to assess retrospectively the middle cranial fossa and central skull base of patients treated with the Herbst appliance (HA). MATERIALS AND METHODS: 3D surface virtual models of 40 Class II, division 1 malocclusion patients were generated from cone-beam computed tomography (CBCT) acquired before treatment (T0) and after 8 months of HA treatment (T1). T0 and T1 3D models were superimposed volumetrically at the anterior cranial fossa. Twenty subjects who had been treated with the Herbst appliance (HAG) were compared to 20 subjects who were not treated orthopedically. The latter group served as a comparison control group (CG). Quantitative assessments of the location and directional changes were made with linear and angular measurements between anatomical landmarks. Qualitative assessments of the spatial behavior of the middle cranial fossa and central skull base relative to the anterior cranial fossa were displayed graphically for visualization with color maps and semitransparent overlays. Non-parametric tests were performed to compare the between the HAG and CG. RESULTS: Point-to-point linear measurements and skeletal rotation (pitch, roll, and yaw) changes were very small along the observational period and were not significantly different between HAG and CG. Visual analysis of color maps and overlays confirmed that no changes in the cranial base were associated with HA. CONCLUSIONS: HA therapy did not produce clinically significant changes in the middle cranial fossa and central skull base.
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Souki BQ, Vilefort PLC, Oliveira DD, Andrade I, Ruellas AC, Yatabe MS, Nguyen T, Franchi L, McNamara JA, Cevidanes LHS. Three-dimensional skeletal mandibular changes associated with Herbst appliance treatment. Orthod Craniofac Res 2018; 20:111-118. [PMID: 28414870 DOI: 10.1111/ocr.12154] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/26/2017] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Three-dimensional evaluation of skeletal mandibular changes following Herbst appliance treatment. SETTING AND SAMPLE POPULATION Retrospective case-control study, based on a sample size calculation. Twenty-five pubertal patients treated with Herbst appliance (HAG), and 25 matched Class II patients who received other non-orthopaedic dental treatments (CG). MATERIAL AND METHODS Three-dimensional models were generated from pre-treatment (T0) and post-treatment (T1) cone beam computed tomograms. Volumetric registration on the cranial base was used to assess mandibular displacement; volumetric regional registration was performed to evaluate mandibular growth. Quantitative measurements of X, Y, Z and 3D Euclidian changes, and also qualitative visualization by colour-mapping and semi-transparent overlays were obtained. RESULTS Downward displacement of the mandible was observed in both HAG and CG (2.4 mm and 1.5 mm, respectively). Significant forward displacement of the mandible was observed in the HAG (1.7 mm). HAG showed greater 3D superior and posterior condylar growth than the CG (3.5 mm and 2.0 mm, respectively). Greater posterior growth of the ramus was noted in the HAG than in CG. CONCLUSIONS Immediately after Herbst therapy, a significant mandibular forward displacement was achieved, due to increased bone remodelling of the condyles and rami compared to a comparison group. Three-dimensional changes in the direction and magnitude of condylar growth were observed in Herbst patients.
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Affiliation(s)
- B Q Souki
- Pontifical Catholic University of Minas Gerais, Belo Horizonte, Brazil
| | - P L C Vilefort
- Pontifical Catholic University of Minas Gerais, Belo Horizonte, Brazil
| | - D D Oliveira
- Pontifical Catholic University of Minas Gerais, Belo Horizonte, Brazil
| | - I Andrade
- Pontifical Catholic University of Minas Gerais, Belo Horizonte, Brazil
| | - A C Ruellas
- Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - T Nguyen
- University of North Carolina, Chapel Hill, NC, USA
| | - L Franchi
- University of Florence, Florence, Italy
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Angelieri F, Franchi L, Cevidanes LHS, Hino CT, Nguyen T, McNamara JA. Zygomaticomaxillary suture maturation: A predictor of maxillary protraction? Part I - A classification method. Orthod Craniofac Res 2018; 20:85-94. [PMID: 28414869 DOI: 10.1111/ocr.12143] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The aim of this study was to present a method of classifying the maturational level of the zygomaticomaxillary sutures (ZMSs). METHODS Cone-beam CT (CBCT) images from 74 subjects (5.6-58.4 years) were examined to define the radiographic stages of ZMS maturation. Five stages of maturation of the ZMS were identified and defined: Stage A-uniform high-density sutural line, with no or little interdigitation; Stage B-scalloped appearance of the high-density sutural line; Stage C-two parallel, scalloped, high-density lines, separated in some areas by small low-density spaces; Stage D-fusion in the inferior portion of the suture; and Stage E-complete fusion. Intra- and inter-examiner agreements were evaluated by weighted kappa tests. RESULTS The intra- and inter-examiners reproducibility values demonstrated substantial to almost perfect agreement. No fusion of ZMSs was observed in patients up to 10 years of age. From 10 to 15 years, all maturational stages were identified. After 15 years of age, the majority of patients showed fusion of ZMSs. CONCLUSIONS The classification of ZMS maturation using CBCT is a reliable method that allows the assessment of the morphology of the ZMSs in the individual patient.
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Affiliation(s)
- F Angelieri
- Department of Orthodontics, Guarulhos University, Guarulhos, Brazil.,Department of Orthodontics and Pediatric Dentistry, School of Dentistry, The University of Michigan, Ann Arbor, MI, USA
| | - L Franchi
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, The University of Michigan, Ann Arbor, MI, USA.,Department of Orthodontics, The University of Florence, Florence, Italy
| | - L H S Cevidanes
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, The University of Michigan, Ann Arbor, MI, USA
| | - C T Hino
- Special Studies in Orthodontics, São Paulo Military Hospital, São Paulo, Brazil
| | - T Nguyen
- Department of Orthodontics, School of Dentistry, University of North Carolina, Chapel Hill, NC, USA
| | - J A McNamara
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, Ann Arbor, MI, USA.,Cell and Development Biology, School of Medicine, Ann Arbor, MI, USA.,Center of Human Growth and Development, The University of Michigan, Ann Arbor, MI, USA
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Cunha AC, Cevidanes LH, Sant'Anna EF, Guedes FR, Luiz RR, McNamara JA, Franchi L, Ruellas ACO. Staging hand-wrist and cervical vertebrae images: a comparison of reproducibility. Dentomaxillofac Radiol 2018; 47:20170301. [PMID: 29498541 DOI: 10.1259/dmfr.20170301] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES The aim of this study was to compare the reproducibility of skeletal maturation assessments by raters with similar orthodontic experience using hand-wrist (HW) and cervical vertebral maturation (CVM) methods. METHODS HW and lateral cephalometric radiographs from 15 subjects (8 males and 7 females; ages, 9-16 years) were selected randomly. HW skeletal maturation was evaluated by the method of Greulich and Pyle, and CVM staging was evaluated by the method of Baccetti et al. Six orthodontic residents evaluated all images at three time periods: T1, initial evaluation; T2, re-evaluation after 7 days and T3, final evaluation after 5 weeks. Intra- and interexaminer reproducibility was evaluated with the intraclass correlation coefficient; the limits of agreement (LoA) were determined by using the Bland-Altman method. RESULTS The intraexaminer reliability assessed by intraclass correlation coefficient was scored as good for both of methods (T1-T2-T3 HW = 0.89 and CVM = 0.80; T1-T2 HW = 0.87 and CVM = 0.77; T2-T3 HW0 = 0.90 and CVM = 0.81), as well as the interexaminer evaluation, with the exception of HW-T1, which scored excellent (0.92). The width of LoA from Bland-Altman plot of cervical vertebra method was narrower (CVM T1-T2: -2.3 and +1.8; CVM T2-T3: -2.0 and +2.0) than the HW method (HW T1-T2: -3.9 and +4.8; HW T2-T3: -4.0 and +3.5). CONCLUSIONS Both HW and CVM methods presented good reproducibility for intra- and interexaminer correlation assessments. The small LoA indicated that the CVM is a reproducible method.
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Affiliation(s)
- Amanda C Cunha
- 1 Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro , Rio de Janeiro , Brazil
| | - Lucia Hs Cevidanes
- 2 Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan , Ann Arbor, MI , USA
| | - Eduardo F Sant'Anna
- 1 Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro , Rio de Janeiro , Brazil
| | - Fabio R Guedes
- 3 Department of Pathology and Oral Diagnosis, School of Dentistry, Universidade Federal do Rio de Janeiro , Rio de Janeiro , Brazil
| | - Ronir R Luiz
- 4 Institute of Public Health Studies (IESC), Universidade Federal do Rio de Janeiro , Rio de Janeiro , Brazil
| | - James A McNamara
- 2 Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan , Ann Arbor, MI , USA
| | - Lorenzo Franchi
- 2 Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan , Ann Arbor, MI , USA.,5 Department of Surgery and Translational Medicine, University of Florence , Florence , Italy
| | - Antonio Carlos O Ruellas
- 1 Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro , Rio de Janeiro , Brazil
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Abstract
The cervical vertebral maturation (CVM) method is used to determine the craniofacial skeletal maturational stage of an individual at a specific time point during the growth process. This diagnostic approach uses data derived from the second (C2), third (C3), and fourth (C4) cervical vertebrae, as visualized in a two-dimensional lateral cephalogram. Six maturational stages of those three cervical vertebrae can be determined, based on the morphology of their bodies. The first step is to evaluate the inferior border of these vertebral bodies, determining whether they are flat or concave (ie, presence of a visible notch). The second step in the analysis is to evaluate the shape of C3 and C4. These vertebral bodies change in shape in a typical sequence, progressing from trapezoidal to rectangular horizontal, to square, and to rectangular vertical. Typically, cervical stages (CSs) 1 and CS 2 are considered prepubertal, CS 3 and CS 4 circumpubertal, and CS 5 and CS 6 postpubertal. Criticism has been rendered as to the reproducibility of the CVM method. Diminished reliability may be observed at least in part due to the lack of a definitive description of the staging procedure in the literature. Based on the now nearly 20 years of experience in staging cervical vertebrae, this article was prepared as a "user's guide" that describes the CVM stages in detail in attempt to help the reader use this approach in everyday clinical practice.
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Angelieri F, Franchi L, Cevidanes LHS, Bueno-Silva B, McNamara JA. Prediction of rapid maxillary expansion by assessing the maturation of the midpalatal suture on cone beam CT. Dental Press J Orthod 2018; 21:115-125. [PMID: 28125147 PMCID: PMC5278941 DOI: 10.1590/2177-6709.21.6.115-125.sar] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Accepted: 10/10/2016] [Indexed: 11/22/2022] Open
Abstract
Rapid maxillary expansion (RME) primarily involves the mechanical opening of the midpalatal suture of the maxillary and palatine bones. The fusion of the midpalatal suture determines the failure of RME, a common event in late adolescents and young adults. Recently, the assessment of the maturation of midpalatal suture as viewed using cone beam computed tomography (CBCT) has been introduced. Five maturational stages of the midpalatal suture have been presented: Stage A = straight high-density sutural line, with no or little interdigitation; Stage B = scalloped appearance of the high-density sutural line; Stage C = two parallel, scalloped, high-density lines that lie close to each other, separated in some areas by small low-density spaces; Stage D = fusion of the palatine bone where no evidence of a suture is present; and Stage E = complete fusion that extends also anteriorly in the maxilla. At Stage C, less skeletal response would be expected than at Stages A and B, as there are many bony bridges along the suture. For patients at Stages D and E, surgically assisted RME would be necessary, as the fusion of the midpalatal suture already has occurred either partially or totally. This diagnostic method can be used to estimate the prognosis of the RME, mainly for late adolescents and young adults for whom this procedure is unpredictable clinically.
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Affiliation(s)
- Fernanda Angelieri
- Assistant Professor, Guarulhos University, Guarulhos, Brazil; and Visiting Scholar, Department of Orthodontics and Pediatric Dentistry, School of Dentistry, The University of Michigan, Ann Arbor, MI
| | - Lorenzo Franchi
- Research Associate, Department of Surgery and Translational Medicine, The University of Florence, Florence, Italy; and Thomas M. Graber Visiting Scholar, Department of Orthodontics and Pediatric Dentistry, School of Dentistry, The University of Michigan, Ann Arbor, MI
| | - Lucia H S Cevidanes
- Assistant Professor, Department of Orthodontics and Pediatric Dentistry, School of Dentistry The University of Michigan, Ann Arbor, MI
| | | | - James A McNamara
- Thomas M. and Doris Graber Endowed Professor Emeritus (Active), Department of Orthodontics and Pediatric Dentistry, School of Dentistry. Professor Emeritus of Cell and Development Biology, School of Medicine; and Research Professor Emeritus, Center of Human Growth and Development, The University of Michigan, Ann Arbor, MI
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Pavoni C, Lombardo EC, Lione R, Faltin K, McNamara JA, Cozza P, Franchi L. Treatment timing for functional jaw orthopaedics followed by fixed appliances: a controlled long-term study. Eur J Orthod 2017; 40:430-436. [DOI: 10.1093/ejo/cjx078] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Chiara Pavoni
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Italy
| | | | - Roberta Lione
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Italy
| | - Kurt Faltin
- Department of Orthodontics, School of Dentistry, University Paulista, Sao Paulo, Brazil
| | - James A McNamara
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry and Center for Human Growth and Development, The University of Michigan, Ann Arbor, MI, USA
| | - Paola Cozza
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Italy
- Department of Orthodontics, University Zoja e Këshillit të Mirë, Tirane, Albania
| | - Lorenzo Franchi
- Department of Surgery and Translational Medicine, University of Florence, Florence, Italy
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Auconi P, Scazzocchio M, Caldarelli G, Nieri M, McNamara JA, Franchi L. Understanding interactions among cephalometrics variables during growth in untreated Class III subjects. Eur J Orthod 2017; 39:395-401. [PMID: 28064196 DOI: 10.1093/ejo/cjw084] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Objective The aim of the present study was to apply a computational method commonly used in data mining discipline, classification trees (CTs), to evaluate the growth features in untreated Class III subjects. Materials and methods CT was applied to data from 91 untreated Class III subjects (48 females and 43 males) and compared with the results of discriminant analysis (DA). For all subjects, lateral cephalograms were available at T1 (mean age 10.4 ± 2.0 years) and at T2 (mean age 15.4 ± 1.9 years). A cephalometric analysis comprising 11 variables was performed. The subjects were divided into two subgroups, unfavourable ('Bad') and favourable ('Good') growers, according to the quality of the skeletal growth rate in comparison with the normal craniofacial growth. Results CTs showed that the most informative attribute for the prediction of favourable/unfavourable skeletal growth was the SNA angle. Subjects with SNA values lower than 79.1 degrees showed a risk of 94 per cent of growing unfavourably. DA was able to select palatal plane to mandibular plane angle as predictors. DA, however, showed a statistically significant higher rate of misclassification when compared with CTs (40.7 per cent versus 12.1 per cent, binomial exact test: odds ratio = 6.20; P < 0.0001). Conclusions CTs provided a valid measure of elucidating the effective contribution of craniofacial characteristics in predicting favourable/unfavourable growth in untreated Class III subjects.
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Affiliation(s)
| | | | | | - Michele Nieri
- Department of Surgery and Translational Medicine, Università degli Studi di Firenze, Florence, Italy
| | - James A McNamara
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry.,School of Medicine, Center for Human Growth and Development, University of Michigan, Ann Arbor, USA
| | - Lorenzo Franchi
- Department of Surgery and Translational Medicine, Orthodontics, Università degli Studi di Firenze, Florence, Italy.,Department of Orthodontics and Pediatric Dentistry, University of Michigan, Ann Arbor, USA
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Angelieri F, Ruellas AC, Yatabe MS, Cevidanes LHS, Franchi L, Toyama-Hino C, De Clerck HJ, Nguyen T, McNamara JA. Zygomaticomaxillary suture maturation: Part II-The influence of sutural maturation on the response to maxillary protraction. Orthod Craniofac Res 2017; 20:152-163. [PMID: 28660731 DOI: 10.1111/ocr.12191] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To evaluate the influence of the maturational stages of zygomaticomaxillary sutures (ZMS) on the response to maxillary protraction. SUBJECTS AND METHODS A total of 40 Class III patients were treated retrospectively with either a combination of rapid maxillary expansion and facial mask (RME/FM) or bone-anchored maxillary protraction (BAMP). The RME/FM group consisted of 18 patients (mean age 8.3 years), while the BAMP group was comprised of 22 patients (mean age 11.8 years). The initial CBCT images (T1) of the ZMSs were classified blindly. 3D models from CBCT images at the start and at the end of orthopaedic treatment were registered on the anterior cranial base, and corresponding structures were measured on colour-coded maps and semitransparent overlays. The amounts of protraction of the maxilla, zygoma, orbitale and maxillary first molars for both groups were analysed with two-way ANOVA with Holm-Sidak post hoc test for multiple comparisons. RESULTS A significant association was found between the early maturation stages of the ZMSs and the amount of maxillary protraction, regardless of the protraction method used. Class III patients with ZMS stages A and B showed greater maxillary protraction than patients at stage C. CONCLUSION The maturational stages of ZMS are associated with the response maxillary protraction.
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Affiliation(s)
- F Angelieri
- Department of Orthodontics, Guarulhos University, Guarulhos, Brazil.,Department of Orthodontics and Pediatric Dentistry, School of Dentistry, The University of Michigan, Ann Arbor, MI, USA
| | - A C Ruellas
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, The University of Michigan, Ann Arbor, MI, USA.,Department of Orthodontics and Pediatric Dentistry, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - M S Yatabe
- Bauru Dental School, University of São Paulo, Bauru, Brazil
| | - L H S Cevidanes
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, The University of Michigan, Ann Arbor, MI, USA
| | - L Franchi
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, The University of Michigan, Ann Arbor, MI, USA.,Department of Surgery and Translational Medicine, The University of Florence, Florence, Italy
| | - C Toyama-Hino
- Special Studies in Orthodontics, São Paulo Military Hospital, São Paulo, Brazil
| | - H J De Clerck
- Department of Orthodontics, School of Dentistry, University of North Carolina, Chapel Hill, NC, USA.,Private Practice, Brussels, Belgium
| | - T Nguyen
- Department of Orthodontics, School of Dentistry, University of North Carolina, Chapel Hill, NC, USA
| | - J A McNamara
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, The University of Michigan, Ann Arbor, MI, USA.,Center of Human Growth and Development, School of Medicine, The University of Michigan, Ann Arbor, MI, USA
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Ahlbrecht CA, Ruellas ACDO, Paniagua B, Schilling JA, McNamara JA, Cevidanes LHS. Three-dimensional characterization of root morphology for maxillary incisors. PLoS One 2017; 12:e0178728. [PMID: 28594852 PMCID: PMC5464764 DOI: 10.1371/journal.pone.0178728] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Accepted: 05/17/2017] [Indexed: 11/23/2022] Open
Abstract
The aim of this study was to test the reproducibility of three-dimensional (3D) surface models of maxillary incisors and to propose a characterization of root morphology. The sample was comprised of pre-treatment cone-beam computed tomography (CBCT) images of fifty-five patients. The CBCTs were used to construct 3D surface models of the maxillary incisors. The reproducibility of surface models was tested by repeated construction of them by two observers. A 3D surface model that corresponded to the average of all lateral and all central incisors was generated. 3D surface distances and vector differences were calculated for each individual tooth and the average of the teeth considered. The corresponding points on the 3D surface mesh for each subgroup were compared statistically to those of the neutral subgroup using shape analysis MANCOVA and Hotelling's t-statistic (p < 0.05). Repeated construction of surface models demonstrated adequate inter-rater reproducibility. The distribution of 3D models into root morphology subgroups was: blunt (11% and 26% of the central and lateral incisors, respectively), conical (15% of the central incisors), long (27% and 20% of the central and lateral incisors, respectively), and short (15% and 4% of the central and lateral incisors, respectively). Compared to the neutral average, statistically significant differences in root morphology were found for blunt, long, conical, and short central incisors and for blunt, long, and short lateral incisors. We can conclude that 3D surface models construction for upper incisors is reproducible. 3D shape analysis using CBCT images allows a phenotypic characterization of incisor root morphology.
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Affiliation(s)
- Carly A. Ahlbrecht
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Antonio Carlos de Oliveira Ruellas
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Michigan, United States of America
- Department of Orthodontics and Pediatric Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Beatriz Paniagua
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Juan A. Schilling
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Michigan, United States of America
| | - James A. McNamara
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Lucia Helena Soares Cevidanes
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Michigan, United States of America
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Abstract
James A. McNamara, diplômé de l’Université de Californie de Berkeley, a suivi ses études de dentisterie et d’orthodontie au sein de l’Université de Californie de San Francisco, et a obtenu un doctorat en anatomie à l’Université du Michigan. Il est titulaire actif de la chaire de professeur émérite Thomas M. and Doris Graber dans le département d’orthodontie et d’odontologie pédiatrique. Il est également professeur émérite de biologie cellulaire et du développement à la faculté de médecine de l’Université du Michigan, et professeur émérite chargé de recherche au Centre de la croissance et du développement humains. Il est l’auteur (avec l’artiste William L. Brudon) de Orthodontics and Dentofacial Orthopedics, manuel très largement utilisé.
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McNamara JA. Henri Petit, 1928-2015. Am J Orthod Dentofacial Orthop 2016. [DOI: 10.1016/j.ajodo.2016.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Fernández-Pérez MJ, Alarcón JA, McNamara JA, Velasco-Torres M, Benavides E, Galindo-Moreno P, Catena A. Spheno-Occipital Synchondrosis Fusion Correlates with Cervical Vertebrae Maturation. PLoS One 2016; 11:e0161104. [PMID: 27513752 PMCID: PMC4981417 DOI: 10.1371/journal.pone.0161104] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Accepted: 07/30/2016] [Indexed: 11/18/2022] Open
Abstract
The aim of this study was to determine the relationship between the closure stage of the spheno-occipital synchondrosis and the maturational stage of the cervical vertebrae (CVM) in growing and young adult subjects using cone beam computed tomography (CBCT). CBCT images with an extended field of view obtained from 315 participants (148 females and 167 males; mean age 15.6 ±7.3 years; range 6 to 23 years) were analyzed. The fusion status of the synchondrosis was determined using a five-stage scoring system; the vertebral maturational status was evaluated using a six-stage stratification (CVM method). Ordinal regression was used to study the ability of the synchondrosis stage to predict the vertebral maturation stage. Vertebrae and synchondrosis had a strong significant correlation (r = 0.89) that essential was similar for females (r = 0.88) and males (r = 0.89). CVM stage could be accurately predicted from synchondrosis stage by ordinal regression models. Prediction equations of the vertebral stage using synchondrosis stage, sex and biological age as predictors were developed. Thus this investigation demonstrated that the stage of spheno-occipital synchondrosis, as determined in CBCT images, is a reasonable indicator of growth maturation.
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Affiliation(s)
| | - José Antonio Alarcón
- Department of Orthodontics, School of Dentistry, University of Granada, Granada, Spain
- * E-mail:
| | - James A. McNamara
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, The University of Michigan, Ann Arbor, Michigan, United States of America
| | - Miguel Velasco-Torres
- Department of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, Granada, Spain
| | - Erika Benavides
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Pablo Galindo-Moreno
- Department of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, Granada, Spain
| | - Andrés Catena
- Mind, Brain, and Behavior Research Center, University of Granada, Granada, Spain
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Ruellas ACDO, Huanca Ghislanzoni LT, Gomes MR, Danesi C, Lione R, Nguyen T, McNamara JA, Cozza P, Franchi L, Cevidanes LHS. Comparison and reproducibility of 2 regions of reference for maxillary regional registration with cone-beam computed tomography. Am J Orthod Dentofacial Orthop 2016; 149:533-42. [PMID: 27021458 DOI: 10.1016/j.ajodo.2015.09.026] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Revised: 09/01/2015] [Accepted: 09/01/2015] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The aims of this study were to evaluate the differences between 2 regions of maxillary voxel-based registration and to test the reproducibility of the registration. METHODS Three-dimensional models were built for before-treatment (T1) and after-treatment (T2) based on cone-beam computed tomography images from 16 growing subjects. Landmarks were labeled in all T2 models of the maxilla, and voxel-based registrations were performed independently by 2 observers at 2 times using 2 reference regions. The first region, the maxillary region, included the maxillary bone clipped inferiorly at the dentoalveolar processes, superiorly at the plane passing through the right and left orbitale points, laterally at the zygomatic processes through the orbitale point, and posteriorly at a plane passing through the distal surface of the second molars. In the second region, the palate and infrazygomatic region had different posterior and anterior limits (at the plane passing through the distal aspects of the first molars and the canines, respectively). The differences between the registration regions were measured by comparing the distances between corresponding landmarks in the T2 registered models and comparing the corresponding x, y, and z coordinates from corresponding landmarks. Statistical analysis of the differences between the T2 surface models was performed by evaluating the means and standard deviations of the distances between landmarks and by testing the agreement between coordinates from corresponding landmarks (intraclass correlation coefficient and Bland-Altman method). RESULTS The means of the differences between landmarks from the palate and infrazygomatic region to the maxillary region 3-dimensional surface models at T2 for all regions of reference, times of registrations, and observer combinations were smaller than 0.5 mm. The intraclass correlation coefficient and the Bland-Altman plots indicated adequate concordance. CONCLUSIONS The 2 regions of regional maxillary registration showed similar results and adequate intraobserver and interobserver reproducibility values.
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Affiliation(s)
- Antonio Carlos de Oliveira Ruellas
- Associate professor, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; Brazilian National Counsel of Technological and Scientific Development (CNPq) researcher and postdoctoral fellow, School of Dentistry, University of Michigan, Ann Arbor, Mich.
| | | | - Marcelo Regis Gomes
- Postgraduate student, Department of Prosthetics, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Carlotta Danesi
- Postgraduate student, Department of Clinical Sciences and Translational Medicine, University of Rome, Rome, Italy
| | - Roberta Lione
- PhD fellow, Department of Clinical Sciences and Translational Medicine, University of Rome "Tor Vergata," Rome, Italy
| | - Tung Nguyen
- Assistant professor, Department of Orthodontics, School of Dentistry, University of North Carolina, Chapel Hill, NC
| | - James A McNamara
- Thomas M. and Doris Graber Endowed Professor Emeritus, Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Mich
| | - Paola Cozza
- Professor and department chair, Department of Clinical Sciences and Translational Medicine, University of Rome "Tor Vergata," Rome, Italy
| | - Lorenzo Franchi
- Research associate, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy; Thomas M. Graber Visiting Scholar, Department of Orthodontics and Pediatric Dentistry, University of Michigan, Ann Arbor, Mich
| | - Lucia Helena Soares Cevidanes
- Assistant professor, Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Mich
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Franchi L, McNamara JA. Validity of the CVM method to determine mandibular length. Am J Orthod Dentofacial Orthop 2016; 150:6-7. [PMID: 27364198 DOI: 10.1016/j.ajodo.2016.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Revised: 03/25/2016] [Accepted: 04/28/2016] [Indexed: 10/21/2022]
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Lineberger MB, Franchi L, Cevidanes LHS, Huanca Ghislanzoni LT, McNamara JA. Three-dimensional digital cast analysis of the effects produced by a passive self-ligating system. Eur J Orthod 2016; 38:609-614. [PMID: 26843516 DOI: 10.1093/ejo/cjv089] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
AIM To evaluate maxillary and mandibular dental arch changes induced by a passive self-ligating system by analysing digital dental casts. SUBJECTS AND METHODS A sample of 25 growing patients (16 females and 9 males, mean age 12.8 years) treated with passive self-ligating brackets was compared to a sample of 25 untreated controls (15 females and 10 males, mean age 13.4 years). Sixty three-dimensional points were digitised on the maxillary and mandibular pre- and post-treatment virtual models to evaluate differences in the transverse and antero-posterior arch dimensions and in the torque values of representative anterior and posterior teeth. Statistical comparisons were performed with independent sample t-tests with Holm-Bonferroni correction for multiple tests. RESULTS The greatest increments in arch widths were found at the maxillary and mandibular premolar level (ranging from 2.0 to 2.2mm) and they were associated with significant increases in maxillary and mandibular arch perimeters (2.3 and 2.5mm, respectively), and in buccal crown torque of the upper premolars (with adequate torque control of all other teeth). CONCLUSIONS The passive self-ligating system produced a modest but statistically significant widening of both maxillary and mandibular dental arches that were associated with significant net gains in maxillary and mandibular arch perimeters.
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Affiliation(s)
- Megan B Lineberger
- Graduate Orthodontic Program, The University of Michigan, Ann Arbor, MI, USA.,Private Practice, Huntersville, NC, USA
| | - Lorenzo Franchi
- Department of Surgery and Translational Medicine, Division of Orthodontics, The University of Florence, Italy.,Department of Orthodontics and Pediatric Dentistry, School of Dentistry, The University of Michigan, Ann Arbor, MI, USA
| | - Lucia H S Cevidanes
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, The University of Michigan, Ann Arbor, MI, USA
| | | | - James A McNamara
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, The University of Michigan, Ann Arbor, MI, USA, .,Department of Cell and Developmental Biology, School of Medicine, The University of Michigan, Ann Arbor, MI, USA.,Center for Human Growth and Development, The University of Michigan, Ann Arbor, MI, USA.,Private Practice, Ann Arbor, MI, USA
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Perinetti G, Contardo L, Castaldo A, McNamara JA, Franchi L. Diagnostic reliability of the cervical vertebral maturation method and standing height in the identification of the mandibular growth spurt. Angle Orthod 2015; 86:599-609. [PMID: 26600421 DOI: 10.2319/072415-499.1] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To evaluate the capability of both cervical vertebral maturation (CVM) stages 3 and 4 (CS3-4 interval) and the peak in standing height to identify the mandibular growth spurt throughout diagnostic reliability analysis. MATERIALS AND METHODS A previous longitudinal data set derived from 24 untreated growing subjects (15 females and nine males,) detailed elsewhere were reanalyzed. Mandibular growth was defined as annual increments in Condylion (Co)-Gnathion (Gn) (total mandibular length) and Co-Gonion Intersection (Goi) (ramus height) and their arithmetic mean (mean mandibular growth [mMG]). Subsequently, individual annual increments in standing height, Co-Gn, Co-Goi, and mMG were arranged according to annual age intervals, with the first and last intervals defined as 7-8 years and 15-16 years, respectively. An analysis was performed to establish the diagnostic reliability of the CS3-4 interval or the peak in standing height in the identification of the maximum individual increments of each Co-Gn, Co-Goi, and mMG measurement at each annual age interval. RESULTS CS3-4 and standing height peak show similar but variable accuracy across annual age intervals, registering values between 0.61 (standing height peak, Co-Gn) and 0.95 (standing height peak and CS3-4, mMG). Generally, satisfactory diagnostic reliability was seen when the mandibular growth spurt was identified on the basis of the Co-Goi and mMG increments. CONCLUSIONS Both CVM interval CS3-4 and peak in standing height may be used in routine clinical practice to enhance efficiency of treatments requiring identification of the mandibular growth spurt.
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Affiliation(s)
- Giuseppe Perinetti
- a Research Fellow, Department of Medical, Surgical and Health Sciences, School of Dentistry, University of Trieste, Trieste, Italy
| | - Luca Contardo
- b Assistant Professor, Department of Medical, Surgical and Health Sciences, School of Dentistry, University of Trieste, Trieste, Italy
| | - Attilio Castaldo
- c Professor, Department of Medical, Surgical and Health Sciences, School of Dentistry, University of Trieste, Trieste, Italy
| | - James A McNamara
- d Thomas M. and Doris Graber Endowed Professor of Dentistry Emeritus, Department of Orthodontics and Pediatric Dentistry, School of Dentistry; Professor Emeritus of Cell and Developmental Biology, School of Medicine; Research Professor Emeritus, Center for Human Growth and Development, The University of Michigan, Ann Arbor, Mich; and Private Practice, Ann Arbor, Mich
| | - Lorenzo Franchi
- e Assistant Professor, Department of Orthodontics, School of Dentistry, University of Florence, Florence, Italy, Department of Orthodontics and Pediatric Dentistry, School of Dentistry, The University of Michigan, Ann Arbor, Mich
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McNamara JA, Lione R, Franchi L, Angelieri F, Cevidanes LHS, Darendeliler MA, Cozza P. The role of rapid maxillary expansion in the promotion of oral and general health. Prog Orthod 2015; 16:33. [PMID: 26446931 PMCID: PMC4596248 DOI: 10.1186/s40510-015-0105-x] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2015] [Accepted: 09/20/2015] [Indexed: 11/10/2022] Open
Abstract
Rapid maxillary expansion (RME) is an effective orthopedic procedure that can be used to address problems concerned with the growth of the midface. This procedure also may produce positive side effects on the general health of the patient. The aim of the present consensus paper was to identify and evaluate studies on the changes in airway dimensions and muscular function produced by RME in growing patients. A total of 331 references were retrieved from a database search (PubMed). The widening of the nasal cavity base after midpalatal suture opening in growing patients allows the reduction in nasal airway resistance with an improvement of the respiratory pattern. The effects of RME on the upper airway, however, have been described as limited and local, and these effects become diminished farther down the airway, possibly as a result of soft-tissue adaptation. Moreover, limited information is available about the long-term stability of the airway changes produced by RME. Several studies have shown that maxillary constriction may play a role in the etiology of more severe breathing disorders such as obstructive sleep apnea (OSA) in growing subjects. Early orthodontic treatment with RME is able to reduce the symptoms of OSA and improve polysomnographic variables. Finally, early orthopedic treatment with RME also is beneficial to avoid the development of facial skeletal asymmetry resulting from functional crossbites that otherwise may lead to functional and structural disorders of the stomatognathic system later in life.
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Affiliation(s)
- James A McNamara
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, The University of Michigan, Ann Arbor, MI, USA
- Cell and Developmental Biology, School of Medicine, The University of Michigan, Ann Arbor, MI, USA
- Center for Human Growth and Development, The University of Michigan, Ann Arbor, MI, USA
| | - Roberta Lione
- Department of Clinical Sciences and Translational Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Lorenzo Franchi
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, The University of Michigan, Ann Arbor, MI, USA.
- Department of Surgery and Translational Medicine, University of Florence, Via del Ponte di Mezzo, 46-48, Florence, 50127, Italy.
| | - Fernanda Angelieri
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, The University of Michigan, Ann Arbor, MI, USA
- Department of Orthodontics, São Paulo Methodist University, São Bernardo do Campo, Brazil
| | - Lucia H S Cevidanes
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, The University of Michigan, Ann Arbor, MI, USA
| | - M Ali Darendeliler
- Discipline of Orthodontics, Faculty of Dentistry, University of Sydney, Sydney, Australia
- Sydney Dental Hospital, Sydney South West Area Health Service, Sydney, Australia
| | - Paola Cozza
- Department of Clinical Sciences and Translational Medicine, University of Rome "Tor Vergata", Rome, Italy
- Department of Dentistry, UNSBC, Tirana, Albania
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McNamara JA, Proffit WR. Robert P. Scholz, 1939-2015. Am J Orthod Dentofacial Orthop 2015; 148:518-9. [PMID: 26547934 DOI: 10.1016/j.ajodo.2015.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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McNamara JA. Graduate Orthodontic Residents Program: Exactly what is GORP? Am J Orthod Dentofacial Orthop 2015; 148:198-9. [PMID: 26232818 DOI: 10.1016/j.ajodo.2015.04.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Revised: 04/21/2015] [Accepted: 04/21/2015] [Indexed: 11/29/2022]
Affiliation(s)
- James A McNamara
- Graber endowed professor emeritus, Department of Orthodontics and Pediatric Dentistry, University of Michigan, Ann Arbor, Mich
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McNamara JA. Robert Edison Moyers: War hero, motivator, collaborator. Am J Orthod Dentofacial Orthop 2015; 147:650-2. [PMID: 26038067 DOI: 10.1016/j.ajodo.2015.02.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Revised: 02/24/2015] [Accepted: 02/25/2015] [Indexed: 10/23/2022]
Affiliation(s)
- James A McNamara
- Graber endowed professor emeritus, Department of Orthodontics and Pediatric Dentistry, School of Dentistry; professor emeritus of Cell and Developmental Biology, School of Medicine; research professor emeritus, Center for Human Growth and Development, University of Michigan, Ann Arbor; private practice, Ann Arbor, Mich.
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