A modified presurgical alveolar molding technique for treatment of cleft in Down syndrome

Craniofacial clefts are extremely rare deformities. Tessier’s classification is a widely accepted system that is based on clinical, radiographical, and surgical observations. The Tessier No. 0 cleft most commonly affects the upper lip, nose, and palate. This case presentation aims to report the outcome of a modified presurgical alveolar molding (PAM) appliance used in the treatment of an infant with Tessier No. 0 cleft as an alternate approach to mold such defects before surgery. The modified PAM appliance consisted of reciprocal parts connected by a helix. The segments were approximated by stripping the appliance at the midline in a V-shaped manner and the force was exerted by the extraoral elastics. The procedure gave results in 8 weeks, which may be regarded as a reasonable duration. The anterior cleft gap, which was 13 mm before the treatment, was reduced to 3 mm after the treatment by using modified PAM appliance. On a 21-month follow-up period, oral reshaping was regarded successful due to stability of the improved oral mold.

Household attributes associated with peak period domestic appliance loads

Household appliances represent substantial electricity load within the residential sector, particularly during the electricity system's period of peak evening load. While there is broad understanding of the factors that systematically impact on aggregate residential loads, much less is known about appliance loads. A research priority is understanding how socio-demographic, dwelling, and appliance factors are associated with the timing and scale of appliance loads. Using data from Ireland the analysis finds that the number of household occupants; number of appliances; and daytime occupancy of the home are closely associated with appliance loads but varies depending on the time of day. No association is found between appliance uses and building tenure, type or age; or socio-demographic variables such as income, age or education. The empirical findings have relevance for modelling residential electricity loads, and for design of measures to shift residential loads away from the evening peak period.

Comparison of Antimicrobial Efficacy of Natural Extracts as a Disinfectant for Removable Orthodontic Appliances: An Ex Vivo Study

Aim

The purpose of the study is to formulate a standard protocol for cleaning and disinfecting removable appliances by evaluating the antimicrobial efficacy of three natural extracts.

Materials and methods

Fifty patients with removable orthodontic appliances were selected and divided into five groups [chlorhexidine 0.2% (positive control), extracts of neem, katha, cinnamon, and normal saline (negative control)] with 10 samples each. Saliva sample from the appliance was collected using a sterile cotton swab and cultured. Agar diffusion method was used and zones of inhibition were measured.

Statistical analysis

The obtained data were subjected to statistical analysis by the Kruskal–Wallis ANOVA test and the Mann–Whitney U test.

Results

The neem extract had the highest zone of inhibition measuring 14.95 mm (mean) followed by katha extract with the value of 13.85 mm which was found to be comparable to chlorhexidine with 15.85 mm.

Conclusion

Thus, neem and katha extracts can be used to disinfect removable appliances because of their good antimicrobial activity.

Clinical significance

By following these simple cleaning protocols, it is possible to avoid numerous health hazards caused by unclean removable appliances in children.

How to cite this article

Janani J, Nagar P, Kaniappan AS, et al. Comparison of Antimicrobial Efficacy of Natural Extracts as a Disinfectant for Removable Orthodontic Appliances: An Ex Vivo Study. Int J Clin Pediatr Dent 2020;13(6):640–643.

Lingual Fixed Orthodontic Appliances May Be Associated With More Adverse Effects Than Buccal Appliances

ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION

Adverse effects of lingual and buccal orthodontic techniques: A systematic review and meta-analysis. Ata-Ali F, Ata-Ali J, Ferrer-Molina M, Cobo T, De Carlos F, Cobo J. Am J Orthod Dentofacial Orthop 2016; 149:820-9.

SOURCE OF FUNDING

Not stated.

TYPE OF STUDY/DESIGN

Systematic review and meta-analysis.

On the necessity of improving the environmental impacts of furniture and appliances in net-zero energy buildings

There is now clear evidence regarding the extensive use of furniture and appliances in daily human life, but there is less evidence of their impact on the environment. Responding to this gap in knowledge, this study focuses on an assessment of the environmental impacts of furniture and appliances as used in highly energy efficient buildings. Their primary energy, non-renewable energy and global warming potential indicators have been assessed by extending the boundaries of the Life Cycle Assessment (LCA) study beyond the building itself. In conclusion, we found that furniture and appliances were responsible for around 30% of greenhouse gas emissions and non-renewable energy consumption and 15% of primary energy consumption comparing to the overall impacts of the building. Since embodied impacts represent the largest values, the process for labelling the appliances' energy efficiency should encompass a life-cycle point of view, not just a usage point of view as the case currently. Among office appliances, computer equipment was ranked as the highest impacting element, especially laptops and monitors. As for domestic appliances, refrigerators and electric ovens had the biggest impacts. Concerning furniture, the greatest impacts were from office and kitchen cabinets.

Effects of bracket slot size during en-masse retraction of the six maxillary anterior teeth using an induction-heating typodont simulation system

Objective

To investigate how bracket slot size affects the direction of maxillary anterior tooth movement when en-masse retraction is performed in sliding mechanics using an induction-heating typodont simulation system.

Methods

An induction-heating typodont simulation system was designed based on the Calorific Machine system. The typodont included metal anterior and resin posterior teeth embedded in a sticky wax arch. Three bracket slot groups (0.018, 0.020, and 0.022 inch [in]) were tested. A retraction force of 250 g was applied in the posterior-superior direction.

Results

In the anteroposterior direction, the cusp tip of the canine in the 0.020-in slot group moved more distally than in the 0.018-in slot group. In the vertical direction, all six anterior teeth were intruded in the 0.018-in slot group and extruded in the 0.020- and 0.022-in slot groups. The lateral incisor was significantly extruded in the 0.020- and 0.022-in slot groups. Significant differences in the crown linguoversion were found between the 0.018- and 0.020-in slot groups and 0.018- and 0.022-in slot groups for the central incisor and between the 0.018- and 0.022-in slot groups and 0.020- and 0.022-in slot groups for the canine. In the 0.018-in slot group, all anterior teeth showed crown mesial angulation. Significant differences were found between the 0.018- and 0.022-in slot groups for the lateral incisor and between the 0.018- and 0.020-in slot groups and 0.018- and 0.022-in slot groups for the canine.

Conclusions

Use of 0.018-in slot brackets was effective for preventing extrusion and crown linguoversion of anterior teeth in sliding mechanics.

Household and caregiver characteristics and behaviours as predictors of unsafe exposure of children to paraffin appliances

This study examines adult safety knowledge and practices regarding the use of paraffin cooking appliances. The use of these is common in South Africa with injury risks that are poorly understood. This cross-sectional study was in an informal settlement in Johannesburg, South Africa, where children were reportedly at high risk for burns. This study sought to clarify relationships between key risks and developed individual and composite variables from theoretical constructs and operational definitions of risks for burns. Risks included Child Use of Paraffin Appliances, Child Proximity to Cooking, Risky Stove Use, Caregiver's Burn Treatment Knowledge, Children Locked in House, Children Alone in House. Number of children remains as in proof as this was not a composite scale. Child Proximity to Cooking was associated with more children in the home. Households where children were in greater proximity to cooking were 6 times more likely to be left alone at home, with caregivers with no education over 100 times more likely to lock their children at home. Children locked in were often from homes where caregivers used appliances unsafely. In settings with hazardous energy use, compressed household configurations, and families with multiple children, Risky Stove Use and the practice of locking children in the home may be catastrophic.

Long-term skeletodental stability of mandibular symphyseal distraction osteogenesis: Tooth-borne vs hybrid distraction appliances

OBJECTIVE

To evaluate and compare the long-term skeletodental stability of mandibular symphyseal distraction osteogenesis (MSDO) achieved with the use of tooth-borne vs. hybrid distraction appliances.

MATERIALS AND METHODS

Posttreatment and follow-up orthodontic records were collected for 33 patients. The 14 patients who underwent distraction with a tooth-borne appliance had a mean follow-up of 5.08 years. The 19 patients who underwent distraction with a hybrid appliance had a mean follow-up of 6.07 years. Records included intraoral photographs, study models, postero-anterior cephalometric radiographs, and lateral cephalometric radiographs. Total changes of 16 measurements were analyzed to compare patients who underwent the tooth-borne vs. the hybrid distraction.

RESULTS

Both groups shared several similar and significant (P < .05) changes from posttreatment to follow-up records. Cast analysis showed a decrease in intercanine width and arch length and an increase in irregularity index. The postero-anterior cephalometric radiograph showed an increase in the width of the interincisal apices. The lateral cephalometric radiograph showed a decrease in the MP-L1 angle. The only statistically significant difference between the two appliances was the intercentral incisor contact point.

CONCLUSION

Changes found are consistent with those found in untreated and orthodontically treated individuals over time. The long-term changes in the current patient sample can be determined to be expected and acceptable. MSDO is a viable treatment option with the use of either a hybrid or tooth-borne appliance.

Clinical Tip for Adjusting Reverse Pull Facemask/Headgear Assembly

Point of force application is critical in predicting the result of reverse pull headgear assembly. Different people have suggested different point of force application. A clinical tip is provided for adjusting the hook of intraoral stabilizing appliance, so that it rests on zero moment line which helps in translatory movement of maxilla. Simple and effective clinical method of adjusting the reverse pull headgear is illustrated here along with its biomechanical justification.

Effectiveness of en-masse retraction using midpalatal miniscrews and a modified transpalatal arch: Treatment duration and dentoskeletal changes

Objective

The purpose of this study was to compare the treatment duration and dentoskeletal changes between two different anchorage systems used to treat maxillary dentoalveolar protrusion and to examine the effectiveness of en-masse retraction using two miniscrews placed in the midpalatal suture.

Methods

Fifty-seven patients (9 men, 48 women), who had undergone level anchorage system treatment at Aichi-Gakuin University Dental Hospital (Nagoya, Japan) were divided into two groups according to the method of maxillary posterior anchorage reinforcement: midpalatal miniscrews (25 patients, mean age 22 years) and conventional anchorage (32 patients, mean age 19 years). The en-masse retraction period, overall treatment duration, pre-treatment effective ANB angle, and change in the effective ANB angle were compared with an independent-samples t-test.

Results

Compared to the headgear group, the duration of en-masse retraction was longer by approximately 4 months in the miniscrew group (p < 0.001). However, we found no significant difference in the total treatment duration between the groups. Moreover, a greater change in the effective ANB angle was observed in patients treated with miniscrews than in those treated with the conventional method (p < 0.05).

Conclusions

The level anchorage system treatment using miniscrews placed in the midpalatal area will allow orthodontists more time to control the anterior teeth during en-masse retraction, without increasing the total treatment duration. Furthermore, it achieves better dentoskeletal control than does the conventional anchorage method, thereby improving the quality of the treatment results.

Maxillary expansion with the memory screw: a preliminary investigation

Objective

The purpose of this study was to investigate the effects of a newly developed rapid maxillary expansion screw-the memory screw-over 6 months.

Methods

Five subjects, aged between 11.7 and 13.75 years, were enrolled in this study. All subjects underwent placement of a maxillary expansion appliance containing superelastic nickel-titanium open-coil springs in its screw bed. The parents of the patients and/or the patients themselves were instructed to activate the expansion screw by 2 quarter-turns 3 times a day (morning, midday, and evening; 6 quarter-turns a day). The mean expansion period was 7.52 ± 1.04 days. Dentoskeletal effects of the procedure, including dentoalveolar inclination, were evaluated. Measurements of all the parameters were repeated after 6 months of retention in order to check for relapse.

Results

Sella-Nasion-A point (SNA) and Sella-Nasion/Gonion-Menton angles increased, and Sella-Nasion-B point (SNB) angle decreased in all the subjects during the expansion phase. However, they approximated to the initial values at the end of 6 months. On the other hand, the increments in maxillary apical base (Mxr-Mxl) and intermolar widths was quite stable. As expected, some amount of dentoalveolar tipping was observed.

Conclusions

The newly developed memory expansion screw offers advantages of both rapid and slow expansion procedures. It widens the midpalatal suture and expands the maxilla with relatively lighter forces and within a short time. In addition, the resultant increments in the maxillary apical base and intermolar width remained quite stable even after 6 months of retention.