Alveolar bone grafting (ABG) is a critical surgical intervention in patients with a cleft of the alveolus, aimed at reconstructing the alveolar ridge to facilitate proper eruption, periodontal support, and alignment of adjacent permanent teeth. The optimal timing for ABG remains debated, with late secondary ABG between the ages of 9 and 11 being widely adopted. This study compared the palatal shapes of 28 children at a mean age of 9.5 years (SD = 0.7) who underwent early secondary ABG at a mean age of 2.1 years (SD = 0.6) or 33 children at a mean age of 10.8 years (SD = 1.5) who underwent late secondary ABG at a mean age of 8.6 years (SD = 1.3) to 60 non-cleft controls at a mean age of 8.6 years (SD = 1.2). The palatal shapes were captured with 239 landmarks digitized on the palate on a digital model. Utilizing geometric morphometric methods, i.e., generalized Procrustes superimpositions, principal component analysis, and permutation tests, we assessed the impact of ABG timing on palatal morphology. The first five principal components (PCs) explained 64.1% of the total shape variability: PC1 = 26.1%; PC2 = 12%; PC3 = 11.9%; PC4 = 7.8%; and PC5 = 6.4%. The Procrustes distance between both cleft groups and the control group was more than twice as large as the Procrustes distance between the early ABG and late ABG groups. Nonetheless, all intergroup differences were statistically significant. Our findings suggest that early ABG has a limited negative effect on palatal shape, providing comparable outcomes to late ABG. The study highlights the potential suitability of early ABG, challenging conventional practices and encouraging further exploration into its long-term effects on maxillary growth.

Objective: We propose a method utilizing mixed reality (MR) goggles (HoloLens 2, Microsoft) to facilitate impacted canine alignment, as planning the traction direction and force delivery could benefit from 3D data visualization using mixed reality (MR).Methods: Cone‐beam CT scans featuring isometric resolution and low noise‐to‐signal ratio were semi‐automatically segmented in Inobitec software. The exported 3D mesh (OBJ file) was then optimized for the HoloLens 2. Using the Unreal Engine environment, we developed an application for the HoloLens 2, implementing HoloLens SDK and UX Tools. Adjustable pointers were added for planning attachment placement, traction direction, and point of force application. The visualization was presented to participants of a course on impacted teeth treatment, followed by a 10‐question survey addressing potential advantages (5‐point scale: 1 = totally agree, 5 = totally disagree).Results: Out of 38 respondents, 44.7% were orthodontists, 34.2% dentists, 15.8% dental students, and 5.3% dental technicians. Most respondents (44.7%) were between 35 and 44 years old, and only 1 (2.6%) respondent was 55–64 years old. Median answers for six questions were ‘totally agree’ (25th percentile 1, 75th percentile 2) and for four questions ‘agree’ (25th percentile 1, 75th percentile 2). No correlation was found between age, profession, and responses.Conclusion: Our method generated substantial interest among clinicians. The initial responses affirm the potential benefits, supporting the continued exploration of MR‐based techniques for the treatment of impacted teeth. However, the recommendation for widespread use awaits validation through clinical trials.

The main characteristic of orthodontic intermaxillary elastics is the generated force. Therefore, it is necessary to know the exact properties of elastics for clinical use and their force degradation over time. Methods: A total of 500 latex elastics of the type 3/16” Medium from the manufacturers Dentaurum, American Orthodontics, 3M, Ortho Organizers, and G&H Orthodontics were tested; 100 elastics from each. The force was measured with a force meter at time 0 and at 2, 8, 24, and 48 h. Elastics were stored being stretched three times on a 3D-printed board in an incubator at 37 °C and under controlled humidity. Shapiro–Wilk normality tests, ANOVA tests, and Bonferroni post hoc tests were used. Results: The mean initial force among the manufacturers ranged from 1.109 N to 1.550 N, with Dentaurum elastics being the closest to the declared force of 1.255 newton. The greatest force degradation occurred during the first two hours; the decrease in force within 24 h ranged from 20% to 33% among the manufacturers. The maximum decrease was observed for American Orthodontics elastics. The smallest decrease occurred between 2 and 8 h for 3M, and between 24 and 48 h for Ortho Organizers. Conclusion: Intermaxillary 3/16” Medium elastics measured in vitro differ in initial force and force degradation among individual manufacturers. The attending clinician must be aware of the basic parameters of the elastics when recommending them to patients, and measuring the initial force directly in the patient’s mouth with a force meter might be helpful.

Background: There is a multitude of protocols of treatment of cleft lip and palate (CLP) worldwide differing in number of operations, surgical techniques, and timings of surgeries. Despite, facial appearance in subjects with CLP is rarely ideal and residual stigmata are easy to notice in many patients irrespective of the protocol. The prospective controlled investigations are optimal for comparing effectiveness of treatment protocols. Because prospective studies are very challenging to perform in CLP field, it is reasonable to retrospectively assess different surgical protocols to identify the promising ones and then to test them in a prospective way. Methods: Our objective was to assess the nasolabial appearance in a preadolescent Slavic population with unilateral cleft lip and palate (UCLP) by using the 0–200 numeric scale with reference photographs. Patients treated in Warsaw, Poland (n = 32), Prague, Czech Republic (n = 26) and Bratislava, Slovakia (n = 17) were included in this retrospective study. Each cleft center used a unique surgical protocol. Two panels of professional raters (n = 7) and laypeople (n = 10) scored blindly the nasolabial esthetics on cropped frontal and profile images with cropped reference photograph present on the same slide. Intra- and inter-rater agreement was assessed with Cronbach’s alpha, intraclass correlation coefficients, t-tests, and Bland–Altman plots. Inter-group differences were evaluated with one-way ANOVA and regression analysis. Results: The agreement within and between raters was acceptable. We found that patients treated in Warsaw, Prague, and Bratislava showed comparable nasolabial appearance on frontal and profile photographs when judged by both professional raters (p > 0.05) and laypeople (p > 0.05). Regression analysis did not identify influence of gender, group (i.e., Warsaw, Prague, and Bratislava), age at lip repair, surgeon, and age at photographic assessment on esthetic outcome (p > 0.05). Conclusion: This study showed that none of the surgical protocols showed superiority to produce good nasolabial appearance.

Objective: This study aimed to compare the force degradation of intermaxillary elastics (IE) in vitro and in vivo while stretching the IE to a precise diameter.Materials and Methods: IE 3/16″ medium Dentaurum from five different batches of packaging were analyzed. The in vivo study involved 10 volunteers, of which 100 IE were examined. To achieve three times the original diameter of the elastic, the distance between the upper canine and the lower dental arch was measured. Buttons were then placed in the mouth accordingly, and IE and passive aligners were inserted for five sessions of 48 h each. To investigate in vitro, 100 IE were placed in an incubator set at 37°C in a humid environment and stretched three times their diameter. The force of the elastics was measured in both investigations using a force meter at 0, 2, 8, 24, and 48 h.Results: In all patients except one, the three times diameter distance extended from the upper canine to the lower second premolar. The force degradation in vivo at 2, 8, 24, and 48 h was 20.58%, 26.78%, 34.81%, and 38.56% and in vitro was 16.38%, 22.83%, 28.32%, and 30.78%.Conclusions: The amount of stretching of IE varies for each patient when using standard insertion points. The force of IE decreases exponentially, the force degradation in vivo being higher. The clinician must consider the force decrease when advising the patient of the time interval to change the elastics.

Aim: The aim was to determine perception of esthetics of smile with modified position of canine in patients after orthodontic treatment of impacted canine by laypersons, general dentists and orthodontists Method: Photographs with modified position of left upper canine were evaluated by means of an electronic questionnaire. The following parameters were changed: rotation, inclination, level of marginal gingiva, vertical position of canine and crown torque. There were 411 respondents: 153 laypersons, 157 general dentists, 101 orthodontists. Results: All rotations, inclinations and torques were evaluated significantly worse by all respondents than those in the original photograph. In case of level of marginal gingiva there were statistically significant differences between the three groups. Laypersons and general dentists perceived the change of –0.8źmm and +1źmm and over as unesthetic, while for orthodontists and general dentists even the change of +0.5źmm was unesthetic. Conclusion: Treatment of impacted canine must emphasize both functional and esthetic results. Our study shows that to achieve optimal esthetics rotation correction is necessaryɸ– especially mesial rotation that is frequent and esthetically disturbing, as well as adequate extrusionɸ– apical shift of canine was perceived as negative by all groups, and torque adjustmentɸ– insufficient correction of torque is esthetically disturbing. Short clinical crown is unesthetic compared to the long one. Torque correction is vital as their insufficient treatment shows visually the previously impacted canine.