Aim:The aim of this study was to compare the number of teeth in the premaxilla (cleft area) and to assess the presence of tooth agenesis with the ultimate goal of finding whether differences existed in the two suggested subtypes of nonsyndromic bilateral cleft lip and palate (BCLP) patients.Settings and Design:A retrospective comparative study was conducted, where cone- beam computed tomography (CBCT) images of 22 BCLP patients (10 males and 12 females, with age range 8 to 14, mean age 9.6 years) obtained from archive of Cleft Clinic, affiliated to the Oral and Maxillofacial Surgery department, Ain-Shams University, Cairo, Egypt were assessed.Subjects and Methods:CBCT images were divided into two subtypes: Group (P) – this represents BCLP characterized by well-developed (P) prominent premaxilla and SNA >80 ± 2 and Group (R) – this represents BCLP characterized by ill-developed (R) rudimentary premaxilla and SNA <80 ± 2. The number of teeth in the premaxilla was evaluated, and the presence of agenesis in the premaxilla and posterior segments was documented.Statistical Analysis Used:Unpaired-Student's t-test was used to compare the number of teeth among the two groups and to test significance at P < 0.05. Intraobserver agreement was assessed using alpha (Cronbach) reliability analysis. A descriptive analysis using percentages was performed to characterize tooth agenesis.Results:A significant difference was found in the number of teeth in the premaxilla among Group R and Group P. Maxillary lateral incisor showed the highest percentage of agenesis in the two groups followed by the maxillary second premolar.Conclusions:The number of teeth might be useful in differentiating different subtypes of nonsyndromic BCLP.
Objective: The aim of this study is to assess the effect of different CBCT voxel sizes on the soft tissue thickness measurements in a variety of maxillary and mandibular regions. Methods: Two thicknesses (less than 2.0 mm and more than 2.0 mm) of pink baseplate wax as simulated soft tissue were overlaid on a maxilla and mandible of a dry human skull. The thicknesses were measured with a digital caliper as the physical measurements. The skull was scanned using CBCT with four different voxel sizes (0.20, 0.25, 0.30 and 0.4 mm). CBCT measurements were compared to the physical measurements. Intraclass Correlation Coefficient was used to assess both intra-and inter-observer reliability. Significance was considered to be 5% (P ≤ 0.05). Results: Results showed a significant difference between the CBCT measurements using the 0.3 and 0.4 mm voxel sizes scans compared to the physical measurements when wax thickness was less than 2.0 mm. On the other hand, no significant difference was found for the CBCT measurements using the four voxel sizes when thickness was greater than 2.0 mm. Conclusions: CBCT scans with voxel sizes of 0.3 mm and 0.4 mm provide accurate simulated soft tissue measurements when the thickness is more than 2.0 mm. However, when greater visualization of details are required, scans with lower voxel sizes is required. Therefore, in a clinical situation, it is of great importance to customize the resolution protocol according to the accuracy needed.
Purpose:The aim was to study the skeletal effect of rapid palatal expansion (RPE) on the anterior and posterior nasal width in a sample of Egyptian children (age range 9.4-14.3 years, mean 11.16 years) with bilateral cleft lip and palate (BCLP).Methods: Twenty Egyptian children with complete BCLP exhibiting maxillary transverse deficiency were divided randomly into; Group 1 received a fixed fan expander and Group 2 a hyrax expander. Cone-beam computed tomography (CBCT) images were taken before T1 and 3 months after expansion T2, just before the alveolar cleft grafting (ACG) surgical procedure. Linear and angular measurements were assessed to measure the degree of change on the anterior and posterior nasal chamber widths, dentition, and dental arch.Results: Repeated measure ANOVA with a between variable analysis was used to examine the effect of the two expanders on the dental arch and anterior nasal width as well as posterior nasal width. Statistically significant increase in dentoalveolar measurements were found in each group, nasal widths showed no statistically significant differences before and after expansion.
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