Purpose: Treatment of patients with class III malocclusion is one of the most challenging problems in orthodontic practice. This problem which causes functional and esthetic problems can result from prognathism of mandible or deficiency of nasomaxillary complex or a combination of both. It has been estimated that the incidence of this type of malocclusion in Iranian population is between 7.22- 19.5 percent. The importance of early identification and treatment of this malocclusion is significant. The aim of this study was to determine the cephalometric changes following combined use of rapid maxillary expansion and facemask therapy in class III malocclusion.Methods & Materials: In this quasi experimental prospective clinical trial, 15 Iranian patients (6 males and 9 females with a mean age of 8.6 years) were selected. They were first treated with rapid maxillary expansion for 14 days prior to facemask delivery. Then facemask therapy was initiated untill normal canines and molars relationship and a normal overjet were achieved. Cephalometric means (consist of 11 angular and 8 linear measure) before and after treatment was calculated and compared with paired t-test to determine significant differences.Results: Cephalometric analysis showed following changes:SNA=1.3±1.6, SNB=-0.5±1.6, ANB=1.7±2.3, Gonial Angle=-1.4±4.1, Articular Angle=-6±27.5, SNPog=-0.7±1.7, Inclination Angle=2.3±7.3, Y axis Angle=1.5±3.4, Mandibular Plan Angle=2.3±3.3, Occlusal Plan to SN=1±5.4, NSAr=0.8±2.3, PFH/AFH=0.8±1.9,N┴LFH to A=1.1mm±1.9, N┴LFH to Pog=1mm±4.6, Maxilla length=2.3mm±2.9, Mandible length=0.4mm±0.8, Overjet=3.8±2.7, Overbite=-0.8mm±1.5, Wit's appraisal=2.4±2.5.Conclusion: This result indicate that facemask and rapid maxillary expansion improve class III malocclusion by increase in maxillary growth in anterioposterior dimension and a slight limitation of mandibular growth.

Aim: One of the main problems concerning society health is conductive hearing loss which become more important in school age children. This study conducted for the purpose of the evaluation of rapid maxillary expansionon conductive hearing loss. Material and Methods: A total of 10 patient (6 female and 4 male) with the age of 13.98±2.25 years old and with bilateral posterior skeletal cross bite were selected for the study. The selected patients were tested with Pure tone test 3 times, before RME, after the opening of midpalatal suture and after fixed retention. All RME apparatus were manufactured in a laboratory activating by an orthodontist. Changes in pure tone thresholds for bone condition and air condition and also the air bone gap measurements and Eustachian tube function were noted. The paired t-test was used in order to identify significant differences between different records. Results: The study showed that there was statistically significant difference between the first and second records and first and third records for pure tone threshold (bone condition, air condition and air bone - gap), su-ggesting the notable improvement of both ears. There was no significant difference between second and third records which showed the continuos effect of RME. 8 cases (80 %) were suffering from type AD tympanic disorder before the treatment which changed to type AN. The other 2 cases had this disorder before and after the treatment without any change. Conclusion: The study showed the stable effect ofRME on pure tone threshold (air and bone conditions) and on air bone gap in all cases.

Introduction: The aim of this study was to perform a systematic review and meta-analysis to compare the effect of bone-borne expansion (BBE) and tooth-borne expansion (TBE) in patients with maxillary constriction. Methods: Electronic databases, including MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials, were searched up to February 2019. Eligible clinical trials and cohort studies that studied the effects of bone-borne and tooth-borne expansion appliances on patients with constricted maxilla were selected. The study selection, data extraction, and risk of bias assessment were independently performed by two authors. Then, the random-effects meta-analysis and post-hoc heterogeneity tests were performed. Results: In the end, four studies were included in the present meta-analysis (i. e., a randomized clinical trial, two prospective controlled clinical trials, and a cohort study) that collected data from 117 patients. The mean differences between TBE and BBE were 0. 38 mm and-0. 28 mm for premolar and molar apices, 0. 67 mm and 1. 18 mm for premolar and molar crowns, 0. 19 mm and 0. 17 mm for alveolar bone in premolar and molar areas, and-0. 61 mm and 0. 02 mm for nasal and maxillary bones, respectively. Moreover, the differences between TBE and BBE for dental angulation were 3. 84◦ and 1. 52◦ for left and right molars, as well as 4. 85◦ and 3. 46◦ for left and right premolars, respectively. Conclusion: The BBE appliances do not have any advantages over tooth-borne devices with regard to the amount of skeletal or dental expansion; however, it seems to produce less tipping in posterior teeth.

Introduction & Objective: Pulmonary edema after chest tube insertion is a rare complication and is associated with high mortality. The cause of this phenomenon is not clear, although causes such as decrease in surfactant and inflammatory process have been defined. Early diagnosis and treatment decrease the mortality. This study introduces a case of re-expansion pulmonary edema after rapid pleural evacuation.Case: The case is a 4.5 y/o boy, a case of Tetralogy of Fallot, who developed respiratory distress after surgery (Total Correction) in ICU of Namazi Hospital in 1385. Chest X ray showed pneumothorax of left lung. For the patient, chest tube was inserted and the symptoms improved. After few hours the patient developed tachypnea, tachycardia, and CXR showed pulmonary edema of left lung. Appropriate treatment was done for the patient and his condition improved.Conclusion: Pulmonary edema after sudden evacuation of pleura is a rare phenomenon and early diagnosis decreases the mortality.

Transverse maxillary deficiency is relatively prevalent in orthodontic patients. This article reports the use of a Miniscrew-Assisted Rapid Palatal Expansion (MARPE) device for the correction of transverse skeletal maxillary constriction in an adult patient. The patient was a 20-year-old girl with a transverse maxillary deficiency and bilateral posterior crossbite. A MARPE device was positioned on her palate using 4 miniscrews. The activation protocol was one-quarter turn per day every other day, with a total activation duration of 10 weeks following with a 3-month retention period. Pre-MARPE and post-MARPE cone-beam computed tomography cross sections presented a skeletal expansion of maxilla. This report confirms the effective treatment of a mature patient with severe maxillary constriction, highly deep palate, and posterior crossbite using a custom-made modification of MARPE

Background: The effects of rapid maxillary expansion (RME) have been widely studied with classic bidimensional imaging. Objectives: The study aimed to determine immediate post-expansion effect of RME with three-dimensional imaging. Methods: Computed tomography (CT) low dose scan records were taken for three patients before applying RME (T0), and immediately after the end of the active expansion phase (T1). For one patient a CT scan was available also at T2, at time of RME removal. Image analysis was done in 4 steps: segmentation of the face skull, model construction and exportation of. stl surface shells, cranial base superimpositions and colorimetric maps overlay. Results: There were differences in the bone adaptations to RME, but it was possible to identify some common trends in the three patients. All of the three patients showed a pattern of forward movement of the maxilla associated to the suture opening. Patients 1 and 3 demonstrated also a downward movement of the maxilla, which was not visible on patient 2. As a sagittal advancement of almost 6 mm, as visible in patients 1 and 3, was not possible due to growth in only two weeks, all bony changes could be attributed to the RME. For patient 1, the bony changes present at T1, were still present at T2, while the suture was closed. Conclusions: A pattern of forward immediate displacement of the maxilla with respect to the cranial base was consistently noticed in three patients. The vomer bone maintained a connection with one half of the maxilla when the suture opened.

Dissolution pressure and nozzle temperature effects on particle size and distribution were investigated for RESS (Rapid Expansion of Supercritical Solution) process. Supercritical CO2 was used as solvent and Ibuprofen was applied as the model component in all runs. The resulting Ibuprofen nano-particles (about 50 nm in optimized runs) were analyzed by SEM and laser diffraction particle size analyzer systems.Results show that in low supercritical pressure ranges, depending on the solvent and solid component properties (Lower than 105 bar for Ibuprofen-CO2 system), nozzle temperature should be as low as possible (80-90oC for Ibuprofen-CO2 system).In the other hand in high supercritical pressure ranges (above 105 bar), high nozzle temperatures work better. The border line of these two areas depends on the solvent phase behavior. Rapid Expansion of Supercritical Solution into a liquid solvent (RESOLV) was also studied with and without the presence of surfactant and compared with RESS process by measuring of formed particles size, size distribution and dissolution rate. Results show that the RESS process generally creates better conditions for achieving fine and uniform organic powders (with mean particles size of 40-180 nm), in contrast to the RESOLV method (minimum particles size of 80-400 nm).