Long-term assessment of conventional and mini-screw–assisted rapid palatal expansion on the nasal cavity

ABSTRACT Objectives To evaluate the long-term effects of mini-screw–assisted rapid palatal expansion (MARPE), rapid palatal expansion (RPE), and controls on the nasal cavity with cone-beam computed tomography (CBCT). Materials and Methods A total of 180 CBCT scans that were part of a previous randomized trial were evaluated retrospectively for 60 patients at pretreatment (T1), postexpansion (T2), and posttreatment (T3). Patients were randomly assigned into 3 groups: MARPE, RPE, and controls (time period T1 to T3; MARPE: 2 years 8 months; RPE: 2 years 9 months; control: 2 years 7 months). Nasal height, nasal length, nasion–ANS height, ANS–PNS length, pyriform height, and nasal septal deviation angle were measured. The changes in alar width, alar base width, anterior nasal cavity width, posterior nasal cavity width, maxillary intermolar width, and maxillary intercanine width were also evaluated. Results The alar base width, posterior nasal cavity width, anterior nasal cavity width, maxillary intercanine width, and maxillary intermolar width significantly increased (P < .05), and the nasal septal deviation angle significantly decreased (P < .05) in both the MARPE and RPE groups as compared with controls in the short term. In the long term, the nasal septal deviation angle was significantly decreased (P < .05) in the MARPE and RPE groups as compared with controls, and the posterior nasal cavity width was significantly increased (P < .05) in the MARPE group compared with the RPE group and controls. Conclusions MARPE and RPE led to a significant increase in the nasal cavity and alar base width compared with controls in the short term. In the long term, a significant increase was observed only in the posterior nasal cavity width with MARPE. Both MARPE and RPE led to a minimal decrease in nasal septal deviation angle in comparison with controls.

Radiologic Analysis of Causes of Early Recurrence after Percutaneous Endoscopic Transforaminal Discectomy

Objective: To retrospectively analyze causes of, and factors influencing, early recurrence after percutaneous endoscopic transforaminal discectomy (PETD) used to treat lumbar-disc herniation. Methods: We included 285 patients with single-segment lumbar-disc herniation, treated using PETD from January 2017 to December 2019 in the First Affiliated Hospital of the University of South China. Patients were classified into early recurrence and non-early recurrence groups based on clinical symptoms and MRI reexamination. Differences in disc-height index (DHI), sagittal range of motion (sROM), base-width of intervertebral disc degeneration, and postoperative intervertebral annulus-fibrosus tear size were compared using independent-sample t test. Differences in degree of intervertebral disc degeneration and herniation sites were analyzed using rank-sum and chi-square tests. Logistic regression was used for multivariate analysis of factors associated with early recurrence after PETD. Results: Two hundred and eighty five patients completed surgery and underwent clinical follow-up. Mean follow-up duration was 15.5 months (12–24 months). During follow-up, 19 patients relapsed within 6 months post-surgery. Early recurrence rate was 6.7%, and mean recurrence duration was 73.4 days (3–168 days). Differences in DHI, base-width, postoperative annulus-fibrosus tear size, degree of intervertebral disc degeneration, and herniation sites between early recurrence and non-early recurrence groups were statistically significant (P<0.05). Herniation site and base-width of herniation were significantly correlated with early recurrence after PETD. Conclusions: DHI, postoperative annulus-fibrosus tear size, and degree of intervertebral disc degeneration were associated with early recurrence after PETD. Increased base-width of herniation was a risk factor for early recurrence after PETD. Central-herniation patients with were more prone to postoperative early recurrence than paracentral-herniation patients.

MORPHOMETRIC PATTERNS OF MAXILLAR Y APICAL BASE VARIABILITY IN PEOPLE WITH VARIOUS DENTAL ARCHES AT PHYSIOLOGICAL OCCLUSION

Morphometric data on the structure of the craniofacial complex are reliable and diagnostically significant values that are of applied nature in terms of practical dentistry. Within this study, analysis of conebeam computed tomograms, biometric indicators of plaster models obtained from the jaws of 83 people (aged 21–35) with physiological occlusion and various types of dental, gnathic dental arches, the degree of proportion between the maxillary apical base and the inter-canine distance were identified. Depending on the dental arch type, the patients were divided into three groups. The morphometric study in the CBCT frontal plane was the distance between the canines tearing tubercles and the inter-canine distance in the apical area. The study outcomes revealed discrepancies between the calculated and actual indicators of the apical base width for all types of dental arches in people with physiological occlusion. In case of mesotrusive dental arches (incisional angle — 127–143°), the width of the apical base corresponded to the width of the dental arches between the canines, while the differences in indicators were not statistically significant. In people with retrusive dental arches (incisional angle exceeding 144°), the width of the dental arch was found to be significantly above the width of the apical bases. As far as protrusive dental arches are concerned (incisional angle below 126°), these patients featured predominance of the apical bases width over the inter-canine distance. The obtained data add to that already available in research literature regarding the relationships and dimensional features pertaining to the craniofacial complex structures, as well as have applied value in orthodontic clinical practice

Effectiveness of the Nasal Creator Device after Cheiloplasty in Patients with Cleft Lip and Palate as Measured by 3D Stereophotogrammetry

Objective: To evaluate nostril morphology post-cheiloplasty after patients with unilateral cleft lip and palate (UCLP) use of the nasal creator device. Study Design: This is a prospective study. Sixteen patients with nonsyndromic UCLP treated at Khon Kaen University underwent cheiloplasty and then wear the nasal creator device for 6 months. Three-dimensional images were taken, from which 5 lines and 8 landmark points were evaluated prior to (T0) and 1 day (T1), 1 month (T2), 3 months (T3), and 6 months (T4) after cheiloplasty. A Repeated Measure ANOVA was used to evaluate nostril changes between time periods and a paired t-test was used to compare values between the affected and non-affected side at T4 (P &lt; .05). Results: On the affected side, the nostril height significantly increased from T0 (2.46±0.89 mm) to T4 (4.22±1.03 mm), and the nostril width significantly decreased from T0 (9.46±2.57 mm) to T4 (7.34±1.41 mm). On the non-affected side, the nostril height significantly increased from T0 (3.39±0.78 mm) to T4 (4.65±1.07 mm), and the nostril width was not significantly different from T0 (6.00±1.25 mm) to T4 (6.59±0.95 mm). The alar base width was not significantly different between T0 (30.18±2.72 mm) and T4 (29.82±1.69 mm). Nostril height and width were not significantly different by T4 when comparing the affected and non-affected sides. Conclusion: Using nasal creator device for 6 months significantly increased the nostril height and decreased nostril width and alar base width after cheiloplasty.

Refractive changes of a new asymmetric intracorneal ring segment with variable thickness and base width: A 2D finite-element model

Purpose To evaluate the local geometric effects of a unilateral intrastromal ring segment with a combined variation of ring thickness and base width in a finite element simulation, and to compare it against the isolated effect of thickness or base width variation alone. Methods A two-dimensional finite-element model of a transversely isotropic cornea was created assuming either axisymmetric stress or plane strain condition. The model geometry was composed of a three-layered corneal tissue (epithelium, anterior and posterior stroma) fixed at the limbus. The implantation of a triangular-shape asymmetric ring segment with varying ring thickness (150 to 300 μm) and base width (600 to 800 μm) was simulated. Also, changes induced by thickness or base width alone were studied and compared their combined effect in the asymmetric ring segment. Geometrical deformation of the simulated cornea and sagittal curvature were the main parameters of study. Results Increasing ring thickness and base width along the arc of the asymmetric ring segment produced a more pronounced flattening in this part of the ring. The asymmetric design did find a good balance between maximizing corneal flattening at one end and minimizing it at the other end, compared to the isolated effect of ring thickness and width. Ring thickness was the most robust parameter in flattening both, the central and peripheral cornea. Conclusion The finite-element model permitted a theoretical study of corneal deformation undergoing implantation of realistic and hypothetical ring geometries. Intracorneal asymmetric ring segments with varying thickness and base width can be a good alternative in corneas with asymmetric keratoconus phenotypes.

Three-Dimensional Analysis of Definitive Secondary Unilateral Cleft Rhinoplasty Using Cartilage Graft

Objective Three-dimensional assessment of nasal morphology in patients with unilateral cleft lip nose treated by cartilage graft augmentation. Design Retrospective study. Patients and Intervention Thirteen patients with unilateral cleft lip nose underwent definitive secondary rhinoplasty and postsurgical changes were examined using a three-dimensional (3D) laser scan. Main Outcome Measure Nasal dorsum length, nasal tip, alar width, and alar base width in frontal view; nasion depth, nasal tip projection, nasal dorsal angle, and nasal tip angle in lateral view; nostril width, nostril height, and nasal tip height in basal view were measured at preoperative (T1: within 6 months), short follow-up (T2: 2-10 weeks), and long follow-up (T3: 9-14 months). Results A significant change in alar width, alar base width, nostril width, and nostril height at the cleft side, nasal dorsum length, nasion depth, nasal tip projection, and nasal tip height was observed from T1 to T3 follow-up after rhinoplasty ( P < .05), whereas the nostril height at the noncleft side was also significantly increased at T2 follow-up but the mean change in height relapsed at T3 follow-up. Alar width, alar base width, and nostril width at the noncleft side, and nasal tip angle did not change significantly after surgery at any follow-up period. Conclusions 3D imaging evaluation after secondary cleft rhinoplasty demonstrated improved functional and aesthetic outcomes using a septal or conchal graft.

Design of Kawlewada Dam and its Components

This paper presents the design and stability analysis of Kawlewada dam (a concrete gravity dam situated in kawlewada village of gondia district) and its components. Through, the demanding years, it has been observed that failures of dams due to many factors are common. So, it is the essential to analysis the various components, parts of dam against all its modes of failures, forces acting on it, uncontrollable disasters such as earthquake, disaster, etc. For this, the preliminary data of the dam required for design, such as control levels, dimensions, crest width, base width, etc. was collected through the Inspection Engineer, posted at Dhapewada Lift Irrigation Office, Tirora, Dist. Gondia. On the basis of collected data the elementary profile and practical profile of dam was estimated, further all the major and the minor force forces acting on dam were calculated, stability analysis of designed dam against all modes of failure and for various load combinations was carried out in STAAD PRO software and was checked for permissible limits. Design of spillway, stilling basin and earthen dam was also carried out for the designed dam. Further, canal originating from the dam and carrying water to culturable command area was also designed by taking care of peak discharge as required by crops.

Performance of piezoceramic sensors

This study is in continuation of the previous research conducted at Ryerson University to develop a model for active monitoring of reinforced concrete members using piezo-ceramic sensor. In the previous research large concrete beam were investigated. The following study examines the performance of piezo-ceramic sensor to monitor maturity of concrete and to evaluate crack width of large base width concrete plates. Small scale beams and large scale slabs specimens were tested under three and four points bending respectively to evaluate the effectiveness of piezo-sensors at different failure modes. Test results from small scale beams were used to model correlation between concrete crack width/strains and sensor signals. The test result indicated that piezo-sensor can be used for active concrete strength monitoring at later stages. It can also be used as an effective indicator of crack width for reinforced concrete members with small base width.

Performance of piezoceramic sensors

This study is in continuation of the previous research conducted at Ryerson University to develop a model for active monitoring of reinforced concrete members using piezo-ceramic sensor. In the previous research large concrete beam were investigated. The following study examines the performance of piezo-ceramic sensor to monitor maturity of concrete and to evaluate crack width of large base width concrete plates. Small scale beams and large scale slabs specimens were tested under three and four points bending respectively to evaluate the effectiveness of piezo-sensors at different failure modes. Test results from small scale beams were used to model correlation between concrete crack width/strains and sensor signals. The test result indicated that piezo-sensor can be used for active concrete strength monitoring at later stages. It can also be used as an effective indicator of crack width for reinforced concrete members with small base width.