Stability of the hard and soft tissue profile after mandibular advancement in sagittal split osteotomies: a longitudinal and long-term follow-up study

The aim of the study was to conduct a long-term follow-up investigation of the stability of hard and soft tissues after bilateral sagittal split osteotomy (BSSO) with rigid internal (RIF) fixation to advance the mandible. Sixteen consecutive patients (12 females and 4 males, mean age 21.4 years) were available for re-examination 12.7 years (T5) after surgery. The preceding follow-ups were before (T1), and 5 days (T2), 7.3 months (T3), and 13.9 months (T4) after surgery. Lateral cephalograms were traced by hand, digitized, and evaluated with the Dentofacial Planner program. The x-axis for the system of co-ordinates ran through sella (point zero) and the line NSL -7 degrees. Thus, the program determined the x- and y-values of each variable and the usual angles and distances. Statistical analysis was carried out using Wilcoxon's matched-pair signed-ranks test with Bonferroni adjustments. The relationships between the examined variables were analysed by Spearman rank correlation coefficients. The backward relapse at point B (T5) was 2.42 mm, or 50 per cent, and at pogonion 3.21 mm, or 60 per cent of the initial advancement. The mean net effect at T5 on the labial fold (soft tissue point B) was 94 per cent of the advancement at point B. For the soft tissue chin (soft tissue pogonion), it was 119 per cent of the advancement at pogonion. The net effect on the lower lip (labrale inferior) was 55 per cent of the advancement at incision inferior. The amount of the surgical advancement of the mandible was correlated with the long-term relapse in point B. Among possible reasons for this relapse are the initial soft tissue profile, the initial growth direction, and the remodelling processes of the hard tissue.

TECHNOLOGICAL ADVANCEMENT IN REMOTE SENSING AND INNOVATIVE APPLICATION TO VOLCANOLOGY

The integration of remote monitoring techniques at different scales is of crucial importance for monitoring of volcanoes and assessment of the associated hazard. In this optic, technological advancement and collaboration between research groups also play a key role. Vhub is a community cyberinfrastructure platform designed for collaboration in volcanology research. Within the Vhub framework, this dissertation focuses on two research themes, both representing novel applications of remotely sensed data in volcanology: advancement in the acquisition of topographic data via active techniques and application of passive multi-spectral satellite data to monitoring of vegetated volcanoes. Measuring surface deformation is a critical issue in analogue modelling of Earth science phenomena. I present a novel application of the Microsoft Kinect sensor to measurement of vertical and horizontal displacements in analogue models. Specifically, I quantified vertical displacement in a scaled analogue model of Nisyros volcano, Greece, simulating magmatic deflation and inflation and related surface deformation, and included the horizontal component to reconstruct 3D models of pit crater formation. The detection of active faults around volcanoes is of importance for seismic and volcanic hazard assessment, but not a simple task to be achieved using analogue models. I present new evidence of neotectonic deformation along a north-south trending fault from the Mt Shasta debris avalanche deposit (DAD), northern California. The fault was identified on an airborne LiDAR campaign of part of the region interested by the DAD and then confirmed in the field. High resolution LiDAR can be utilized also for geomorphological assessment of DADs, and I describe a size-distance analysis to document geomorphological aspects of hummock in the Shasta DAD. Relating the remote observations of volcanic passive degassing to conditions and impacts on the ground provides an increased understanding of volcanic degassing and how satellite-based monitoring can be used to inform hazard management strategies in nearreal time. Combining a variety of satellite-based spectral time series I aim to perform the first space-based assessment of the impacts of sulfur dioxide emissions from Turrialba volcano, Costa Rica, on vegetation in the surrounding environment, and establish whether vegetation indices could be used more broadly to detect volcanic unrest.

Stability after bilateral sagittal split osteotomy advancement surgery with rigid internal fixation: a systematic review

PURPOSE: The purpose of this systematic review was to evaluate horizontal relapse and its causes in bilateral sagittal split advancement osteotomy (BSSO) with rigid internal fixation of different types. MATERIALS AND METHODS: A search of the literature was performed in the databases PubMed, Ovid, Cochrane Library, and Google Scholar Beta. From 488 articles identified, 24 articles were finally included. Six studies were prospective, and 18 were retrospective. The range of postoperative study records was 6 months to 12.7 years. RESULTS: The short-term relapse for bicortical screws was between 1.5% and 32.7%, for miniplates between 1.5% and 18.0%, and for bioresorbable bicortical screws between 10.4% and 17.4%, at point B. The long-term relapse for bicortical screws was between 2.0% and 50.3%, and for miniplates between 1.5% and 8.9%, at point B. CONCLUSIONS: BSSO for mandibular advancement is a good treatment option for skeletal Class II, but seems less stable than BSSO setback in the short and long terms. Bicortical screws of titanium, stainless steel, or bioresorbable material show little difference regarding skeletal stability compared with miniplates in the short term. A greater number of studies with larger skeletal long-term relapse rates were evident in patients treated with bicortical screws instead of miniplates. The etiology of relapse is multifactorial, involving the proper seating of the condyles, the amount of advancement, the soft tissue and muscles, the mandibular plane angle, the remaining growth and remodeling, the skill of the surgeon, and preoperative age. Patients with a low mandibular plane angle have increased vertical relapse, whereas patients with a high mandibular plane angle have more horizontal relapse. Advancements in the range of 6 to 7 mm or more predispose to horizontal relapse. To obtain reliable scientific evidence, further short-term and long-term research into BSSO advancement with rigid internal fixation should exclude additional surgery, ie, genioplasty or maxillary surgery, and include a prospective study or randomized clinical trial design with correlation statistics.

Effect of progressive mandibular advancement on pharyngeal airway size in anesthetized adults.

BACKGROUND: General anesthesia in adult humans is associated with narrowing or complete closure of the pharyngeal airway. The purpose of this study was to determine the effect of progressive mandibular advancement on pharyngeal airway size in normal adults during intravenous infusion of propofol for anesthesia. METHODS: Magnetic resonance imaging was performed in nine normal adults during wakefulness and during propofol anesthesia. A commercially available intraoral appliance was used to manually advance the mandible. Images were obtained during wakefulness without the appliance and during anesthesia with the participants wearing the appliance under three conditions: without mandibular advancement, advancement to 50% maximum voluntary advancement, and maximum advancement. Using computer software, airway area and maximum anteroposterior and lateral airway diameters were measured on the axial images at the level of the soft palate, uvula, tip of the epiglottis, and base of the epiglottis. RESULTS: Airway area across all four airway levels decreased during anesthesia without mandibular advancement compared with airway area during wakefulness (P < 0.007). Across all levels, airway area at 50% advancement during anesthesia was less than that at centric occlusion during wakefulness (P = 0.06), but airway area with maximum advancement during anesthesia was similar to that during wakefulness (P = 0.64). In general, anteroposterior and lateral airway diameters during anesthesia without mandibular advancement were decreased compared with wakefulness and were restored to their wakefulness values with 50% and/or maximal advancement. CONCLUSIONS: Maximum mandibular advancement during propofol anesthesia is required to restore the pharyngeal airway to its size during wakefulness in normal adults.

Vehicle Impact Simulation Technology Advancement (VISTA): planning document.

Federal Highway Administration, Office of Safety and Traffic Operations Research and Development, McLean, Va.

Motorcycle Rider Advancement Course Development Plan. Final report.

National Highway Traffic Safety Administration, Office of Driver and Pedestrian Research, Washington, D.C.

Advanced education and training : interim report on the career advancement voucher demonstration /

Mode of access: Internet.

The centenary of the electric current, 1799-1899. A lecture delivered in the Connaught Hall, Dover, on Monday evening, September 18th, 1899, during the meeting of the British association for the advancement of science, 1899.

Illustrated t.-p.

Proposed solution of the railway rate problem; a paper presented at the fifty-ninth annual meeting of the American Association for the Advancement of Science, before the Section on Social and Economic Science, at New Orleans, Louisiana, on December 30, 1905.

Mode of access: Internet.

Engineering as a profession; scope, training, and opportunities for advancement,

Mode of access: Internet.