Hybrid treatment of varied orthodontic appliances for a patient with skeletal class II and temporomandibular joint disorders:A case report and review of literature

BACKGROUND The relation between orthodontic treatment and temporomandibular disorders(TMDs)is under debate;the management of TMD during orthodontic treatment has always been a challenge.If TMD symptoms occur during orthodontic treatment,an immediate pause of orthodontic adjustments is recommended;the treatment can resume when the symptoms are managed and stabilized.CASE SUMMARY This case report presents a patient(26-year-old,female)with angle class I,skeletal class II and TMDs.The treatment was a hybrid of clear aligners,fixed appliances and temporary anchorage devices(TADs).After 3 mo resting and treatment on her TMD,the patient’s TMD symptom alleviated,but her anterior occlusion displayed deep overbite.Therefore,the fixed appliances with TAD were used to correct the anterior deep-bite and level maxillary and mandibular deep curves.After the levelling,the patient showed dual bite with centric relation and maximum intercuspation discrepancy on her occlusion.After careful examination of temporomandibular joints(TMJ)position,the stable bite splint and Invisible Mandibular Advancement appliance were used to reconstruct her occlusion.Eventually,the improved facial appearance and relatively stable occlusion were achieved.The 1-year follow-up records showed there was no obvious change in TMJ morphology,and her occlusion was stable.CONCLUSION TMD screening and monitoring is of great clinical importance in the TMD susceptible patients.Hybrid treatment with clear aligners and fixed appliances and TADs is an effective treatment modality for the complex cases.

Effects and Predictions of Oral Appliances in Obstructive Sleep Apnea

Since April 2004, the Asahi University Medical and Dental Center (hereinafter referred to as our center) has been providing oral appliances (hereinafter referred to as OA) to treat patients diagnosed with obstructive sleep apnea. The effects of using the OA and progress of 71 patients who received treatment at our center by wearing OA from March 2005 to the end of March 2016 were examined through questionnaires sent by physical mail. In 21 of 24 patients who underwent polysomnography after wearing OA, the apnea-hypopnea index (hereinafter referred to as AHI) significantly decreased after wearing OA (9.44 ± 10.37) compared to that before wearing OA (24.02 ± 13.57) (p = 8.7 × 10-8). The results showed that for patients who continuously use OA, it is necessary to have sound sleep/sleep soundly;further, the patients experienced a decrease in snoring when wearing OA, with only a few side effects on the temporomandibular joints and teeth. In addition, the closer the distance from the plane of the lower margin of the mandible to the hyoid bone after wearing OA, the more likely it was for the AHI to decrease, which suggests that wearing OA contributes to the prediction of therapeutic effects.

ApplianceBricks: A Scalable Network Appliance Architecture for Network Functions Virtualization

Network Functions Virtualization(NFV) is an attempt to help operators more effectively manage their networks by implementing traditional network functions embedded in specialized hardware platforms in term of virtualized software instances. But, existing novel network appliances designed for NFV infrastructure are always architected on a general-purpose x86 server, which makes the performance of network functions limited by the hosted single server. To address this challenge, we propose ApplianceB ricks, a novel NFV-enable network appliance architecture that is used to explore the way of consolidating multiple physical network functions into a clustered network appliance, which is able to improve the processing capability of NFV-enabled network appliances.

Clinical Effect of Tip-Edge plus Appliance in Children with Angle Ⅱ1 Malocclusion

The effects of Tip-Edge plus appliance in the treatment of Angle Ⅱ1 malocclusion and the mechanism were investigated. Fifty-two Angle Ⅱ1 children, aged from 12.3-14.2 years, with mandibu- lar retrusion in permanent dentition were selected and treated with Tip-Edge plus appliance. Lateral cephalometric films taken before and after treatment were analyzed. The arithmetic mean and standard deviation were calculated for each variable. Paired t-test was performed to evaluate the significant treatment change. Results showed that the average treatment time was 16 months. Normal overjet and overbite were established with retroclination of upper incisors and proclination of lower incisors. U1-NA was decreased by 15.4° （P〈0.01）. ANB and Y axial angle were decreased significantly （P〈0.05） Soft tissue measurements showed that FCA and UL-E were decreased dramatically （P〈0.05）, and LL-E was increased significantly （P〈0.05）. Remarkable soft tissue change was noted after the treatment and convex facial profile changed to the straight profile. In conclusion, Tip-Edge plus technique can quickly and efficiently correct anterior bite and lateral outlook.

Experimental determination and research on combustion characteristics domain of gas appliance

This manuscript developed an adjustability test system of gas appliances,and proposed determination methods of adjustability domain and technical approach of performance testing of gas appliance,in order to develop experimental determination,quantify the product performance,design quality and combustion characteristics of gas appliances,and provide test foundation and platform for product design,performance test,quality assessment and technology upgrading for gas appliance industry aiming to multi-gas resources in China.The flexible range of gas appliances to different gases and the interchangeability domain of city gases were determined experimentally,together with the equation of combustion characteristics limit curves of gas appliances.The results showed that the second gas appliance has the biggest capability for the change of gas quality,which permits an 11.2% fluctuation in the Wobbe Index of gas;while the third gas appliance has the least capability for the change of gas quality,which only permits a 1.9% fluctuation in the Wobbe Index of gas.The paper also provides the common adjustability domain of the three gas appliances.

Prognostic predictors on the efficacy of oral appliance therapy for obstructive sleep apnea syndrome

Objectives: The aim of this study was to identify independent prognostic predictors of the efficacy of oral appliance (OA) therapy for obstructive sleep apnea syndrome (OSAS). Materials and methods: The subjects consisted of 89 patients (77 males and 12 females) in whom OSAS had been treated with an OA. The mean age of the subjects was 52.4 years (range: 20 to 78 years) and mean body mass index (BMI) was 23.9 kg/m2 (range: 17.3 to 32.2 kg/m2). Lateral cephalograms were taken and 15 angle, 15 distance and 5 area measurements were calculated by means of a computerized program. Overnight polysomnography (PSG) was performed before treatment and several months after titration of OA therapy. OA therapy was considered effective if the apnea-hypopnea index several months after titration was under 15 events/h and was reduced to at least 50% of that before treatment. The examined data such as patient age, sex, BMI, data from cephalometric analyses, Epworth sleepiness scale, and data for pretreatment PSG were analyzed statistically, and multivariate logistic regression analysis was performed to clarify predictive variables for treatment outcome. Results: LFH (OR = 0.350;p = 0.035) and McN-A (OR = 0.276;p = 0.057) were selected as independent predictors from the explanatory variables. The predictive accuracy of the calculated logistic regression model was 74.2%. Conclusion: This results show that OA therapy for OSAS is more effective in patients with large anteroposterior diameter of the maxilla and large lower facial height.

Comparison of skeletal, dental and soft tissue changes in young adults with Class II malocclusion, treated either by camouflage, fixed functional appliance or orthognathic surgery—A prospective study on Indian subjects

Introduction: Borderline Class II malocclusion due to deficient mandible can be treated either by orthodontic camouflage, fixed functional appliances or by orthodontics followed by surgical mandibular advancement. Methodology: A prospective study was designed on young adults with Class II malocclusion on account of a deficient mandible. A total of 45 subjects were divided into three groups of 15 individuals each. The patients were treated either by camouflage, fixed functional appliances or by orthognathic surgery. Pre and post treatment cephalograms were used to assess the skeletal, dental and soft tissue changes. Pre and post treatment profile photographs were assessed on a Visual Analogue Scale (VAS) by orthodontists, oral surgeons and laypersons. Results: Each group achieved a reduction in facial convexity, but the results obtained from the surgical group were more pronounced than the camouflage and the fixed functional group. Conclusion: The reduction in convexity in the camouflage group was by retracting the upper anteriors, which increases the nasolabial angle. In the fixed functional appliance a combination of skeletal and dentoalveolar changes can be observed. However the most appropriate reduction in profile convexity can be obtained by combined orthodontic and surgical treatment of malocclusion.

Genetic expression of Col-2A and Col-10A as a function of administration of IGF-1 &TGF-<i>β</i>with and without anterior mandibular repositioning appliance on the growth of mandibular condylar cartilage in young rabbit

New Zealand (NZ) young rabbits with the administration of insulin-like growth factor (IGF-1) and transforming growth factor-β (TGF-β) with and without mandibular anterior repositioning appliances are explored for the growth of the mandibular condylar cartilage (MCC). 32 growing NZ and rabbits were divided into 4 groups: the group with saline injection in TMJ, the group which received growth factor injection in TMJ, the group which received anterior positioning appliance and the group which received growth factors injection as well as mandibular repositioning appliance. Gene expression was studied by real-time RT-PCR and cartilage growth by histomorphometry. Administration of growth factors along with mandibular repositioning appliances has induced 1) 1.70-fold expression of Col-2Agene (p value < 0.0005) and 2) 1.47-fold expression of Col-10Agene (p value < 0.0005). In contrast, administration of only mandibular repositioning appliances induced 1) 1.28-fold expression of Col-2Agene (p value < 0.0005) and 2) merely 0.62-fold expression of Col-10Agene (p value < 0.0005), while administration of growth factors only induced 1) mere 0.56-fold expression of Col-2Agene (p value 10A gene (p value growth factors along with mandibular repositioning appliances causes an increase in genetic expressions which have been corroborated by histomorphometry and validated by statistical analysis, during an accelerated growth of mandibular condylar cartilage. Administration of growth factors in the TMJ could provide a synergistic role along with mandibular repositioning appliances for treatment of mandibular retrognathism as well as disorders on the MCC.

Multi-objective reconfigurable production line scheduling for smart home appliances

In a typical discrete manufacturing process,a new type of reconfigurable production line is introduced,which aims to help small-and mid-size enterprises to improve machine utilization and reduce production cost.In order to effectively handle the production scheduling problem for the manufacturing system,an improved multi-objective particle swarm optimization algorithm based on Brownian motion(MOPSO-BM)is proposed.Since the existing MOPSO algorithms are easily stuck in the local optimum,the global search ability of the proposed method is enhanced based on the random motion mechanism of the BM.To further strengthen the global search capacity,a strategy of fitting the inertia weight with the piecewise Gaussian cumulative distribution function(GCDF)is included,which helps to maintain an excellent convergence rate of the algorithm.Based on the commonly used indicators generational distance(GD)and hypervolume(HV),we compare the MOPSO-BM with several other latest algorithms on the benchmark functions,and it shows a better overall performance.Furthermore,for a real reconfigurable production line of smart home appliances,three algorithms,namely non-dominated sorting genetic algorithm-II(NSGA-II),decomposition-based MOPSO(dMOPSO)and MOPSO-BM,are applied to tackle the scheduling problem.It is demonstrated that MOPSO-BM outperforms the others in terms of convergence rate and quality of solutions.

Distributed demand side management via smart appliances contributing to frequency control

Nowadays renewable energy has become a trend for energy production but its variable nature has made balancing of demand and supply of the power grid difficult. Dynamic demand management using smart appliances is proposed to serve as a way that part of the regulation burden of balancing demand and supply is shifted to the demand side. However, if all appliances respond to the same frequency deviation, they may start to synchronize, causing large power overshoots and instability of the power grid. Therefore, the idea of implementing randomness into the frequency control of the appliances is proposed and this is what we call a stochastic approach. Simulators are built from scratch to model both scenarios. The effect of synchronization is analyzed and the parameters that can affect the synchronization are investigated. It has been found that the larger the contribution from the smart appliances to the power grid, the easier and faster the synchronization takes place. The stochastic approach solves the problem of synchronization and averages out the large power overshoot. However, the overall performance of stochastic operations is unacceptable due to the randomness in the operation though the mean and variance are as expected. More advanced feedback policies and schemes may be designed to achieve a better performance.

Development of Cr-free anti-fingerprint hot-dip galvanized sheet for household appliances

China has become the maximum household appliances manufacturing base worldwide.It is a new challenge facing the steel industry to develop the low-cost and environment-friendly sheet for household appliance industry,so Cr-free anti-fingerprint hot-dip galvanized sheet for household appliances is the upgraded product which satisfies the requirement of China household appliance industry' s nuisanceless treatment.The paper discusses the technical key points of development on Cr-free anti-fingerprint galvanized sheet for household appliances,including the development of the Cr-free anti-fingerprint chemical and the production technology of Cr-free anti-fingerprint galvanized sheet for household appliances.The paper elaborates the main compositions,physical features and properties of the Cr-free anti-fingerprint chemical, surface quality control technology,anti-fingerprint coating quality control technology,influence of anti-fingerprint film weight on corrosion resistance,conductibility,high-temperature discolouration resistance,acid resistance,alkaline resistance and solvent resistance of Cr-free anti-fingerprint hot-dip galvanized sheet, influence of anti-fingerprint coating uniformity on paintability of the sheet,influence of strip surface roughness on corrosion resistance and conductivity of the sheet and influence of strip surface quality on corrosion resistance of the sheet.Adopting the suitable Cr-free anti-fingerprint chemical and the reasonable production process parameters,the properties of the Cr-free anti-fingerprint hot-dip galvanized sheet conform to the delivery technical norms and the Cr-free anti-fingerprint hot-dip galvanized sheet becomes the new material for household appliances such as computer case.

Periodontal Tissue Status among Mental Retardation Patients with Fixed Prosthodontic Appliances

Background: The mental, physical and social impediments cause limitation of chances in normal life as an equal level with others of the community;particularly in relation to maintain good oral hygiene and periodontal health among the disabled patients who were receiving fixed partial denture. So the present study was performed to evaluate the periodontal tissue status among mental retardation patients with fixed prosthodontic appliances. Subjects and Methods: A total of 400 patients between the ages 18 and 50 years were clinically selected from outpatient clinics, college of dentistry, King Khalid University and rehabilitation center in Abha city, Saudi Arabia. They were divided into two equal groups as the following: group I: Two hundred mental retardation patients without fixed prosthodontic appliances (control group) and, group II: Two hundred mental retardation patients had fixed prosthodontic appliances for at least a year ago. A complete periodontal clinical examination was performed and the following indices were recorded: plaque index (PLI), gingival index (GI), and clinical attachment loss (CAL). All data was recorded and analyzed by ANOVA test. Results: The clinical results of the present study confirmed the relationship among the mental retardation, fixed prosthodontic appliances and destruction of periodontal tissues. It has been found that the severity of periodontal disease increases among the study group compared to the control group. Statistically significant differences were found in PLI, GI and CAL in the comparison between group I and II (p Conclusion: There was a negative relationship between mental retardation with a status of periodontal tissues and oral hygiene among the patients under fixed prosthodontic management.

Analysis of Referrals for Mandibular Advancement Appliances for Sleep Apnoea

Aim: This article investigates the increasing awareness of Obstructive Sleep Apnoea (OSA) as a potentially serious health risk and highlights the role of the dentist in managing mild to moderate OSA cases which can be improved with an intra-oral mandibular advancement appliance. Methods: Data from referrals to a Prosthodontic Unit from 01-01-2019 to 18-8-2022 were analysed. Results: A total of 240 consecutive referrals to an NHS hospital where a patient was fitted with a mandibular advancement appliance (MAA) were analysed and 160 (67%) were male and 80 (33%) were female. The mean age in years was 52 (2019), 50 (2020), 52 (2021) and 51 (2022). Mean age of male referrals was 51 and female referrals was 53. Conclusion: There are a large number of patients with OSA seeking a dental device and practitioners should be aware of this treatment modality to help the medical team manage OSA. Clinical relevance: Dentists may need to have a greater understanding of OSA and be able to provide MAAs.

Improving Energy Efficiency of Smart Household Appliances and Devices

With the ever-increasing volume of applications of various kinds of electric drives in all spheres of human activity, the issues in improving the efficiency of the electromechanical converters of electric energy, one of the most important components of the electric drive (ED), are becoming increasingly important. Such issues include reducing their weight and size, improving the functional characteristics of these devices to increase their operational life and reducing the cost of manufacture. Taking full advantage of these opportunities relates to the AC and DC single-phase commutator motor (SCM), which is widely used in regulated and high-speed motor drives in home appliances and electric hand tools. The SCM is used in machinery where the load torque has a hyperbolic dependence on the rotational speed and the need to work with a large motor overload due to the “soft” mechanical characteristics of such motors.

Forecasting of Appliances House in a Low-Energy Depend on Grey Wolf Optimizer

This paper gives and analyses data-driven prediction models for the energy usage of appliances.Data utilized include readings of temperature and humidity sensors from a wireless network.The building envelope is meant to minimize energy demand or the energy required to power the house independent of the appliance and mechanical system efficiency.Approximating a mapping function between the input variables and the continuous output variable is the work of regression.The paper discusses the forecasting framework FOPF(Feature Optimization Prediction Framework),which includes feature selection optimization:by removing non-predictive parameters to choose the best-selected feature hybrid optimization technique has been approached.k-nearest neighbors(KNN)Ensemble Prediction Models for the data of the energy use of appliances have been tested against some bases machine learning algorithms.The comparison study showed the powerful,best accuracy and lowest error of KNN with RMSE=0.0078.Finally,the suggested ensemble model’s performance is assessed using a one-way analysis of variance(ANOVA)test and the Wilcoxon Signed Rank Test.(Two-tailed P-value:0.0001).

Treatment of Skeletal CL II Patient with Maximum Lower Incisor Protrusion and Minimum Overjet with Rahhal Functional Appliance

Treatment of skeletal Cl II includes functional orthopedic treatment, head-gears, extraction of the upper premolars and orthognathic surgery. To treat any patient with functional appliances (bite jumping) an adequate overjet is necessary. In this case an 11 years old female patient has skeletal CLII due to mandibular deficiency with ANB angle 8 degrees, overbite: 3 mm, overjet: 1 mm, extremely convex profile and underdeveloped chin due to the hyper muscle contraction of the lower lip to obtain oral seal. To obtain an adequate overjet lower first premolars were extracted and maximum retraction using mini screws (for maximum anchorage) was applied. Afterwards Rahhal functional appliance was used by the patient 16 hours a day for 6 months and 10 hours a day for another 6 months for retention. After that fixed orthodontic treatment was completed. Lateral cephalometrics were taken, traced and analyzed. In the result Skeletal CLI was obtained (ANB 4 degree), straight facial profile, normal over bite overjet and particular chin development were noticed. As a conclusion, in skeletal CLII malocclusions, lower incisor protrusion will cause a contraindication for functional treatment. Extraction of the lower premolars and retraction of the lower incisors followed by functional orthopedic treatment is an efficient method to treat these cases instead of waiting for orthognathic surgery, also reducing the muscle pressure on the chin will change the development characteristics of it.

Obstructive Sleep Apnea, Prevalence, Etiology &Role of Dentist &Oral Appliances in Treatment: Review Article

Objective: The aim of this article is to provide a detailed description for obstructive sleep apnea regarding its signs and symptoms, the way it is diagnosed, the risk factors, management, the role of dentists and oral appliances in treatment and consequences of untreated condition. Material and Method: Electronic searching was done in PubMed, Medline, EMBASE and CENTRAL databases. Inclusion criteria were: dental, oral and maxillofacial oriented articles. Exclusion criteria: cardiac, obesity and non dental oriented articles were excluded. Result: 59 articles meet the criteria. Conclusion: Obstructive sleep apnea (OSA) is a potentially life threatening disorder characterized by repeated collapse of the upper airway during sleep, with periodic cessation of breathing for more than ten seconds. The frequency of obstructive sleep apnea has been found to increase with age;ranging from two percent among children to two and half percent - six percent among adolescents. Overnight polysomnographic test at specialized sleep clinics remains the gold standard for diagnosing obstructive sleep apnea disorder. Management of this condition can be performed via surgical and non surgical methods. Continuous positive airway pressure represents the first line of treatment for most patients with obstructive sleep apnea.

A simplified two-piece mandibular advancement appliance for obstructive sleep apnea

Nowadays mandibular advancement appliances (MA- As) are available and distributed widely in the field of dentistry for the treatment of snoring and ob- structtive sleep apnea (OSA). However, a few stud- ies discussed temporomandibular joint (TMJ) discom- fort and masticatory muscle stiffness during wearing MAAs are found. A new appliance that we introduced in this pilot study has shown significant jaw move- ment and could diminish TMJ and masticatory side effects.

Impact of Implementation Energy Efficient Appliances in Palestinian Market

Recently, Palestine has been willing to improve its energy efficiency action plan and policies. As the Electrical demand for energy is increasing in Palestine, improving energy efficiency can be considered as an efficient way to achieve reductions in energy consumptions. In this respect, energy efficiency action plan and its strategies must be designed to overcome existing market barriers against using energy efficient appliances in residential and commercial sectors in Palestine. This study provides background on the benefits of stakeholders and steps needed to support energy efficiency standards and labeling in Palestine. Furthermore, this study attempts to predict the techno-economic impact of implementing high efficient electrical appliances in Palestine. Survey-based analyses from 300 households were conducted in 2019 to estimate residential sector electrical appliances usage, behavior and their knowledge in electrical appliances labels and standards, the study aims also to estimate the perception and willingness of Palestinian householders to shift towards more energy efficient choices. The study will focus on 8 electrical appliances that constitute a major share of the electricity used within households and commercial sectors in Palestinian market.