Background: This study aimed to reveal the efficacy of the artificial intelligence (AI)-assisted dental age (DA) assessment in identifying the characteristics of growth delay (GD) in children. Methods: The panoramic films matching the inclusion criteria were collected for the AI model training to establish the population-based DA standard. Subsequently, the DA of the validation dataset of the healthy children and the images of the GD children were assessed by both the conventional methods and the AI-assisted standards. The efficacy of all the studied modalities was compared by the paired sample t-test. Results: The AI-assisted standards can provide much more accurate chronological age (CA) predictions with mean errors of less than 0.05 years, while the traditional methods presented overestimated results in both genders. For the GD children, the convolutional neural network (CNN) revealed the delayed DA in GD children of both genders, while the machine learning models presented so only in the GD boys. Conclusion: The AI-assisted DA assessments help overcome the long-standing populational limitation observed in traditional methods. The image feature extraction of the CNN models provided the best efficacy to reveal the nature of delayed DA in GD children of both genders.

Purpose. The purpose of the present study was to review the literature regarding the blood loss and postoperative pain in the isolated sagittal split ramus osteotomy (SSRO) and intraoral vertical ramus osteotomy (IVRO). Materials and Methods. Investigating the intraoperative blood loss and postoperative pain, articles were selected from 1970 to 2021 in the English published databases (PubMed, Web of Science, and Cochrane Library). Article retrieval and selection were performed by two authors, and they independently evaluated them based on the eligibility criteria. The articles meeting the search criteria had especially at least 30 patients. Results. In the review of intraoperative blood loss, a total of 139 articles were retrieved and restricted to 6 articles (SSRO: 4; IVRO: 2). In the review of postoperative pain, a total of 174 articles were retrieved and restricted to 4 articles (SSRO: 3; IVRO: 1). The mean blood loss of SSRO and IVRO was ranged from 55 to 167 mL and 82 to 104 mL, respectively. The mean visual analog scale (VAS) scores of the first postoperative day were 2 to 5.3 in SSRO and 2.93 to 3.13 in IVRO. The mean VAS scores of the second postoperative day were 1 to 3 in SSRO and 1.1 to 1.8 in IVRO. Conclusion. Compared to traditional SSRO, IVRO had a significantly lower amount of blood loss. However, the blood transfusion is not necessary in a single‐jaw operation (SSRO or IVRO). Postoperative pain was similar between SSRO and IVRO.

A major drawback of nanocomposite scaffolds in bone tissue engineering is dimensional shrinkage after the fabrication process. Shrinkage yields gaps between the scaffold and host bone in the defect site and eventually causes failure in osteointegration by micromovement. The present study was conducted using titanium (Ti) mesh and Gelfoam^® to prevent radial and axial micromovement, respectively. A critical-sized defect (CSD) was created in the center of the calvarium of Sprague Dawley rats to implant porous polydopamine-laced hydroxyapatite collagen calcium silicate (HCCS-PDA), a novel nanocomposite scaffold. Gelfoam^® was applied around the edge of the defect, and then the HCCS-PDA scaffold was inserted in the defect area. Ti mesh was placed between the periosteum and skin right, above the inserted scaffold site. There were two test groups, with a fixture (Gelfoam^® and Ti mesh) and without a fixture, each group contained five animals. The rats were sacrificed after three months post-operation. The explanted calvaria underwent micro-CT scanning and a push-out test to quantify osteointegration and mechanical strength between the scaffold and host bone. Histological analysis of undecalcified bone was performed by grinding resin infiltrated calvaria blocks to prepare 10 μm slices. Osteointegration was higher in the group with fixation than without fixation. Movement of the HCCS-PDA scaffold in the gap resulted in diminished osteointegration. With fixation, the movement was inhibited and osteointegration became prominent. Here we present a successful method of preventing axial and radial movement of scaffolds using Gelfoam^® and Ti mesh. Applying this fixture, we expect that an HCCS-PDA scaffold can repair CSD more effectively.

Background. The orthognathic strategies to treat patients with a concave profile but different tissue conditions remain controversial. The aim of this case‐control study was to investigate the outcome predictability of orthognathic surgery in cleft lip and palate (CLP) patients and matched controls. Methods. Fifty consecutive CLP and 45 matched non‐CLP patients who received whole‐piece Le Fort I and bilateral sagittal split osteotomy to correct class III skeletal relations were enrolled. The outcome discrepancies (ODs) from simulations among all groups were evaluated with consideration of the possible influences from planned surgical movements (PSM). Receiver operating characteristic curves were used to determine threshold values of PSMs that yielded clinically relevant OD. Results. Unilateral CLP (UCLP) patients had comparable postsurgical OD to non‐CLP patients in both jaws, whereas bilateral CLP (BCLP) patients had greater deviations from predicted results. Vertical movement of the A − point > 1.33 mm and yaw correction > 1.65^° in the BCLP patients was associated with clinically relevant maxillary OD. Conclusions. The OGS outcomes of BCLP patients were less predictable than those of the UCLP and noncleft patients. Vertical movements of the A − point > 1.33 mm and yaw correction > 1.65^° in BCLP patients increased OD to a clinically relevant extent.

Background: Traditional distraction osteogenesis (DO) with the tooth-borne rigid external device (RED) system was regularly used in treating patients with cleft-related maxillary hypoplasia. However, the bone-borne RED system with miniplates and bone screws has currently become an effective treatment. This retrospective study was to compare bone-borne RED with traditional tooth-borne RED in distraction effectiveness, blood loss, operative time, and long-term stability. Methods: Twenty-two growing patients who underwent RED therapy were divided into two groups: eleven patients utilizing the bone-borne RED system with the transcutaneous wire attached with skeletal anchorage; another eleven patients using the traditional tooth-borne RED system with the intra-oral device attached with dental anchorage. Serial lateral cephalograms were analyzed for comparing treatment outcomes and stability in 1 month, 6 months, and 1.5 years after distraction. Results: In bone-borne RED group, the maxilla was advanced by 19.98 mm with slight clockwise rotation of 0.40° and minimal palatal inclination change of incisor by −3.94°. In traditional tooth-borne RED group, the maxilla showed less advancement by 14.52 mm, with significant counter-clockwise rotation of −11.23° and excessive palatal inclination change of incisor by −10.86°. Although operative time was longer in the bone-borne RED group by 38.4 min, this did not bring about greater blood loss. Conclusions: the bone-borne RED via transcutaneous wire system provides an easy, simple, and comfortable procedure as well as favorable long-term stability in maxillary distraction.

Objective: Mandibular full-arch distalization (MFD) is a popular approach, particularly in non-extraction cases. However, we still cannot confirm whether facial patterns affect the amount of limits. This study aimed to determine the anatomical MFD limits in patients with different facial patterns. Study design: Using computed tomography (CT), the shortest distances from the mandibular second molar to the inner cortex of the mandibular lingual surface and from the lower central incisor to the inner cortex of the lingual mandibular symphysis were measured in 60 samples (30 patients). The available distalization space in both regions was compared between groups with different facial patterns. Results: The available space in symphysis was more critical than that in retromolar area: the shortest distances to the inner cortex of the lingual mandibular symphysis at root levels 8 mm apical to the cementoenamel junction of the incisor were 1.28, 1.60, and 3.48 mm in the high-, normal-, and low-angle groups, respectively. Conclusions: Facial patterns affected the MFD capacity, and the thickness of the lingual mandibular symphysis was the most critical anatomic limit encountered. Practitioners should always pay attention to the possible impacts from facial patterns, especially in the treatment of high-angle cases.