No abstract

Introduction: Parathyroid hormone (PTH) is the chief regulator of calcium homeostasis in the human body. Primary hyperparathyroidism (PHPT) occurs in a setting of excessive PTH secretion with an autonomous parathyroid gland which resulting in hypercalcemia [1]. Most patients with PHPT have a single adenoma (about 80% of cases), but multigland disease can occur in 10%-15% of cases and double adenomas in 4%-5% [2]. Parathyroid carcinoma is a rare cause (usually less than 1% of patients) of hyperparathyroidism [3,4]. There is a great variation in the manifestations of PHPT. The clinical presentation of PHPT is changing from a severe disease with nephrolithiasis and metabolic bone disease to mild asymptomatic disease [5,6]. The most common clinical presentation of PHPT is asymptomatic hypercalcemia with an elevated or high-or normal intact PTH level. Patients with hypercalcemia may present with vague constitutional symptoms, anorexia, lethargy, or polydipsia and polyuria [7][8][9]. Less specific features of PHPT are fatigue, proximal muscle weakness, mild cognitive disturbances, hypertension, left ventricular hypertrophy, valvular calcification, and cardiovascular mortality [2,10]. Classic skeletal lesions, which are bone resorption, bone cysts, brown tumors and generalized osteopenia, occur in less than 5% of cases [11]. PHPT affects compact bone more than trabecular bone with particular sensitivity in the cortices of long bones leading to subperiostal bone resorption (seen as periosteal elevation on plain radiography) [12]. PHPT is prone to cause loss of the lamina dura [13].

Objectives: To investigate the treatment efficacy and follow-up stability of the asymmetric Forsus appliance by evaluating longitudinal changes in dental arch asymmetry on digital dental models from 21 patients. Materials and Methods: Maxillary and mandibular reference lines were used for measurements of intra-arch asymmetry at pretreatment (T1), posttreatment (T2), and 4.2 years after treatment (T3). Maxillary and mandibular measurements were performed relative to the dental midline and anterior reference line on digital dental models. To determine the amount of asymmetry between the Class I and Class II sides of a given arch, all maxillary and mandibular parameters were measured on each side of the model separately. Repeated-measures analysis of variance/paired sample t-tests were performed to evaluate dental arch asymmetries at the P < .05 level. Results: The alveolar transverse dimensions of the posterior segment of both arches were increased during treatment (P < .05) and remained stable during the retention period. Class II subdivision malocclusion was caused by distal positioning of the mandibular canine, premolars, and first molar on the Class II side (P < .05). Asymmetry was resolved by treatment with asymmetric Forsus appliances. The resolved asymmetry remained stable over the long term. There were no significant differences between T2 and T3 (P > .05). Conclusions: The asymmetric Forsus appliance can be used to treat dental arch asymmetry in patients with Class II subdivision malocclusions.

Objective: This study aimed to evaluate the resorptions of the roots of the maxillary posterior teeth after traditional rapid maxillary expansion (TRME) therapy and boneborne rapid maxillary expansion (BBRME) appliances and to compare the findings obtained using the two appliances. Materials and Methods:The study enrolled 40 patients treated at the orthodontics clinic. These patients were divided into the TRME group (13.4±1.2 years old, n=20) and BBRME group (13.2±1.3 years old, n=20) according to the appliance used. Conebeam computed tomography images taken before the treatment (T0) and after a 3-month retention period (T1) was transferred to an image-processing software. Volumetric measurements of the teeth were made after the segmentation procedure, and volumetric changes before and after treatments were analysed statistically. Paired-sample t-test was used for the intra-group comparison, and independentsample t-test was used for the inter-group comparison. Results: In both groups, the amount of resorption in all teeth that occurred between T0 and T1, was statistically significant (p<0.001). In the TRME group, the highest resorption was measured in the 1 st molars (79.65 mm 3 ), and the lowest resorption was measured in the 2 nd premolars (33.38 mm 3 ). In the BBRME group, the highest resorption was measured in the 1 st molars (46.74 mm 3 ), and the lowest resorption was measured in the 1 st premolars (21.61 mm 3 ). In the comparison of root resorptions that occurred between T0 and T1 in the two groups, analysis results showed that the BBRME group demonstrated lower root resorption (p<0.05). Conclusion:The results suggest that BBRME causes less root resorption than TRME.

Gold weight implantation is generally considered a safe procedure for the treatment of paralytic lagophthalmos. The most frequently seen complications are extrusion, malpositioning, and migration of the implant. To decrease the rate of these complications, several modifications were defined in the composition and the shape of the implant as well as the surgical technique itself. Despite these precautions, implant revision rates are still as high as 8% to 14%. Nowadays, implant-covering or implant-wrapping procedures are becoming more popular to avoid implant-related problems. However, there is limited information in the literature regarding the management of these complications. In this study, we aimed to present the treatment of migration and extrusion of the gold weight implant in a patient with Moebius syndrome by wrapping the implant with autogenous fascia lata graft.