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.

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.

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.

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.

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.

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).

A Universal Portable Appliance for Stellarator W7-X Power Supply Controlling

In the project Wendelstein 7-X (W7-X), the popular fieldbus Profibus has been determined as a uniform connection between the central control system and all the subordinate systems. A universal embedded control system has been developed for W7-X power supply controlling. Siemens 80C167CR microcontroller is used as the central control unit of the system. With a user-defined printed circuit board (PCB) several control buses, i.e., Profibus, CAN, IEEE 488, RS485 and RS 232 have been connected to the microcontroller. The corresponding hardware interfaces for the control buses have been designed. A graphic liquid crystal display(LCD) and a user-defined keyboard are used as user interface. The control software will be developed with a C-like language, i.e., C166 for the controller.

Changes in sleep parameters following biomimetic oral appliance therapy: A case report

BACKGROUND Mandibular advancement devices(MADs)are used to treat mild to moderate obstructive sleep apnea(OSA),but there is a risk that the underlying condition can worsen in the long-term.Therefore,this case report is based on biomimetic oral appliance therapy as an alternative to MADs,which was found to be beneficial in the treatment of a case with severe OSA.CASE SUMMARY An overnight sleep study was undertaken in a 50-year-old male with excessive daytime sleepiness that lead to a diagnosis of severe OSA as the apnea-hypopnea index(AHI)was found to be 32.8/h.Since the patient was unable to comply with continuous positive airway pressure therapy and declined surgical intervention,treatment with a MAD was initiated.Approximately 10 years later,another sleep study was performed with no MAD in the mouth,which revealed an AHI of 67.9/h.In view of the deterioration in sleep quality,the patient sought alternative treatment and elected on biomimetic oral appliance therapy,using a mandibular repositioning nighttime appliance(mRNA appliance®,Vivos Therapeutics,Inc.,United States).After 10 mo,another sleep study was performed with no device in the patient’s mouth,which revealed an AHI of 11.8/h,a mean oxygen saturation of 94%and a mean oxygen desaturation index of 5.3%while sleeping.Finiteelement analysis of the pre-and post-treatment study models of the upper jaw showed localized size increases of 15%-17%in the premolar regions and 15%-23%in the molar regions.CONCLUSION In adults with severe OSA that are unable to accept continuous positive airway pressure or surgical treatment,biomimetic oral appliance therapy may be preferable over MADs since biomimetic oral appliance therapy may be able to prevent worsening of sleep parameters by remodeling the nasomaxillary complex.Long-term follow up studies are required to verify these novel findings.

Indoor Electromagnetic Radiation Intensity Relationship to Total Energy of Household Appliances

The rapid technological developments in the modern era have led to increased electrical equipment in our daily lives,work,and homes.From this standpoint,the main objective of this study is to evaluate the potential relationship between the intensity of electromagnetic radiation and the total energy of household appliances in the living environment within the building by measuring and analyzing the strength of the electric field and the entire electromagnetic radiation flux density of electrical devices operating at frequencies(5 Hz to 1 kHz).The living room was chosen as a center for measurement at 15 homes in three different environmental regions(urban,suburbs,and open areas).The three measurement methods are(Mode 1:people in a sitting position with electrical appliances on.Mode 2:People in a standing position with electrical appliances on.Mode 3:People are in the upright positionwhile turning off the electrical devices)in the living room.These measurement methods and their results reinforce the importance of this research.The results showed that the average electric field strengthmeasured inMode 2 ismuch greater than the two methods,and we also found less electromagnetic radiation in Mode 3 than in the two modes.All results remain within the recommended overall exposure developed by the International Committee for the Prevention of Non-Ionizing Radiation and the International Electrotechnical Commission.

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.

Network Appliance公司的成长速度高于网络磁盘存储系统市场的增长速度

Network Appliance公司于近日宣报其成长速度高于光纤通道存储网络(FC SAN)和开放系统网络存储或光纤连接存储(FAS)市场的增长水平，公司业务的快速增长显示了客户对NetApp解决方案的拥护和认可。根据IDC公司季度全球磁盘存储系统跟踪报告显示，NetApp在FC SAN市场的营收年同比增长95．0％．与之对应的是FC SAN的市场同比增长16．3％。

Smart Object Detection and Home Appliances Control System in Smart Cities

During the last decade the emergence of Internet of Things(IoT)based applications inspired the world by providing state of the art solutions to many common problems.From traffic management systems to urban cities planning and development,IoT based home monitoring systems,and many other smart applications.Regardless of these facilities,most of these IoT based solutions are data driven and results in small accuracy values for smaller datasets.In order to address this problem,this paper presents deep learning based hybrid approach for the development of an IoT-based intelligent home security and appliance control system in the smart cities.This hybrid model consists of;convolution neural network and binary long short term model for the object detection to ensure safety of the homes while IoT based hardware components like;Raspberry Pi,Amazon Web services cloud,and GSM modems for remotely accessing and controlling of the home appliances.An android application is developed and deployed on Amazon Web Services(AWS)cloud for the remote monitoring of home appliances.A GSM device and Message queuing telemetry transport(MQTT)are integrated for communicating with the connected IoT devices to ensure the online and offline communication.For object detection purposes a camera is connected to Raspberry Pi using the proposed hybrid neural network model.The applicability of the proposed model is tested by calculating results for the object at varying distance from the camera and for different intensity levels of the light.Besides many applications the proposed model promises for providing optimum results for the small amount of data and results in high recognition rates of 95.34%compared to the conventional recognition model(k nearest neighbours)recognition rate of 76%.

IBM和Network Appliance建立存储联盟

IBM存储系统事业部和Network Appliance(NetApp)公司宣布建立存储战略合作关系，以此来推动企业实现随需应变的信息解决方案。同时对IBM的存储解决方案系列进行扩展，IBM拥有业界最丰富和最先进的存储和信息管理产品。

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.

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.