Neal C. Murphy

Longitudinal study of cephalometric soft tissue profile traits between the ages of 6 and 18 years.

OBJECTIVE To study the longitudinal changes in 19 soft tissue cephalometric traits (according to the Bergman cephalometric soft tissue facial analysis). MATERIALS AND METHODS Cephalograms and photographs of 40 subjects (20 male, 20 female, from the Burlington Growth Centre) that were obtained at ages 6, 9, 12, 14, 16, and 18 years were used. Subjects were orthodontically untreated whites and had Class I dentoskeletal relationships (ideal overjet and overbite). Images were obtained with the lips in a relaxed position or lightly touching. RESULTS Three groups of soft tissue traits were identified: (1) traits that increased in size with growth (nasal projection, lower face height, chin projection, chin-throat length, upper and lower lip thickness, upper lip length, and lower lip-chin length); (2) traits that decreased in size with growth (interlabial gap and mandibular sulcus contour [only in females]); and (3) traits that remained relatively constant during growth (facial profile angle, nasolabial angle, lower face percentage, chin-throat/lower face height percentage, lower face-throat angle, upper incisor exposure, maxillary sulcus contour, and upper and lower lip protrusion). CONCLUSION Current findings identify areas of growth and change in individuals with Class I skeletal and dental relationships with ideal overjet and overbite and should be considered during treatment planning of orthodontic and orthognathic patients.

Tissue Engineering and Stem Cell Therapy for Orthodontists

Historically the field of dentofacial biology, despite some pseudoscientific gambits into physiognomy, has progressed at many levels of inquiry. This progression, driven by advancements in basic science and social trends, continues into tissue engineering and stem cell therapy. This new imperative demands that the traditional art of wire bending surrenders some equity to osteology and tissue level science. Despite the challenge, the orthodontist is fully capable of taking on the new challenges which this chapter chronicles. Biological concepts of stem cell therapy are reviewed and synthesized with traditional clinical concepts. A therapeutic bone wound can set the stage for the alteration of genetic expression that changes the size and form of the alveolus bone. So this review focuses on an “engineered optimal response,” rather than “applied optimal force.” Since the former depends upon a deep understanding of the latter, principles of mechanobiology must be embraced when engineering new tissue. Literature in basic science and clinical documentation focuses on demonstrable changes and discussion of ethical imperatives combined to provide a sufficient conceptual basis for further study.

The prevalence of OSA in snorers presenting with various chief complaints: a pilot study

Abstract Aims: The incidence of obstructive sleep apnea (OSA) in snoring patients is reported in the literature to range from 20% to 70%. The aim of this study was to obtain exact data on the percent of snorers who have OSA, and to classify them as having normal, mild, moderate, or severe sleep apnea. Methodology: There were 273 patients who came into the senior author’s office with sleep disorder breathing problems. They suffered with various sleep problems. All 273 patients also had a snoring problem. None of the 273 patients had ever had a sleep test, or polysomnograph (PSG). All 273 required a PSG for evaluation of their sleep problem. They were referred to a certified sleep lab local to them. When the results of the PSG came back, the authors were able to classify them as having normal, mild, moderate, or severe sleep apnea. Results: The results of the 273 PSGs showed the following: 12 patients (4%) had PSGs of apnoea–hypopnoea index (AHI)<5 (normal), 57 patients (21%) had PSGs with AHIs 5–<15 (mild), 79 patients (29%) had PSGs with AHIs 15–<30 (moderate), 119 patients (44%) had PSGs 30 or >30 (severe), and 6 patients (2%) had PSGs >100 (severe). Conclusions: Based on this study, of 273 patients who snored, the incidence of OSA is high. Ninety-six percent of the patients suffered with mild to severe sleep apnea. This malady, which can be very serious and degenerating, could be much more prevalent than previously believed. Additional research is needed to verify these figures.