Archive of Orofacial Data Science

Gender Links and Non-Syndrome Related Mutations Linking Isolated Cleft Palate and Ankyloglossia in the Fetal Development

Dana Hodge King, Sven David Stefan Kaminiorz, Bethany Marie Patterson — Wed, 03 Jul 2024 00:00:00 +0200

AIM: To compare the pathogenesis of ankyloglossia (tongue-tie) with isolated cleft palate only (CPO) by examining the influence of genetic and epigenetic factors.

METHODS: A comprehensive literature review encompassing the years 2012-2017, yielded a substantial body of research linking cleft palate and ankyloglossia. Inclusion criteria comprised randomized controlled clinical trials, both prospective and retrospective; with the exclusion of non-English studies.

RESULTS: The embryonic parallels between CPO and ankyloglossia suggest a phenotypic expression through neural crest cells along the anterior-posterior axis. These developmental pathways persist during palatogenesis, affecting structures such as palatal shelves and the lingual frenum. Significantly, the cranial neural crest derived connective tissue of the lingual frenum demonstrates a functional correlation with the genioglossus muscle. In the context of cleft palate (CP) models, malformation of the genioglossus muscle is associated with micrognathia in extrinsic perspectives, while intrinsic perspectives focus on causal genes affecting palatal shelves. Ankyloglossia is identified as part of an X-linked, gender-specific disease spectrum with various midline-related variations along the anterior-posterior axis.

CONCLUSION: The functional perspective has brought attention to the interplay of structures surrounding the palate in comprehending CP etiology. This approach underscores the importance of tongue position and the attachment of the lingual frenum connective tissue to the genioglossus muscle. Early intervention aimed at reducing the lingual frenum may potentially enhance the form and function of the oral cavity.

Dentoskeletal Effects of Modern Hybrid Fixed Functional Appliances

Alexander Khoi-Nguyen Thanh Lam, Jonas Quirin Schmid — Thu, 04 Jul 2024 00:00:00 +0200

AIM: This study performs an in-depth analysis of the literature to evaluate the dentoalveolar and skeletal effects of modern hybrid fixed functional appliances (HFFAs).

METHODS: An extensive literature search spanning from January 2010 to November 2023 was executed across three databases: PubMed, Cochrane Library, and Google Scholar. Additionally, a manual search was done by employing the names of relevant authors and screening the references within the included articles. The assessment for eligibility was based on the PICO approach: (P)articipants: Any patients exhibiting Class II division 1 malocclusion up to the age of 18; (I)ntervention: Treatment with HFFAs; (C)omparison: Untreated individuals; (O)utcome measures: (a) Amount of overjet reduction; (b) Changes in upper and lower incisor proclination/protrusion; (c) Skeletal maxillary/mandibular alterations (ANB, SNA, SNB values); (d) Mandibular growth (changes in mandibular length); and (e) Treatment duration.

RESULTS: Nine clinical trials were included in this study, representing a total of 584 adolescents with Class II division 1 malocclusion. Cephalometric measurements indicate pronounced dentoalveolar effects, including lower incisor proclination and upper incisor retroclination, to correct overjet and overbite. Skeletal effects, such as modest maxillary restriction and improvement in the maxillary-mandibular anteroposterior relationship, were less prominent.

CONCLUSION: Although successful at Class II dental malocclusion correction, HFFAs induce unwanted side effects such as significant lower incisor proclination and clockwise rotation of the occlusal plane. Further research, particularly focusing on HFFAs coupled with skeletal anchorage, is necessary.

Gummy Smile - Advantages and Disadvantages of Botulinum Toxin Treatment Compared to Orthognathic Surgery

Tan Siew Yong — Wed, 20 Mar 2024 00:00:00 +0100

AIM: This narrative literature review aims to evaluate the treatment of botulinum toxin compared to Le Fort I orthognathic surgery in patients with a gummy smile.

METHODS: An electronic search was conducted via PubMed/Medline and Google Scholar using keywords such as "gummy smile", "excessive gingival display", "high smile line", "botulinum toxin treatment and correction", "botox usages" and "orthognathic surgery" for studies published until January 2015. After excluding unrelated items, the initial search yielded 84 articles. Following the exclusion of irrelevant articles based on abstract and title, the full texts of 60 articles were reviewed and included in this study.

RESULTS: Botulinum toxin treatment and Le Fort I osteotomy present distinct advantages and disadvantages. Botulinum toxin serves as an adjunct for correcting excessive gingival display and is gaining popularity due to its minimally invasive nature. However, Le Fort I osteotomy remains the gold standard for correcting vertical maxillary excess in gummy smile patients.

CONCLUSIONS: Both botulinum toxin treatment and Le Fort I osteotomy are essential for correcting different types of gummy smiles. Neither can completely replace the other in the correction of gummy smiles.

Recycling Debonded Metal Orthodontic Brackets - A Comprehensive Review and Meta-Analysis

Ming Wei Goh — Wed, 20 Mar 2024 00:00:00 +0100

AIM: This work provides orthodontic practitioners with an updated literature review and meta-analysis on the practicality of reusing debonded metal orthodontic brackets.
METHODS: An electronic search from January 1989 to June 2017 on MEDLINE-PubMed and EBSCOhost Research Databases yielded 63 studies after removing duplicates. Following initial screening, 47 potentially relevant articles were identified. Detailed scrutiny led to the exclusion of 19 studies. The remaining 19 studies were divided into two groups: Group I (same bracket brand and bonding agent) and Group II (different bracket brand and bonding agents). Meta-analysis and sensitivity tests were conducted using RevMan Analysis in Review Manager (version 5.3).
RESULTS: The mean shear bond strength (SBS) for debonding a new bracket was 10.16 MPa. Five chairside recycling methods were compared: erbium laser, aluminum oxide sandblasting, high-speed grinding, slow-speed grinding, and direct flaming. Average reductions in SBS were 0.65 MPa, 0.89 MPa, 2.82 MPa, 3.49 MPa, and 3.93 MPa, respectively.
CONCLUSION: Erbium laser recycling is highly efficient, though cost-prohibitive. Chairside aluminum oxide sandblasting with a microetcher offers a cost-effective alternative with comparable SBS. High-speed grinding surpasses slow-speed grinding, but both exhibit less favorable rebonding strength than sandblasting. Direct flaming yields the lowest SBS. Chairside sandblasting emerges as the most practical and economical method for recycling debonded metal orthodontic brackets.

Smile Asymmetry in Patients treated with combined Orthodontics and Orthognathic Surgery

Sofia Martins — Wed, 20 Mar 2024 00:00:00 +0100

AIM: The aim of this study was to examine the relationship between lip canting and the extent of a smile, both pre- and post-operatively, in patients who were treated with combined orthodontics and orthognathic surgery.
METHODS: This study included 90 clinical photographs of 45 patients smiling, both before and after orthognathic surgery. Facial landmark points were traced to compare pre- and post-operative photographs. The data were used to measure the vertical distance of the lips when smiling – lip elevation and the extent of a smile, both before and after surgery. The correlations among canting, the type of surgery, and Angle class were evaluated by a one-way analysis of variance (ANOVA) and multiple comparisons using the Tamhane post hoc test.
RESULTS: The magnitude of the post-operative extent of a smile was not significantly correlated with lip elevation and changes in lip canting. There were no statistical differences for Angle class I and asymmetric cases, in contrast to Class II and III results regarding the extent of a smile post-operatively. Bimaxillary surgery resulted in significantly broader smiles, and bilateral sagittal split osteotomy resulted in higher lip elevation post-operatively, though not to a significant extent.
CONCLUSION: Soft tissues, particularly the smiling lip line, are affected by orthognathic surgery and skeletal malocclusion. However, further studies will be needed to better assess and study smile dynamics.

Growth and Maxillofacial Surgery - A Plea for a more Physiological Approach to Surgery

Jean Delaire, Ulrich Joos — Wed, 20 Mar 2024 00:00:00 +0100

The present article is the unfinished final scientific work of the late Professor Jean Delaire and offers insights into his innovative ideas during the concluding phase of his career. Right at the beginning, Delaire challenges traditional teachings by asserting that all growth sites in the skeleton share the same histological origin, namely the cephalic neural ectomesenchyme. He advocates for a comprehensive understanding of biokinetic effects and sutural physiology beyond mere union elements.
In addition, embryological, morphological, and biomechanical aspects are combined to present a comprehensive understanding of the development and evolution of maxillary and premaxillary structures in humans. Delaire argues that the development of the cranio-facial skeletal construct strictly adheres to universal laws governing harmonious and balanced states and highlights the adherence to universal mathematics in life while emphasizing that life does not accept fixity.
Case presentations are used to demonstrate how orthopedic and surgical interventions are aimed at preventing, interrupting, and healing issues related to various growth sites in the facial skeleton, such as the premaxilla, tuberosity regions, mid-palatal suture, condylar region, and bony chin. These treatments also address soft tissue involvement, including masticatory muscles, nasolabial muscles, muscles affecting the chin, and soft palate muscles.
Pioneering work by renowned anatomists accompanies and substantiates Delaire's explanations by tracing the historical development of these ideas, with the realization that the actual physiology of the sutures only became widely known in the orthodontic and maxillofacial world at a very late stage.

An Introduction to Publishing Research in Archive of Orofacial Data Science

Thomas Stamm — Wed, 20 Mar 2024 00:00:00 +0100

The Archive of Orofacial Data Science is committed to advancing open access publishing and disseminating high-quality research to a global audience. We believe that open access to scientific knowledge is vital for the progress of science, innovation, and societal development. This statement outlines our principles and commitment to providing free and unrestricted access to scholarly content.