This study is aimed for measuring the accuracy of simulation and prediction of our CASNOS protocol in adult patients treated with 2-jaw orthognathic surgery. Adult patients with skeletal Class III malocclusions requiring 2-jaw orthognathic surgery were enrolled in the study. Three-dimensional imaging data of 1-month pre-surgical (T1) and 6-month post-surgical (T2) CT were compared to assess accuracy of CASNOS planning. The accuracy of CASNOS protocol was evaluated by calculating the differences in the positions of selected landmarks between simulated surgical and post-surgical 3D images parameters, including ANB, A-Nv, Pog-Nv, and the positions of selected landmarks (ANS, Point A, Point B, Pog) changes in horizontal (x-axis) and vertical (y-axis) directions. Overall geographical discrepancy of planning was assessed by superimposing the color mapping of T1 and T2 imaging. Thirty adult patients with a mean age of 20.6 ± 1.5 years (female/male = 18/12) were enrolled. The geographical changes of overall superimposition between the planned and post-surgical imaging was 0.60 ± 0.19 mm (range: 0.42-1.08 mm). The discrepancies between simulated and post-surgical ANB, A-Nv, Pog-Nv were 1.16 ± 0.36°, 1.25 ± 0.33 mm, 1.19 ± 0.35 mm, respectively. The deviations between simulated and post-surgical Point A and Point B positions were within 1 mm in horizontal and vertical directions. The application of the pre-designed bony guiding splints of CASNOS protocol can allow surgeons to treat patients with craniofacial deformities precisely. CASNOS provides a novel approach for orthodontists and surgeons accurately remedying the patients with complex craniofacial discrepancies.

A novel fiber-optic probe based on reflection-based localized surface plasmon resonance (LSPR) was developed to quantify the concentration of hydrofluoric acid (HF) in aqueous solutions. The LSPR sensor was constructed with a gold nanoparticle-modified PMMA fiber, integrated with a SiO₂ sol-gel coating. This fiber-sensor was utilized to assess the relationship between HF concentration and SiO₂ sol-gel layer etching reduction. The results demonstrated the LSPR sensor was capable of detecting HF-related erosion of hydrofluoric acid solutions of concentrations ranging from 1% to 5% using Relative RI Change Rates. The development of the LSPR sensor constitutes the basis of a detector with significant sensitivity for practical use in monitoring HF solution concentrations.

This retrospective study evaluated the volume of blood loss and operative time associated with management of nongrowing patients with cleft lip and palate (CLP) using bimaxillary orthognathic surgery (OGS) designed by a three-dimensional (3D) computer-assisted simulation and navigation for orthognathic surgery (CASNOS) system. This study included 53 skeletal Class III nongrowing patients with unilateral CLP who underwent bimaxillary OGS using either the CASNOS protocol (n = 30) or the traditional two-dimensional (2D) method (n = 23). The skeletal parameters of jaw-bone components, the levels of hemoglobin (Hb) and hematocrit (Hct) were measured before and after surgery. The estimated blood loss and actual blood loss (ABL) were also calculated. The two groups did not differ significantly with regard to the demographic parameters (age, gender, and body mass index), the preoperative skeletal parameters and surgical changes of jaw-bone components. The mean ABL of the CASNOS group was significantly lower than that of the control group (915.6 ± 280.5 vs. 1204.9 ± 201.0 ml, p < 0.001), and the changes in Hb and Hct level also followed a similar pattern in both groups. The mean operative time was significantly shorter in the CASNOS group compared with the control group (384.2 ± 48.5 vs. 469.0 ± 94.9 min, p < 0.001). This study demonstrated that the application of the 3D CASNOS approach in OGS for the management of complicated Class III nongrowing patients with CLP significantly shortened the operative time and reduced ABL in comparison with the traditional 2D methods.

The aim of this study was to investigate the prevalence of tooth agenesis, tooth malformation, and eruption patterns of upper canines/first premolars in Taiwanese children. A total of 132 cleft lip and cleft palate (CLCP) patients (82 boys and 50 girls) underwent alveolar bone grafting (ABG) between 2012 and 2022. The patients’ dental records and X-ray images were inspected. We examined dental anomalies, including congenital missing teeth, microdontia, and transposition from the upper canines to the upper first premolars in these CLCP patients. Additionally, we investigated the mean ABG operation age (9.27 ± 0.76 years) of our patient; 40.9% of them received pre-ABG orthodontic treatment at 8.72 ± 0.70 years. Among the 132 cleft subjects, the prevalence of tooth agenesis is 73.5% (97/132). The most frequently missing teeth are the maxillary lateral incisors (right side: 46.2%; left side: 47.0%). In this study, microdontia are found in all the upper incisors, of which the highest percentage (18.9%) is observed in the upper left lateral incisors. The prevalence of upper canine and first premolar transposition is 10.6%. The pattern of tooth agenesis and microdontia of the upper lateral incisors shows a strong correlation with the cleft sites of these CLCP patients in our study. These results may support the idea that the patterns of dental anomalies in CLCP patients are region-specific.

Cleft lip and cleft palate (CLCP) patients often have a retrusive maxilla and a severe skeletal Class III malocclusion, which can result in velopharyngeal insufficiency (VPI). The aim of this study was to evaluate the changes in the volume of the 3D airway in CLCP children after maxilla distraction using the transcutaneous maxillary distraction osteogenesis (TMDO) method. 15 children with bilateral or unilateral CLCP were included in the study. 3D CBCT images were taken before and after distraction and were segmented and reconstructed to create a 3D airway model. The airway was divided into three regions: the upper, oropharyngeal, and hypopharyngeal airway. Pearson correlation tests were used to assess correlations between volume changes and corresponding skeletal and dental landmark movements (Point N, ANS, A, B, Pog, U1, and L1). The results showed that the ANS point advanced 9.85 ± 3.60 mm, and the A point advanced 14.22 ± 4.57 mm. The total airway volume change increased by 2535.06 ± 2791.80 mm³. However, there was no significant correlation between the A/ANS/U1 and the three different airway regions. Only B/Pog/L1 showed a positive correlation with these airway regions, with a high correlation between B/Pog/L1 and the hypopharyngeal airway region. TMDO can result in greater anterior advancement of the maxilla and an increase in airway volume, but the changes in bony landmarks did not show a strong positive correlation with the increase in airway volume as expected. Further investigation is needed to analyze the influence of surrounding soft tissue on the changes in airway volume.