Informationen aus Orthodontie & Kieferorthopädie, 2017
ZusammenfassungDas obstruktive Schlafapnoesyndrom (OSAS) ist eine häufig auftretende Erkrankung, ... more ZusammenfassungDas obstruktive Schlafapnoesyndrom (OSAS) ist eine häufig auftretende Erkrankung, die mit einer erhöhten Morbidität und Mortalität einhergeht. Es entsteht aufgrund einer Obstruktion des Nasopharynx, die zu einer Hypoxie führt. Die gängigste Behandlungsmethode von OSA besteht in der Verwendung von CPAP-Geräten (Continuous Positive Airway Pressure). Eine weitere Therapiemöglichkeit ist der Einsatz von mandibulären Protrusionsschienen (MADs), durch die der anteroposteriore Durchmesser des Rachens vergrößert und damit die Atmung erleichtert wird, was eine Atemwegsobstruktion verhindert. Die Daten für diesen Bericht wurden durch Beobachtung von 12 Patienten mit OSA erhoben. Bei 10 der 12 Patienten konnte eine signifikante Verbesserung sowohl des Apnoe-Hypopnoe-Index (AHI) als auch der Symptomatik festgestellt werden. Gemäß der Literatur sind Komplikationen durch die Verwendung von MADs zu erwarten. Die Mehrzahl der Patienten berichtete über vermehrte Sialorrhö in den erste...
Objective: To assess the surface roughness of in-house 3D-printed orthodontic aligners compared t... more Objective: To assess the surface roughness of in-house 3D-printed orthodontic aligners compared to Invisalign® appliances, both retrieved as well as in the ‘as-received’ control status. Design: An in vitro study following intra-oral material aging. Setting and participants: Twelve clinically used Invisalign® appliances and the same number of 3D-printed aligners were obtained from a respective number of patients, without involvement of attachments. A similar number of ‘as-received’ aligners of each material were used as control (CON) groups. Method: Four groups of materials were examined: A = Invisalign® CON; B = Invisalign® used; C = 3D-printed CON; and D = 3D-printed used. Optical profilometry was employed to examine the following surface roughness parameters: amplitude parameters Sa, Sq and Sz and functional parameters Sc and Sv. Descriptive statistics and quantile regression modeling were conducted, and the level of statistical significance was set at α = 0.05. Results: Intra-ora...
Background The aim of this trial was to assess the effect of enamel sandblasting in addition to t... more Background The aim of this trial was to assess the effect of enamel sandblasting in addition to the acid-etch technique in reducing first-time failures of fixed mandibular retainers placed over a 12-month period. Materials and methods Ethical approval was obtained. Participants were recruited in a single private practice. The primary outcome of this study was any first-time failure of the mandibular fixed retainer assessed at three timepoints over a 12-month period. Three consecutive teeth either on the left or right side (from lower canine-lower central incisor) were randomly allocated to the intervention (sandblasting) and the control (non-sandblasted). Randomization was performed using a centralized randomization service. The patients were randomized in blocks of four and eight with allocation concealment secured by contacting the sequence generator for group assignment. Blinding of either the patient or clinicians was not possible at time of placement of the mandibular retainer....
espanolEl tratamiento del paladar hendido varia segun el paciente y el tipo de malformacion. Exis... more espanolEl tratamiento del paladar hendido varia segun el paciente y el tipo de malformacion. Existen diversas tecnicas quirurgicas adecuadas para el cierre inicial del paladar, a menudo conocidas como «cirugia primaria». Los resultados de los estudios todavia resultan polemicos, y la decision acerca del tipo de tratamiento quirurgico se basa principalmente en las particularidades de cada caso. El motivo principal para llevar a cabo una cirugia para cerrar un paladar hendido es crear un mecanismo de valvula velofaringea que sea capaz de separar la cavidad nasal de la oral durante el habla. Ademas, otros beneficios que el paciente obtendra de la cirugia es una disminucion de las infecciones de las vias respiratorias superiores, una ingesta mas facil de alimentos y una mejora del estado del oido medio. En los articulos se trata ampliamente el problema de la inhibicion del crecimiento de la zona media del rostro como resultado de una cirugia palatal realizada de forma temprana, lo cual nos lleva a la siguiente pregunta: «?Que es mas importante, el habla o el crecimiento?». Los patologos del habla sugieren que la produccion del habla con normalidad es el objetivo mas importante de la cirugia del labio y del paladar hendido, mas importante que el aspecto y que la oclusion o el crecimiento de la zona media del rostro3. De todas formas, la importancia de los dos ultimos objetivos no debe considerarse menor sino que se deben integrar en el plan de tratamiento. Los ninos con habla ininteligible o de cualquier modo distorsionado, principalmente con hipernasalidad o patrones de articulacion incorrectos, presentan una discapacidad mucho mas grave que un aspecto o denticion imperfectos. Un paciente con una malformacion maxilar se puede corregir mas facilmente con cirugia mediante un segundo procedimiento ortognatico que un paciente con patrones de articulacion distorsionados y un desarrollo incorrecto del habla. El objetivo de este documento es revisar la literatura referente a las diversas tecnicas quirurgicas, asi como sus ventajas y desventajas en los pacientes con paladar hendido. Asimismo, presentaremos la tecnica que estamos utilizando en el Centro Craneofacial Helenico y en el Centro Cyprus de paladar hendido y deformaciones faciales EnglishCleft palate and its management vary from patient to patient. There are a variety of surgical techniques appropriate for the initial closure of the palate, often referred to as �primary surgery�. The results of the studies are still controversial, and the decision for the type of surgical management is based on the individuality of each case. The major reason for performing surgery to close a cleft palate is to create a velopharyngeal valving mechanism that is capable of separating the oral from the nasal cavities during speech. The patient, however, will also benefit from the surgery by having less upper respiratory infections, easier intake of food and improvement of the status of the middle ear. The problem of inhibition of the midfacial growth as a result of an early-performed palatal surgery is discussed widely in the literature, and the question that arises is: �What is more important speech or growth?�. The production of normal speech is suggested to be the most important objective in surgery of the cleft lip and palate by the speech pathologists, more important than appearance and more important than occlusion or midfacial growth3. The importance of the last two objectives, however, must not be considered of less importance but instead be integrated into the plan of treatment. Children with speech that is unintelligible or distorted by many ways mainly hypernasality or distorted articulation patterns have a disability which is more severe than a less-than-perfect appearance or dentition. A patient with a maxillary deformity is easier to be surgically corrected by a second orthognathic procedure than if the patient has distorted articulation patterns and distorted speech development. It was the purpose of this paper to review the literature regarding the various surgical techniques as well as their benefits and destructions on cleft individuals. We will also introduce the technique that we are using in The Hellenic Craniofacial Center and The Cyprus Center for Clefts and Facial Deformities
The purpose of this study was to retrospectively investigate mandibular asymmetry in unilateral c... more The purpose of this study was to retrospectively investigate mandibular asymmetry in unilateral cleft lip and palate individuals (UCLP) in relation to chronologic age and in relation to lower facial asymmetry. The longitudinal records of 34 UCLP individuals and 142 controls treated in the Department of Orthodontics, Eastman Dental Center, Rochester, NY, were included in the study. Posteroanterior and oblique cephalometric radiographs were analyzed for lower facial asymmetry and mandibular asymmetry, respectively. Mandibular asymmetry in UCLP was analyzed relative to three age groups (6-10, 11-14, and 15 or greater) and compared to controls. Moreover, mandibular asymmetry was analyzed relative to lower facial asymmetry. UCLP individuals showed no significant differences in mandibular asymmetry compared to controls. In addition, no significant correlation was found between mandibular asymmetry and lower facial asymmetry in UCLP. The degree of mandibular asymmetry in UCLP appears not to be the major contributing factor to the lower facial asymmetry noted on these individuals. Possible cranial-base/temporal-region anomalies may be involved in unilateral cleft lip and palate and be responsible of the asymmetry noted in the lower facial skeleton.
Informationen aus Orthodontie & Kieferorthopädie, 2017
ZusammenfassungDas obstruktive Schlafapnoesyndrom (OSAS) ist eine häufig auftretende Erkrankung, ... more ZusammenfassungDas obstruktive Schlafapnoesyndrom (OSAS) ist eine häufig auftretende Erkrankung, die mit einer erhöhten Morbidität und Mortalität einhergeht. Es entsteht aufgrund einer Obstruktion des Nasopharynx, die zu einer Hypoxie führt. Die gängigste Behandlungsmethode von OSA besteht in der Verwendung von CPAP-Geräten (Continuous Positive Airway Pressure). Eine weitere Therapiemöglichkeit ist der Einsatz von mandibulären Protrusionsschienen (MADs), durch die der anteroposteriore Durchmesser des Rachens vergrößert und damit die Atmung erleichtert wird, was eine Atemwegsobstruktion verhindert. Die Daten für diesen Bericht wurden durch Beobachtung von 12 Patienten mit OSA erhoben. Bei 10 der 12 Patienten konnte eine signifikante Verbesserung sowohl des Apnoe-Hypopnoe-Index (AHI) als auch der Symptomatik festgestellt werden. Gemäß der Literatur sind Komplikationen durch die Verwendung von MADs zu erwarten. Die Mehrzahl der Patienten berichtete über vermehrte Sialorrhö in den erste...
Objective: To assess the surface roughness of in-house 3D-printed orthodontic aligners compared t... more Objective: To assess the surface roughness of in-house 3D-printed orthodontic aligners compared to Invisalign® appliances, both retrieved as well as in the ‘as-received’ control status. Design: An in vitro study following intra-oral material aging. Setting and participants: Twelve clinically used Invisalign® appliances and the same number of 3D-printed aligners were obtained from a respective number of patients, without involvement of attachments. A similar number of ‘as-received’ aligners of each material were used as control (CON) groups. Method: Four groups of materials were examined: A = Invisalign® CON; B = Invisalign® used; C = 3D-printed CON; and D = 3D-printed used. Optical profilometry was employed to examine the following surface roughness parameters: amplitude parameters Sa, Sq and Sz and functional parameters Sc and Sv. Descriptive statistics and quantile regression modeling were conducted, and the level of statistical significance was set at α = 0.05. Results: Intra-ora...
Background The aim of this trial was to assess the effect of enamel sandblasting in addition to t... more Background The aim of this trial was to assess the effect of enamel sandblasting in addition to the acid-etch technique in reducing first-time failures of fixed mandibular retainers placed over a 12-month period. Materials and methods Ethical approval was obtained. Participants were recruited in a single private practice. The primary outcome of this study was any first-time failure of the mandibular fixed retainer assessed at three timepoints over a 12-month period. Three consecutive teeth either on the left or right side (from lower canine-lower central incisor) were randomly allocated to the intervention (sandblasting) and the control (non-sandblasted). Randomization was performed using a centralized randomization service. The patients were randomized in blocks of four and eight with allocation concealment secured by contacting the sequence generator for group assignment. Blinding of either the patient or clinicians was not possible at time of placement of the mandibular retainer....
espanolEl tratamiento del paladar hendido varia segun el paciente y el tipo de malformacion. Exis... more espanolEl tratamiento del paladar hendido varia segun el paciente y el tipo de malformacion. Existen diversas tecnicas quirurgicas adecuadas para el cierre inicial del paladar, a menudo conocidas como «cirugia primaria». Los resultados de los estudios todavia resultan polemicos, y la decision acerca del tipo de tratamiento quirurgico se basa principalmente en las particularidades de cada caso. El motivo principal para llevar a cabo una cirugia para cerrar un paladar hendido es crear un mecanismo de valvula velofaringea que sea capaz de separar la cavidad nasal de la oral durante el habla. Ademas, otros beneficios que el paciente obtendra de la cirugia es una disminucion de las infecciones de las vias respiratorias superiores, una ingesta mas facil de alimentos y una mejora del estado del oido medio. En los articulos se trata ampliamente el problema de la inhibicion del crecimiento de la zona media del rostro como resultado de una cirugia palatal realizada de forma temprana, lo cual nos lleva a la siguiente pregunta: «?Que es mas importante, el habla o el crecimiento?». Los patologos del habla sugieren que la produccion del habla con normalidad es el objetivo mas importante de la cirugia del labio y del paladar hendido, mas importante que el aspecto y que la oclusion o el crecimiento de la zona media del rostro3. De todas formas, la importancia de los dos ultimos objetivos no debe considerarse menor sino que se deben integrar en el plan de tratamiento. Los ninos con habla ininteligible o de cualquier modo distorsionado, principalmente con hipernasalidad o patrones de articulacion incorrectos, presentan una discapacidad mucho mas grave que un aspecto o denticion imperfectos. Un paciente con una malformacion maxilar se puede corregir mas facilmente con cirugia mediante un segundo procedimiento ortognatico que un paciente con patrones de articulacion distorsionados y un desarrollo incorrecto del habla. El objetivo de este documento es revisar la literatura referente a las diversas tecnicas quirurgicas, asi como sus ventajas y desventajas en los pacientes con paladar hendido. Asimismo, presentaremos la tecnica que estamos utilizando en el Centro Craneofacial Helenico y en el Centro Cyprus de paladar hendido y deformaciones faciales EnglishCleft palate and its management vary from patient to patient. There are a variety of surgical techniques appropriate for the initial closure of the palate, often referred to as �primary surgery�. The results of the studies are still controversial, and the decision for the type of surgical management is based on the individuality of each case. The major reason for performing surgery to close a cleft palate is to create a velopharyngeal valving mechanism that is capable of separating the oral from the nasal cavities during speech. The patient, however, will also benefit from the surgery by having less upper respiratory infections, easier intake of food and improvement of the status of the middle ear. The problem of inhibition of the midfacial growth as a result of an early-performed palatal surgery is discussed widely in the literature, and the question that arises is: �What is more important speech or growth?�. The production of normal speech is suggested to be the most important objective in surgery of the cleft lip and palate by the speech pathologists, more important than appearance and more important than occlusion or midfacial growth3. The importance of the last two objectives, however, must not be considered of less importance but instead be integrated into the plan of treatment. Children with speech that is unintelligible or distorted by many ways mainly hypernasality or distorted articulation patterns have a disability which is more severe than a less-than-perfect appearance or dentition. A patient with a maxillary deformity is easier to be surgically corrected by a second orthognathic procedure than if the patient has distorted articulation patterns and distorted speech development. It was the purpose of this paper to review the literature regarding the various surgical techniques as well as their benefits and destructions on cleft individuals. We will also introduce the technique that we are using in The Hellenic Craniofacial Center and The Cyprus Center for Clefts and Facial Deformities
The purpose of this study was to retrospectively investigate mandibular asymmetry in unilateral c... more The purpose of this study was to retrospectively investigate mandibular asymmetry in unilateral cleft lip and palate individuals (UCLP) in relation to chronologic age and in relation to lower facial asymmetry. The longitudinal records of 34 UCLP individuals and 142 controls treated in the Department of Orthodontics, Eastman Dental Center, Rochester, NY, were included in the study. Posteroanterior and oblique cephalometric radiographs were analyzed for lower facial asymmetry and mandibular asymmetry, respectively. Mandibular asymmetry in UCLP was analyzed relative to three age groups (6-10, 11-14, and 15 or greater) and compared to controls. Moreover, mandibular asymmetry was analyzed relative to lower facial asymmetry. UCLP individuals showed no significant differences in mandibular asymmetry compared to controls. In addition, no significant correlation was found between mandibular asymmetry and lower facial asymmetry in UCLP. The degree of mandibular asymmetry in UCLP appears not to be the major contributing factor to the lower facial asymmetry noted on these individuals. Possible cranial-base/temporal-region anomalies may be involved in unilateral cleft lip and palate and be responsible of the asymmetry noted in the lower facial skeleton.
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