The comparison of coefficients of the forward expansion of conformal latitude derived by Yang (1989, 2000) and the author
\r\n\tThere are generally two types of masonry: brick and stone masonry. Brick masonry: a type of masonry that uses bricks. However, masonry is further divided into "clay work," which uses clay to fill various joints with bricks to build walls, and "cement masonry," the cheapest type of masonry. Masonry: this is the art of building with bricks or stone. The ability of masonry to support the load imposed by the structural elements above it is called strength. The application of loads to masonry creates internal stresses and deformations. The brand of mortar and brick, the shape and size of masonry materials, and the thickness and density of mortar joints affect the strength of masonry. The ability of masonry to maintain its position under horizontal load is called stability. This property limits the height of masonry depending on its thickness and the magnitude of wind loads. The thermal conductivity of bricks of different types (silicate, ceramic, facing, refractory) is considered. A comparison of bricks in terms of their thermal conductivity is made; the thermal conductivity coefficients of refractory bricks are presented at different temperatures - from 20 to 1700°C. The thermal conductivity depends mainly on the density and the configuration of the voids. Architecture and construction consist of various elements for building works, and masonry is the main element with which these constructions are realized. Masonry is a piece of fired clay with a rectangular shape and is used to build walls and structures. Nowadays, eco-masonry can be made of different materials that offer a variety of advantages, but all of them offer benefits at the level of the environment and sustainability; some of these utensils are plastic bottles, clay, etc. The book addresses the holistic issue of using modern masonry in construction. This book interprets masonry as an essential theme of contemporary architecture and sustainable construction. It is one of the most valuable materials in the history of mankind.
",isbn:"978-1-83768-126-6",printIsbn:"978-1-83768-125-9",pdfIsbn:"978-1-83768-127-3",doi:null,price:0,priceEur:0,priceUsd:0,slug:null,numberOfPages:0,isOpenForSubmission:!0,isSalesforceBook:!1,isNomenclature:!1,hash:"85ef86d046d15e7d4b1988f1ec5dd750",bookSignature:"Prof. Amjad Almusaed and Prof. Asaad Almssad",publishedDate:null,coverURL:"https://cdn.intechopen.com/books/images_new/12061.jpg",keywords:"Unreinforced Masonry Buildings, Masonry in Sustainable Building, Energy Saving and Masonry, Eco-Friendly Masonry, Modern Architecture and Masonry, Masonry and Human Behavior, Esthetic and Masonry, History of Advanced Masonry, Structural Masonry, Modeling of Masonry Structures, Modern Masonry Manufacturing, Masonry Walls",numberOfDownloads:null,numberOfWosCitations:0,numberOfCrossrefCitations:null,numberOfDimensionsCitations:null,numberOfTotalCitations:null,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"May 20th 2022",dateEndSecondStepPublish:"July 21st 2022",dateEndThirdStepPublish:"September 19th 2022",dateEndFourthStepPublish:"December 8th 2022",dateEndFifthStepPublish:"February 6th 2023",dateConfirmationOfParticipation:null,remainingDaysToSecondStep:"a month",secondStepPassed:!0,areRegistrationsClosed:!1,currentStepOfPublishingProcess:3,editedByType:null,kuFlag:!1,biosketch:"Prof. Amjad Almusaed, affiliated with Jönköping University has carried out a great deal of research and technical survey work and has performed several studies in these areas. 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There are many fussy symbolic problems to be dealt with in map projections, such as power series expansions of elliptical functions, high order differential of transcendental functions, elliptical integrals and the operation of complex numbers. Many famous cartographers such as Adams (1921), Snyder (1987), Yang (1989, 2000) have made great efforts to solve these problems. Due to historical condition limitation, there were no advanced computer algebra systems at that time, so they had to dispose of these problems by hand, which had often required a paper and a pen. Some derivations and computations were however long and labor intensive such that one gave up midway. Briefly reviewing the existing methods, one will find that these problems were not perfectly and ideally solved yet. Formulas derived by hand often have quite complex and prolix forms, and their orders could not be very high. The most serious problem is that some higher terms of the formulas are erroneous because of the adopted approximate disposal.
With the advent of computers, the paper and pen approach is slowly being replaced by software developed to undertake symbolic derivations tasks. Specially, where symbolic rather than numerical solutions are desired, this software normally comes in handy. Software which performs symbolic computations is called computer algebra system. Nowadays, computer algebra systems like Maple, Mathcad, and Mathematica are widely used by scientists and engineers in different fields (Awang, 2005; Bian, 2006). By means of computer algebra system Mathematica, we have already solved many complicated mathematical problems in special fields of cartography in the past few years. Our research results indicate that the derivation efficiency can be significantly improved and formulas impossible to be obtained by hand can be easily derived with the help of Mathematica, which renovates the traditional analysis methods and enriches the mathematical theory basis of cartography to a certain extent.
The main contents and research results presented in this chapter are organized as follows. In Section II, we discuss the direct transformations from geodetic latitude to three kinds of auxiliary latitudes often used in cartography, and the direct transformations from these auxiliary latitudes to geodetic latitude are studied in Section III. In Section IV, the direct expansions of transformations between meridian arc, isometric latitude, and authalic functions are derived. In Section V, we discuss the non-iterative expressions of the forward and inverse Gauss projections by complex numbers. Finally in Section VI, we make a brief summary. It is assumed that the readers are somewhat conversant with Mathematica and its syntax.
Cartographers prefer to adopt sphere as a basis of the map projection for convenience since calculation on the ellipsoid are significantly more complex than on the sphere. Formulas for the spherical form of a given map projection may be adapted for use with the ellipsoid by substitution of one of various “auxiliary latitudes” in place of the geodetic latitude. In using them, the ellipsoidal earth is, in effect, transformed to a sphere under certain restraints such as conformality or equal area, and the sphere is then projected onto a plane (Snyder, 1987). If the proper auxiliary latitudes are chosen, the sphere may have either true areas, true distances in certain directions, or conformality, relative to the ellipsoid. Spherical map projection formulas may then be used for the ellipsoid solely with the substitution of the appropriate auxiliary latitudes.
The rectifying, conformal and authalic latitudes are often used as auxiliary ones in cartography. The direct transformations form geodetic latitude to these auxiliary ones are expressed as transcendental functions or non-integrable ones. Adams (1921), Yang (1989, 2000) had derived forward expansions of these auxiliary latitudes form geodetic one through complicated formulation. Due to historical condition limitation, the derivation processes were done by hand and orders of these expansions could not be very high. Due to these reasons, the forward expansions for these auxiliary latitudes are reformulated by means of Mathematica. Readers will see that new expansions are expressed in a power series of the eccentricity of the reference ellipsoid
The meridian arc from the equator
where
(1) is an elliptic integral of the second kind and there is no analytical solution. Expanding the integrand by binomial theorem and itntegrating it item by item yield:
where
The rectifying latitude
where
\n\t\t\t\tYang (1989, 2000) gave an expansion similar to (5) but expanded
Omitting the derivation process, the explicit expression for the isometric latitude
For the sphere, putting
Comparing (9) with (8) leads to
Therefore, it holds
Since the eccentricity is small, the conformal latitude is close to the geodetic one. Though (11) is an analytical solution of
as the conventional usage in mathematical cartography.
Through the tedious expansion process, Yang (1989, 2000) gave a power series of the eccentricity
Due to that (11) is a very complicated transcendental function, the coefficients
In fact, Mathematica works perfectly in solving derivatives of any complicated functions. By means of Mathematica, the new derived forward expansion expanded to tenth-order terms of
The derived coefficients in (13) and (14) are listed in Table 1 for comparison.
Coefficients derived by Yang(1989, 2000) | Coefficients derived by the author |
The comparison of coefficients of the forward expansion of conformal latitude derived by Yang (1989, 2000) and the author
Table 1 shows that the eighth order terms of
From the knowledge of mapping projection theory, the area of a section of a lune with a width of a unit interval of longitude
where
Denote
\n\t\t\t\tSuppose that there is an imaginary sphere with a radius
and whose area from the spherical equator
Therefore, it yields
where
(19) is a complicated transcendental function. It is almost impossible to derive its eighth-order derivate by hand. There are some mistakes in the high order terms of coefficients
The derived coefficients in (20) and (21) are listed in Table 2 for comparison.
Coefficients derived by Yang(1989, 2000) | Coefficients derived by the author |
The comparison of coefficients of the forward expansion of conformal latitude derived by Yang (1989, 2000) and the author
Table 2 shows that the eighth-orders terms of
In order to validate the exactness and reliability of the forward expansions of rectifying, conformal and authalic latitudes derived by the author, one has examined their accuracies choosing the CGCS2000 (China Geodetic Coordinate System 2000) reference ellipsoid with parameters
The inverse expansions of these auxiliary latitudes are much more difficult to derive than their forward ones. In this case, the differential equations are usually expressed as implicit functions of the geodetic latitude. There are neither any analytical solutions nor obvious expansions. For the inverse cases, to find geodetic latitude from auxiliary ones, one usually adopts iterative methods based on the forward expansions or an approximate series form. Yang (1989, 2000) had given the direct expansions of the inverse transformation by means of Lagrange series method, but their coefficients are expressed as polynomials of coefficients of the forward expansions, which are not convenient for practical use. Adams (1921) expressed the coefficients of inverse expansions as a power series of the eccentricity
The processes to derive the inverse expansions using the power series method are as follows:
To obtain their various order derivatives in terms of the chain rule of implicit differentation;
To compute the coefficients of their power series expansions;
To integrate these series item by item and yield the final inverse expansions.
One can image that these procedures are quite complicated. Mathematica output shows that the expression of the sixth order derivative is up to 40 pages long! Therefore, it is unimaginable to derive the so long expression by hand. These procedures, however, will become much easier and be significantly simplified by means of Mathematica. As a result, the more simple and accurate expansions yield.
Differentiation to the both sides of (1) yields
Inserting (23) into (22) yields
To expand (24) into a power series of
therefore
and then denote
Making use of the chain rule of implicit differentiation
It is easy to expand (27) into a power series of
Omitting the detailed procedure, one arrives at
where
Multiplying
where
\n\t\t\t\t\tDifferentiating the both sides of (10) yields
Therefore, it holds
For the same reason, we introduce the following new variable
and then denote
Using the same procedure as described in the former section, one arrives at
where
Integrating the both sides of (38) gives the inverse expansion of conformal latitude as
where
Inserting (18) into (15) yields
Differentiating the both sides of (42) yields
For the same reason, we introduce the folllowing new variable
\n\t\t\t\t\tand then denote
(45) can be expanded into a power series of
where
To get the inverse expansion of the authalic latitude, one integrates (46) and arrives at
where
In mathematical analysis, interpolation with functional values and their derivative values is called Hermite interpolation. The processes to derive the inverse expansions using this method are as follows:
To suppose the inverse expansions are expressed in a series of the sines of the multiple arcs with coefficients to be determined;
To compute the functional values and their derivative values at specific points;
To solve linear equations according to interpolation constraints and obtain the coefficients.
The detailed derivation processes are given by Li (2008, 2010). Confined to the length of the chapter, they are omitted. Comparing the results derived by this method with those in 3.1, one will find that they are consistent with each other even though they are formulated in different ways. This fact substantiates the correctness of the derived formulas.
We wish to investigate the inversion of an equation such as
with
The proof of this theorem is given by Whittaker (1902) and Peter (2008).
The processes to derive the inverse expansions using the Lagrange series method are as follows:
To apply the Lagrange theorem to a trigonometric series;
To write the inverse expansions of the rectifying, conformal and authalic latitude;
To express the coefficients of the inverse expansions as a power series of the eccentricity.
The detailed derivation processes are given by Li (2010). Confined to the length of the chapter, they are also omitted. Comparing the results derived by this method with those in 3.1 and 3.2, one will find that they are all consistent with each other even though they are also formulated in different ways. This fact substantiates the correctness of the derived formulas, too.
The accuracies of the inverse expansions derived by Yang (1989, 2000) and the author has been examined choosing the CGCS2000 reference ellipsoid.
The results show that the accuracy of the inverse expansion of rectifying latitude is higher than 10-5″, while the accuracy of the inverse expansion (32) derived by the author is higher than 10-7″. The accuracies of the inverse expansion of conformal and authalic latitudes derived by Yang (1989, 2000) are higher than 10-4″, while the accuracies of the inverse expansions derived by the author are higher than 10-8″. The accuracies of inverse expansions derived by the author are improved by 2~4 orders of magnitude compared to those derived by Yang (1989, 2000).
The meridian arc, isometric latitude and authalic latitude function are functions of rectifying, conformal and authalic latitudes correspondingly. The transformations between the three variables are indirectly realized by computing the geodetic latitude in the past literatures such as Yang (1989, 2000), Snyder (1987). The computation processes are tedious and time-consuming. In order to simplify the computation processes and improve the computation efficiency, the direct expansions of transformations between meridian arc, isometric latitude and authalic latitude function are comprehensively derived by means of Mathematica.
Inserting the known meridian arc
Since the coefficients
where
The whole formulas for the transformation from isometric latitude to meridian arc are as follows:
Expanding
where
The whole formulas for the transformation from meridian arc to authalic latitude function are as follows:
Expanding
where
The whole formulas for the transformation from authalic latitude function to meridian arc are as follows:
Expanding
where
The whole formulas for the transformation from isometric latitude to authalic latitude function are as follows:
Expanding
where
\n\t\t\t\t\tThe whole formulas for the transformation from authalic latitude function to isometric latitude are as follows:
Expanding
where
\n\t\t\t\t\tThe accuracies of the indirect and direct expansions given by Yang(1989, 2000) derived by the author has been examined choosing the CGCS2000 reference ellipsoid.
The results show that the accuracy of the indirect expansion of the transformation from meridian arc to isometric latitude is higher than 10-3″, while the accuracy of the direct expansion (53) is higher than 10-7″. The accuracy of the indirect expansion of the transformation from isometric latitude to meridian arc is higher than 10-2 m, while the accuracy of the direct expansion (56) is higher than 10-7 m. The accuracy of the indirect expansion of the transformation from meridian arc to authalic latitude function is higher than 0.1
Gauss projection plays a fundamental role in ellipsoidal geodesy, surveying, map projection and geographical information system (GIS). It has found its wide application in those areas.
Gauss Projection, where
As shown in Figure 1, Gauss projection has to meet the following three constraints:
① conformal mapping;
② the central meridian mapped as a straight line (usually chosen as a vertical axis of
③ scale being true along the central meridian.
Traditional expressions of the forward and inverse Gauss projections are real functions in a power series of longitude difference. Though real functions are easy to understand for most people, they make Gauss projection expressions very tedious. Mathematically speaking, there is natural relationship between the conformal mapping and analytical complex functions which automatically meet the differential equation of the conformal mapping, or the “Cauchy-Riemann Equations”. Complex functions, a powerful mathematical method, play a very special and key role in the conformal mapping. Bowring (1990) and Klotz (1993) have discussed Gauss projection by complex numbers. But the expressions they derived require iterations, which makes the computation process very fussy. In terms of the direct expansions of transformations between meridian arc and isometric latitude given in section Ⅳ, the non-iterative expressions of the forward and inverse Gauss projections by complex numbers are derived.
where
In terms of complex functions theory, analytical functions meet conformal mapping naturally. Therefore, to meet the conformal mapping constraint, the forward Gauss projection should be in the following form
\n\t\t\t\twhere
(72) shows that the central meridian is a straight line after the projection when
Finally, from the third constraint, “scale is true along the central meridian”, one knows that
(73) defines the functional relationship between meridian arc and isometric latitude. If one extends the definition of
(74) is the solution of the forward Gauss projection by complex numbers. Its correctness can be explained as follows:
The two equations in (74) are all elementary complex functions. Because elementary functions in their basic interval are all analytical ones in the complex numbers domain, the mapping defined by (74) form
In principle, the inverse Gauss projection can be iteratively solved in terms of the forward Gauss projection (74). In order to eliminate the iteration, one more practical approach is proposed based on the direct expansion of the transformation from meridian arc to isometric latitude (53).
In order to meet the conformal mapping constraint, the inverse Gauss projection should be in the following form
where
Finally, from the third constraint, one knows that
If one extends the definition of
Therefore, the isometric latitude
Then one can compute the geodetic latitude through the inverse expansion of the conformal latitude (40).
(77) is the solution of the inverse Gauss projection by complex numbers. Its correctness can be explained as follows:
The two equations in (78) are all elementary complex functions, so the mapping defined by (78) form
Some typical mathematical problems in map projections are solved by means of computer algebra system which has powerful function of symbolical operation. The main contents and research results presented in this chapter are as follows:
Forward expansions of rectifying, conformal and authalic latitudes are derived, and some mistakes once made in the high orders of traditional forward formulas are pointed out and corrected. Inverse expansions of rectifying, conformal and authalic latitudes are derived using power series expansion, Hermite interpolation and Language’s theorem methods respectively. These expansions are expressed in a series of the sines of the multiple arcs. Their coefficients are expressed in a power series of the first eccentricity of the reference ellipsoid and extended up to its tenth-order terms. The accuracies of these expansions are analyzed through numerical examples. The results show that the accuracies of these expansions derived by means of computer algebra system are improved by 2~4 orders of magnitude compared to the formulas derived by hand.
Direct expansions of transformations between meridian arc, isometric latitude and authalic latitude function are derived. Their coefficients are expressed in a power series of the first eccentricity of the reference ellipsoid, and extended up to its tenth-order terms. Numerical examples show that the accuracies of these direct expansions are improved by 2~6 orders of magnitude compared to the traditional indirect formulas.
Gauss projection is discussed in terms of complex numbers theory. The non-iterative expressions of the forward and inverse Gauss projections by complex numbers are derived based on the direct expansions of transformations between meridian arc and isometric latitude, which enriches the theory of conformal projection. In USA, Universal Transverse Mercator Projection (or UTM) is usually implemented. Mathematically speaking, there is no essential difference between UTM and Gauss projections. The only difference is that the scale factor of UTM is 0.9996 rather than 1. With a slight modification, the non-iterative expressions of the forward and inverse Gauss projections can be extended to UTM projection accordingly.
This work was financially supported by 973 Program (2012CB719902), National Natural Science Foundation of China (No. 41071295 and 40904018), and Key Laboratory of Surveying and Mapping Technology on Island and Reef, State Bureau of Surveying, Mapping and Geoinformation, China (No.2010B04).
The correct management of craniofacial differences (CFD’s) -including cleft lip with/without cleft palate (CL ± CP)- is still a challenge for clinicians treating such conditions, due to its treatment length and the different aspects that have to be holistically addressed in accordance with overall and craniofacial growth and development, speech and hearing, facial esthetics, and psychological self-perception of patients with such characteristics.
Although a universal treatment protocol has not been agreed among craniofacial teams worldwide [1], several parameters of evaluation and treatment have been set and reviewed periodically, following the recommended practices for the care of patients with craniofacial differences made by the ACPA (American Cleft-Palate Craniofacial Association) [2] (revised in 2018), based on the call of the Surgeon General of the United States on the needs for children with special health care [3]. A summary of such parameters appears below:
(a) The interdisciplinary team management of patients with craniofacial differences is essential; (b) Clinical expertise in diagnosis and treatment and optimal care for these patients is provided by teams with enough exposure to these patients each year; (c) The first evaluation is within the first few days or weeks of life (ideal), but referral for team evaluation and management is appropriate at any age; (d) Since the beginning, the family of a child with a craniofacial difference must be assisted in adjusting to the birth and consequent demands and stress of having a child with CFD; (e) Responsible adults must receive information about treatment procedures, options, risk factors, benefits, and costs to take informed decisions on the child’s behalf, and to prepare the whole family for all recommended procedures. The family (and patient, when is mature enough) participation and collaboration in treatment planning should be actively asked; (f) Team recommendations are basic to develop and implement treatment plans; (g) Complex diagnostic and surgical procedures should be restricted to centers with experienced health professionals; (h) Each team must be sensitive to linguistic, cultural, ethnic, psychosocial, economic, and physical factors affecting the relationships among the team, the patient and family; (i) Longitudinal follow-up of patients, including appropriate documentation and record-keeping is essential to monitor both short-term and long-term outcomes and falls under the responsibility of each team; (j) The effects on growth, function, appearance satisfaction and psychosocial well-being of the patient should be considered when performing evaluation of treatment outcomes.
Following these parameters, this chapter explain in detail our craniofacial orthodontics treatment algorithms for the patient with unilateral cleft lip and palate (UCLP) from mixed dentition onwards, which addressed all topics related with diagnosis and treatment planning for adolescents and young adults affected with this craniofacial difference.
Mars et al. in 1987 introduced the GOSLON yardstick [4], which has become the standard diagnostic tool for patients with UCLP worldwide. Ozawa et al. in 2011 expanded the same classification for bilateral clefts [5]. This classification, based on dental casts, has proven to be a good and simple option to grade the malocclusion present and to give some hints on the level of difficulty in its correction. Other broader approaches -such as the original Huddart-Bodenham classification (used in deciduous dentition only) [6], or its modification used in both deciduous and permanent dentitions (proposed by Mossey et al. [7])-, are also other interesting approaches to classify all dental components present in UCLP and BCLP malocclusions. However, those indexes missed a common aspect that cannot be forgotten in a craniofacial orthodontic evaluation: the facial pattern in three dimensions that could worsen (or improve) the existing CL ± CP condition. The GOSLON does not consider frontal and lateral facial photographs or cephalometric radiographs, which are regular diagnostic records in orthodontics (taken digitally for these patients in the XXI century). These records are important to detect left-to-right bone vertical discrepancies that could make some UCLP cases more difficult to correct properly than previously thought. This is the reason why the orthodontic diagnosis (and its indicated treatment) cannot be established solely from study dental models. The GOSLON yardstick can be used as a classification system, but not as a determiner of treatment complexity without considering the 3D facial aspects of a complex malocclusion.
Having as a start point the GOSLON yardstick, our unit has developed a modified GOSLON yardstick (named GOSLON+), based not only on dental casts but also on frontal and facial digital photographs and radiographs. These records can be used to accurately determine the involvement of craniofacial orthodontics and craniofacial surgery in the resolution of unilateral (and bilateral) cases, depending on the degree of asymmetry associated with the cleft, following all aspects involved in a complete orthodontic diagnosis. The following diagram and the accompanying patients’ photographs (with full records) demonstrate our current diagnosis categories and changes in the treatment of patients with UCLP (modified from the original GOSLON) (Table 1, Figure 1), [4] Our modified classification considers the influence of facial and occlusal 3D aspects in the craniofacial overall diagnosis and the need for additional treatment created by the existing frontal asymmetry.
Group | Characteristics | Treatment | Prognosis |
---|---|---|---|
1± |
| Surgical orthodontics and surgical treatment for class II malocclusion. | Good/Fair (Depending of Degree of Facial Asymmetry [+]) |
2± |
| Surgical orthodontics and surgical treatment for moderate or complex class I malocclusion. | Excellent (None [−] to some Degree of Facial Asymmetry [+]) |
3± |
| Surgical orthodontics and surgical treatment for mild class III malocclusion. | Good/Fair (Depending of Degree of Facial Asymmetry [+]) |
4± |
| Surgical orthodontics and surgical treatment for severe class III malocclusion. | Fair (Depending of Degree of Facial Asymmetry [+]) |
5± |
| Surgical orthodontics and step-wise surgical treatment for extreme class III malocclusion. (Maxillary Osteogenic Distraction and Orthognathic Surgery). | Fair (Depending of Degree of Facial Asymmetry [+]) |
Modified GOSLON yardstick (GOSLON+) for patients with UCLP. A similar table apply to patients with BCLP.
Facial and intraoral characteristics of patients presenting the five different degrees of GOSLON+ yardstick. Observe that treatment prognosis further decreases when frontal and lateral facial photographs are included in the treatment algorithm to manage successfully the existing alveolar clefts.
It is well known that not all clefts are similar [6, 8, 9, 10, 11]. Moreover, patients affected by UCLP have some degree of facial asymmetry that affects the prognosis (Figure 1). This fact must be considered within the orthodontic-surgical diagnosis. Accordingly, their ortho-surgical treatment plan should not be the same either, due to the type and extension of cleft, the timing for the initiation of those treatments, and the individual needs for surgical treatment influencing the selection of surgical techniques. In addition to these factors that have a negative influence on facial growth, the expertise of the ortho-surgical team and the interdisciplinary management given to the patient is the last -but not the least- item to be considered for obtaining a satisfactory treatment outcome [12].
Based on this improved GOSLON classification, a description of the surgical orthodontic management for average and wide clefts will be addressed. After that, two different surgical orthodontics algorithms will be presented, with clinical cases to summarize the decision-making process applied in the surgical orthodontic care of patients with UCLP with different degrees of sagittal and transversal maxillary-mandibular involvement in the Clínica Noel Foundation at Medellin, Colombia, S.A.
The alveolar cleft -the space between the maxillary segments anterior to the incisor foramen- represents a lack of continuity of both maxillary dental arch and basal bone. Spatially, it can be represented as a pyramid placed on its side, with its base towards the labial side and its apex located in a posterior and superior position inside the cleft maxilla [13]. This gap should be ideally filled by a cancellous bone graft to restore its basal and alveolar normal architecture. This defect gives origin to a particular kind of critical-size segmental defect that creates a significant challenge for craniofacial surgeons, maxillofacial surgeons and craniofacial orthodontists [14].
From all the alternatives to fill completely the maxillary cleft, the secondary (intermediate or late) alveolar bone grafting (SABG) is still the gold standard treatment to restore the alveolar anatomy, either in mixed dentition or early permanent dentition [15]. The objectives of SABG include (1) to restore and stabilize the normal architecture of the maxilla; (2) to allow eruption of permanent lateral incisor and canine; (3) to provide support and elevation of the affected wing base; (4) to close present oronasal fistulas and (5) to provide “adequate” bone support to be restored later with prostodontics with/without dental implants, in case that a closure of the gap with dental eruption cannot be achieved [16, 17]. It has been our approach to limit its objectives to the first three in mixed dentition patients, due to the uncertain nature in time of this type of autografts and the impediment for free dental movement created by cortical grafts at early ages. However, two controversies proposed by Vig still remained valid today: which is the best bone graft type and the best donor site for harvesting? and what is the best timing for maxillary (dento-alveolar) expansion in patients requiring SABG [17]? A third controversy refers to whether the alveolar cleft can be repaired by a combination of bio-engineering alternatives currently available nowadays. Our treatment rationale tries to solve the first two questions as follows:
Several aspects have to be considered for obtaining a successful bone graft in such patients:
During mixed dentition stage, orthodontic treatment can be used previous to surgical treatment to increase maxillary dental arch width and length using the Quad-Helix [18, 19, 20, 21] (Figure 2). This appliance -developed by Ricketts while he was part of the Cleft Palate Clinic at UIC (currently the UIC Craniofacial Center) [22] and improved by Wilson and Wilson in the 80’s [20] and others- is currently applied to correct the collapse of the lateral maxillary segment behind the protruding premaxillary process [23]. In patients with UCLP, the bony palate anatomy presents a primary unilateral deficiency worsen by contraction of scar tissue, as a result of the neonatal surgical palatal closure [19, 23]. In addition to the dento-alveolar effect obtained in patients without clefts, the main bony effect of the Quad-Helix in UCLP cases is the expansion of the lateral maxillary shelves when the de-rotation of the maxillary molars is achieved [19, 23]. In such cases, dento-alveolar expansion before surgery results in similar treatment outcomes than in patients with maxillary expansion [24], with the benefit of working with minimum risk of creating secondary maxillary fistulas. Dento-alveolar expansion could also be obtained by other orthodontic appliances such as the reverse Quad-Helix (with poor correction of the molar rotation) [25], conventional or modified jointed fan (or butterfly) expander [26, 27, 28], NiTi palatal expander [29], or self-ligation appliances [30].
Recovery of normal transversal maxillary width with correct maxillary alignment after the use of Quad-Helix. a. Before Quad-Helix, b. At removal time. Notice the change in the cleft architecture and the creation of alveolar spacing for the alignment of the right maxillary canine.
Dento-alveolar maxillary expansion is usually followed by maxillary dentition segmental leveling and alignment (using an anterior [3*2] utility arch) [21, 31, 32, 33, 34]. In order to obtain similar results than those achieved using an inverse treatment protocol (alveolar grafting followed by orthodontics with maxillary expansion) [24], an orthodontic approximation of maxillary segments using a sectional arch approach -after obtaining proper maxillary width but before surgery- should be considered. In older patients, a mini-screws based molar distalization plus orthodontic dental retraction -by controlling the mesial inclination of the canine for greater bone approximation- is often required to create an alveolar defect with parallel walls to minimize the alveolar gap size when a segmental surgery is planned (Figure 3) [35, 36].
Modified First-Phase Orthodontic Strategies. In addition to the a. maxillary utility arch, two other strategies have been useful in the correct alignment of the maxilla prior to surgery: b. sectional approximation of maxillary segments; and c. mini-screw based distalization.
The suggested order of orthopedic-orthodontic procedures would be as follows: 1. Dento-alveolar maxillary expansion; 2. Maxillary segmental dental leveling and alignment; 3. Mini-screw based molar distalization (if needed in patients that have passed the appropriate timing for grafting) and 4. Orthodontic approximation of maxillary segments.
At the time of bone grafting, many craniofacial centers around the world use SABG during mixed dentition (5 to 12 years of age) before or during permanent canine eruption, taking advantage of the growth potential of the maxilla at this stage [37]. In our center, we use Intermediate or late SABG during mixed or early permanent dentition for GOSLON1–3 patients only. We usually perform such procedure in agreement with dental age characteristics of teeth around the cleft (permanent canine and lateral incisor when present). The ideal age range for surgical procedure should be when the canine on the cleft side is from less than 5 mm of its eruption place to a partially erupted canine (1/3 to ½ of crown visible). Late SABG cases with narrow alveolar clefts at the right age allows to work with bone graft stimulation (either with compression osteogenesis or RPE) to obtain excellent results in both cases (Figure 4) [24, 37]. Using SABG as an alveolar bone matrix, we achieve high degree of success in correcting the canine eruption and migration pathway [38]. The bone graft would give temporary bone support for the eruption of lateral incisor and/or canine without affecting the growth of the midface, with good outcomes similar to other centers in the world when compared with gingivoperiosteoplasty [21, 39]. Ideally, a complete closure of the space with no need for lateral incisor prosthesis is achieved when the migration of the canine occurs.
Intraoral Results of Iliac Crest Late Secondary Alveolar Bone performed at the Correct Time. a. Despite the fact that all teeth around the cleft were erupted at the initial evaluation, the patient still had intermediate mixed dentition and remaining eruption potential in the lateral incisor adjacent to the alveolar cleft; b. After late SABG and finishing restorative dentistry procedures. Note the closure of the alveolar cleft and the normal gingival architecture obtained by the application of orthodontic compression osteogenesis after cancellous iliac bone grafting.
In chosen candidates, cancellous iliac crest bone from the inner anterior portion of the crest is usually required to close mild-to-moderate type of fistulas (patients with UCLP GOSLON1 to 3 at the appropriate age) (Figure 4). This approach is used to restore momentarily alveolar bone continuity needed for dental movement [40, 41]. Figure 4 shows a case with such approach, with an excellent outcome. However, other harvesting sites such as tibia, mandibular symphysis or retromolar area can be successfully used for this purpose [23, 42, 43].
Of all types of bone graft (cortical, cancellous, or mixed), the fresh autogenous cancellous bone is the “ideal” source for reconstruction of bone integrity, due to the fact that it provides living bone cells and is immune-compatible enough to allow osteogenesis and full integration with the maxilla [40]. Autografts have as its main characteristic osteoproduction [44] -bone growth obtained from combined properties of osteoinduction (recruitment, proliferation, and transformation of osteoprogenitor MSC’s into osteoblasts) [45], osteopromotion (process of secondary support of bone healing and tissue regeneration, without capability of initiate bone formation) [46], osteoconduction (process of osseous and vascular cell ingrowth inside the 3D matrix scaffolding) [47], and “relative” osteogenesis (process of deposition of newly formed bone by osteoblasts at the fracture site)- that enhance osteoprogenitor MSC’s response according with autologous graft type. Allografts also share other advantages such as biocompatibility, and mechanical resistance vs. orthodontic remodeling depending on the graft source [48]. Iliac crest site morbidity, accessibility, and availability of areas of graft harvesting of other donor places create a supposedly difficulty that could be overcome with sufficient surgeon’s exposure to this approach [49] in a capabilities-based curriculum [50]. When a successful incorporation (or modeling) of a graft is achieved, the term osseointegration can be used under this definition (Figure 4) [51]. An optional surgical procedure for treating wide alveolar clefts will be described later.
At the Pre-surgical Planning Time of Post-Surgical Procedures. In cases where lateral incisor in the cleft area is partially missing, split in two by the cleft (creating two “real” supernumerary teeth), or absent, all options involved in the dental restoration of the patient must be considered:
When the lateral (and central incisor or canine, depending on the location of the cleft) present a missing portion, a composite restoration could be required either during or once the orthodontic treatment is finished to improve esthetic appearance (Figure 4).
Lateral incisor supernumeraries present additional difficulties to be addressed: their crowns usually are of decreased size, and the roots are short and with many irregularities and dehiscenses along the root length. Performing restorative procedures, such as extensive composite restauration on the wider tooth, are in order if the chosen supernumerary has its root firmly embedded in bone and the final orthodontic placement of the tooth leaves the root with enough alveolar bone on both sides.
If the lateral incisor is missing, an option would be to take advantage of performing an intermediate SABG followed by the mesial eruption of the canine. Later on, restorative procedures in conjunction with orthodontics will convert the canine anatomy in lateral anatomy, although some differences between normal and converted teeth remain regarding color and crown emergent profile from gingiva (Figure 5).
Intraoral Results of Guided Migration of Permanent Canine through SABG performed at the Correct Time. After successful SABG, the left maxillary canine was directed to erupt in a mesial position from its initial site. Note the hypertrophic gingiva surrounding the teeth on the repaired cleft site. The patient will require cosmetic dentistry procedures in addition to the correct bucco-lingual root torques delivered by the use of lower first bicuspid brackets on the maxillary canine (to act as lateral incisor) and first bicuspid (to act as canine). Protraction of the upper first molar to obtain a well-established class II relationship is under way.
Orthodontic procedures (regarding bracket type and bracket positioning -proper height and buccal-lingual crown inclination of canine and first bicuspid on the cleft side), periodontal procedures (to maintain or recover -partial or totally- the periodontal anatomy affected by decreased gingival thickness as a consequence of mesenchymal deficiency in patients GOSLON3+, 4, 4+, 5 and 5+) (Figure 6) and/or additional cosmetic dentistry/prosthodontic procedures (to transform with such strategies the maxillary canine in lateral incisor and the maxillary bicuspid in canine, and perform additional restorative work if needed) are necessary after SABG surgical procedure for an adequate dental characterization with good-to-fair periodontal condition (Figures 7 and 8). Optional plastic surgery procedures could be needed as well.
Periodontal Results of Connective Tissue Graft and Enamel Matrix Protein Application after Ortho-Surgical Procedures. This experimental procedure in cleft patients allow the clinicians working in poor anatomic conditions -due to the negative influence of a mesenchymal deficiency- to partially recover gingival architecture at the short-term follow-up. Long-term follow-up will give us answers regarding the success of the obtained periodontal stabilization. a. Initial intraoral left close-up photo. The patient has a wide left alveolar cleft with dental inclination of left permanent central incisor (moderate), and left permanent canine (severe); b. Intermediate intraoral left close-up photo. After a segmental maxillary advancement, moderate loss of periodontal attachment and apical migration of gingival margins was observed; c. After connective tissue graft plus enamel matrix protein infiltration. Notice the gain on gingival margins and periodontal thickness as a result of this approach; Surgical sequence: d. Harvesting of palatal connective tissue graft; e. graft waiting to be inserted below gingiva; f. Graft placement under keratinized gingiva; g. Emdogain® syringe used in this case.
Patient with UCLP GOSLON2 treated at Mixed Dentition stage. Initial records: a. Frontal facial photograph; b. Periapical radiograph of the alveolar cleft; c. Intraoral frontal view; Final records: d. Frontal facial photograph; e. Periapical radiograph of the alveolar cleft; f. Intraoral frontal view. The application of the compression osteogenesis strategy was fundamental to obtain normal periodontal architecture in the grafted area of the alveolar cleft.
Patient with UCLP GOSLON2 treated at Permanent Dentition stage. Initial records: a. Frontal facial photograph; b. Intraoral frontal view; Final records: c. Frontal facial photograph; d. Intraoral frontal view. A relatively normal dental and gingival architecture was obtained after the surgical management of a Two-piece LeFort I.
Our retention protocol for patients with normal skeletal relationships (GOSLON2 and 2+) or with mild skeletal discrepancies (GOSLON1, 1+ and 3) use Essix-type retainers. As our treatment approach is directed to obtain a maxillary arch without dental spaces if possible, we seldom use wrap-around maxillary retainers with dental temporary replacements. Our countdown-to-retention includes periodontal evaluation and treatment in patients with GOSLON3+ and more, to address the thin and receding gingiva in cleft-adjacent teeth, associated with genetically-driven periodontal ligament loss described previously (Figure 6). In those cases (which have received correction of existing moderate to severe skeletal discrepancies previously), a periodontal connective tissue graft plus dentin matrix protein injections to increase gingival volume and tissue support, and a dual retention strategy with an additional bonded lingual retainer in the maxillary anterior teeth is used.
Young patients affected by UCLP who have severe restriction of maxillary growth and wide oronasal fistulas (GOSLON4, 4+, 5 and 5+), or adult patients with UCLP in all categories of the GOSLON+ yardstick, have been historically (and unsuccessfully) treated using alveolar bone grafting (secondary or tertiary). In addition, inadequate closure of primary incisions, post-operative wound dehiscence and infections could potentially make bone grafting healing worse [35]. Mars et al. recognized that unilateral alveolar bone grafting success was limited to young patients with “average” maxillary growth (patients GOSLON1, 1+, 2, 2+, and 3) and normal gingival thickness compared with an age-matched normal population [4]. What was the problem? They found out that with increased limitation in maxillary craniofacial growth in patients with UCLP, there was an important compromise in making the maxillary segments meet closely to complete a successful bone graft and a greater difficulty to obtain a fair maxillary dentition by subsequent orthodontic treatment [4].
In order to obtain a surgically-created one-piece maxilla [52], craniofacial centers worldwide use strategies based on segmental maxillary advancements (described by Schuchardt [53]). This surgical technique and its modifications were currently used to manage the surgical closure of open bite [54, 55], transverse maxillary deficiency [55, 56, 57], or excess [55, 58]. The last two findings are common in patients with UCLP. After proper soft tissue management of severe and longstanding oronasal fistulas [12], this approach favors the 3D maxillary architecture prior to secondary orthognathic surgery, reduces prosthodontic needs and creates a more cost-effective alternative than using either conventional LeFort I advancement plus extensive prosthodontic replacement or interdental osteogenic distraction [58].
A combination of surgical fistula closure followed by a combination of Le Fort I advancements in two segments [59] plus immediate or delayed alveolar bone graft, depending on the need and extension of additional distraction osteogenesis/orthognathic surgery has been used regularly at the Clínica Noel Foundation since 2015, modified from Stal et al. [12] (Figure 9). This maxillary procedure could be performed alone or in combination with BSSO during the same surgical procedure. This modified approach produce good bone blood flow [60], and stability [61], with fair gingival architecture due to pre-existing periodontal conditions that can be worsened in some cases by local tension on the flaps during gingival closure [59] (Figure 5). Good-to-fair results regarding non-tension flap closure, bone-to-bone contact, and secondary bone healing have been obtained, depending on the degree of cleft maxillary hypoplasia present. For these patients, these successive surgical steps (oronasal fistula treatment followed by segmental maxillary approximation) could be realized previous or simultaneously to the placement of a narrow tertiary alveolar bone grafting and the realization of additional surgical mandibular procedures during orthognathic surgery.
Application of Segmental Maxillary Advancement to reduce the Alveolar Cleft prior to Final Bone Grafting. Pre-surgical records. a. Close-up of alveolar cleft, b. Occlusal view, c. Periapical radiograph, d. CT close-up occlusal view: 10 mm gap between internal radicular surfaces, e. CT occlusal maxillary view; Post-surgical records. f. Close-up of alveolar cleft, g. Occlusal view, h. Periapical radiograph, i. CT close-up occlusal view: 5 mm gap between internal radicular surfaces, j. CT occlusal maxillary view. The left segmental advancement reduced in half the distance to be covered by a tertiary bone grafting and increased the chances of closure success.
Distraction osteogenesis is a treatment technique that deals with the genesis and growth of new bone in a specific body area, through the application of gradual tensile stress [62, 63, 64, 65, 66]. Distraction Osteogenesis can be applied to the surgical correction of hypoplasias of the craniofacial skeleton to replace extensive bone and soft tissue deficiencies without requiring the use of bone grafts [67]. This technique additionally provides the benefit of expanding the overlying soft tissues, which are frequently deficient in these patients.
After the introduction of gradual elastic maxillary distraction to advance a segmental Le Fort I osteotomy (an incipient form of Distraction Osteogenesis -DO) by Wassmund [68], maxillary DO using facemask and elastic traction was successfully reintroduced by Molina and coworkers 60 years later [69], after several animal studies corroborated its feasibility [70, 71]. After the arrival of the Rigid External Distraction (RED) technique for its use for upper and mid-face hypoplasia in 1997 [72], Polley and Figueroa applied their maxillary DO technique in cleft patients [73, 74] and Figueroa and co-workers reported their immediate and long results in this population [75, 76]. In patients with either UCLP or BCLP that present severe maxillary hypoplasia (GOSLON 5 and 5+), worsened by previous pharyngeal repairs that apply additional tension to an already deficient cleft maxillary development, this alternative surgical technique allows the progressive forward displacement of the maxillary complex, while exerts moderate but increasing tension in the pharyngeal musculature that favors their rearrangement in the final maxillary position [73, 74, 75, 76].
Patients prior to the surgical procedure received preferably a customized rigid labial-palatal arch with external vertical hooks adapted partially from a face-bow, or with detachable external hooks located distal to the lateral incisors (Figure 10). These orthodontic options facilitate further distraction modifications and appliance removal in dental settings. After this, the patient was submitted to a high LeFort I osteotomy (in segments according to cleft type), avoiding tooth germs and external halo frame positioning. After 5–7 days latency period, active distraction is performed at 1 mm/day at 0.5 mm each 12 hours, until an additional 20% of the planned DO is achieved. Orthodontic follow-up is highly recommended to control the amount of distraction remaining, to change the direction of distraction when needed, and to give additional instructions to the patient and relatives on how to adjust the distraction if any AP and transverse maxilla-mandible asymmetry is developing. The average amount of maxillary RED distraction in such cases was 9.6 mm [76]. A consolidation period of 3+ months with the distractor in place must be observed to allow maxillary bone to mature from the initially delayed woven bone and guaranteed the obtained results.
Intraoral Tooth-Supported Devices for RED system. a. Customized rigid labial-palatal arch with external vertical hooks adapted partially from a face-bow, b. Customized rigid labial-palatal with detachable external hooks located distal to the lateral incisors.
Despite the appearance of other maxillary DO external and internal devices, the RED system allows the application of important pulling forces to advance the receding maxillary complex without risking external frame integrity, permits to correct direction of distraction due to their flexibility in distractors’ positioning on vertical and horizontals bars [77], and manage a wider range of maxillary distraction than internal DO devices. A maxillary cleft case treated with this approach appears below (Figure 11).
Patient with Maxillary Cleft undergoing Maxillary RED. a. Before maxillary DO; b. During Distraction Osteogenesis; c. After DO. Notice the improvement on maxillary projection at the infraorbital level.
Adult patients affected by CL ± CP require reduced treatment times while obtaining optimal craniofacial results. After obtaining a one-piece maxilla (Except in patients GOSLON2, some GOSLON2+, and GOSLON3 that finished ortho-surgical treatment at the end of SABG) and at the end of maxillary DO in patients GOSLON5 and 5+, the Craniofacial Ortho-Surgical team has to properly plan and execute orthognathic surgery that address three-dimensionally all problems related with the surgical correction of an asymmetric patient. Could a combination of treatments according to the state of the art be used to reduce treatment times in an interdisciplinary scheme? There are several contemporary alternatives from the orthodontic-surgical treatment stand point that can be used in this scenario: First, the re-appearance of self-ligating systems (with passive -regular [e.g. Damon™ System, Ormco Corp., Orange, CA] or CAD-CAM individualized brackets [e.g. Insignia™ System, Ormco Corp., Orange, CA]-, or interactive brackets [e.g. CCO™ System, Dentsply Sirona Orthodontics, York, PA]), and second, the spreading use of Surgical Treatment Acceleration (Surgery-First and Surgery-Early surgical approaches).
Both alternatives are not new. Passive Self-Ligation is an old therapeutic alternative available for clinical use in the 70’s [78] and 80’s [79]. The concept was commercially reintroduced in the late 90’s by the Ormco™ Task Force, to give origin to the Damon™ System [80, 81]. One of its objectives is supposedly to reduce clinical activity time and treatment time -reduction in wire changes and face-to-face clinical activity-, and increase clinical efficiency by simplifying orthodontic mechanics and materials. The passive effect of friction reduction by bracket design is especially noticed during tooth leveling and alignment in severe dental crowding, dentoalveolar expansion, and in less extent during major tooth movements [80, 81]. The second objective is to take advantage of the active use of orthodontic archwires with variable activation temperature. This is the most important change from early self-ligating appliances. Buehler and coworkers were the first to explain the physical properties of the Variable Transformation Temperature concept [82], while Tien and collaborators in 1982 described its application in orthodontics [83]. Later, Burstone and others published on the alloy characteristics and clinical behavior in depth [84, 85, 86, 87]. Thermo-activated wires allow clinicians (1) to use a differential alloy sequence, that permit early cross-sectional form changes and wire gauge increments to fill entirely the bracket’s slot at early treatment stages with early effect of torque, and (2) to take advantage of wider archforms than in current straight-wire systems. This characteristic is potentiated with self-ligation to produce a “free” vestibular tooth movement by using wider arch shapes on unconventional alloys in a shorter period of time [88, 89, 90]. Total appointment time and treatment length could be shorter due to the fulfillment of both objectives in most cases. However, no differences in the positions of incisors and the transverse dimension changes of the maxillary arch were found when self-ligated appliances and conventional-ligated appliances plus Quad-Helix were compared [91]. There is insufficient evidence to justify or contraindicate its use in surgical orthodontics in patients with CL ± CP [30].
Surgical Treatment Acceleration is not a new technique either. During the 1960–1970’s, the early orthognathic surgery approaches were performed without orthodontist intervention (Surgery first -independent-), and subsequent orthodontic treatment was poorly encouraged by maxillofacial surgeons afterwards [92, 93, 94]. Several problems, including the lack of interrelation of orthodontic and surgical treatments, and difficulties for space generation needed for correct orthodontic decompensation, aroused from these early attempts. After the realization that occlusal relationships were a key component of orthognathic surgery results, the orthodontist gained a role in both craniofacial and maxillofacial teams with the objective to eliminate dental compensations before surgery and facilitate posterior orthodontic treatment [95]. The basic sequence of procedures is still applied today. However, creating a maxilla-mandibular decompensation, alignment, and correct maxilla-mandibular anterior and transversal relationships is a long process, even today. A different approach was proposed by Epker and Fish in [96]. They affirmed that it was best to perform surgical procedures as soon as possible to obtain immediate post-surgical benefits for orthodontic treatment (accelerated orthodontic movement after surgery following surgical correction), surgical improvement (early recovery of facial and dental function), and functional aspects (improvements on speech and deglution). Sugawara and Tohoku University/University of Connecticut group in 2009 proposed their Surgery First Approach (SFA) -also called Surgery-First/Early Orthognathic Approach (SFEA) [97]- combined with Skeletal Anchorage System (SAS) for the treatment of a skeletal Class III patient, obtaining excellent results based on the premises mentioned previously [98]. In 2019, the same group published its extensive follow-up on Temporo-Mandibular Symptoms and Function in Class III malocclusion using SFEA compared with Orthodontics-First Approach (OFA) patients, without significant differences between groups [99]. CES University, in conjunction with the mentioned consortium [100], and with the Universidad del Valle [101] have applied SFEA schemes in Latin-American patients. SFEA rely on performing orthognathic surgery at the beginning of treatment with minimal preoperative orthodontics [102]. This treatment protocol allows the reduction in time of pre-surgical treatment (obtaining one-year reduction in average), with the patient’s benefit of an early improvement in facial esthetics. It can be applied not only in patients with UCLP and Class III malocclusion (GOSLON3+ onwards), but also in patients with UCLP and Class II malocclusion (GOSLON 1 and 1+), with or without skeletal vertical discrepancies.
Chang Gung Memorial Hospital group general guidelines for such approach states the following advantages of the procedure as follows [103, 104]: (1) Shorter pre-surgical orthodontic treatment time; (2) Reduction in the difficulty of post-surgical treatment through Regional Acceleratory Phenomena (RAP) [104]; (3) Possibility of planning and computer-guided execution (CAD-CAM); (4) Same effect on ATM as with traditional scheme, in addition to the surgical and functional advantages already mentioned. The post-operative rapid (accelerated) orthodontic tooth movement after SFEA in both dental arches is significant and is due to the increase in odontoclasts activity and dentoalveolar metabolic changes [105]. However, some disadvantages of SFEA include: (1) The need of careful orthodontic-surgical planning; (2) The preparation of the orthodontic-surgical team; (3) The appearance of possible post-surgical orthodontic problems; (4) A poor post-operative stability [97], in opposition to favorable long-term stability reported previously [96].
Mahmood and coworkers suggested that implementing a modified Surgery-Early protocol to speed-up final orthodontic-surgical treatment for CL ± CP patients would be useful [102]. However, Seo and coworkers found smaller incisor overjet, maxillary intercanine and intermolar ratios, and ratio of intercanine and intermolar distance in a group of surgical patients with UCLP and Class III malocclusion prepared to be treated with SFEA, than in a non-cleft group with a dentofacial deformity. The same group had also smaller anterior teeth contact number and larger incisor overjet than patients with UCLP and Class III malocclusion treated with a conventional protocol [106]. These difficulties have to be weighed when planning surgical procedures under this approach.
As a summary of the SFEA application, this modified version of the steps for performing orthognathic surgery under this approach are [103]: (1) Short period (≤6 months) of AP and vertical maxilla-mandibular decompensating orthodontics before the operation; (2) Reduction of possible dental collisions and minimal decompensation of mandibular teeth, through segmental maxillary surgery planning, surgically assisted rapid palatal expansion, or post-operative orthodontic tooth movement; (3) First / Early Modified Surgery 3D Model; (4) First/Early surgery based on specific therapeutic planning. Total treatment time is shortened in around 1 year, depending of the complexity of the remaining orthodontic treatment [103]. Treatment results of a patient with UCLP GOSLON4+ are shown in Figure 12.
Patient with UCLP undergoing maxillo-mandibular asymmetry correction through Surgery-First/Early Approach and Passive Self-ligation. a. and b. Before treatment; c. and d. Previous to Surgery-Early Approach. Noticed the dental changes obtained in the maxillary dentition by the use of passive self-ligation appliances; e. and f. After Surgery-Early Approach; d. After the end of treatment. Treatment time before treatment-surgery: 6 months, 25 days; Total Treatment time: 20 months, 25 days.
The anterior information can be summarized to perform apparently different treatment choices in a rational order that will allow clinicians to identify the increasing difficulty of surgical orthodontic approaches used in the resolution of alveolar cleft with or without distraction osteogenesis and final orthognathic surgery (Figures 13 and 14).
Mixed dentition treatment algorithm for patients with UCLP. The final prognosis and outcome using this approach depends on severity of the cleft, the degree of mandibular deviation, and the surgical ability of the craniofacial team to obtain the desired goals.
Alternative treatment algorithm for adult patients with UCLP. A more expedite protocol following the same parameters (severity of the cleft, degree of mandibular deviation, and surgical ability of the craniofacial team) is performed in all patients with UCLP who have non-repaired clefts and require a definitive solution to their craniofacial difference.
Orthodontic treatment for patients with unilateral cleft lip and palate varies in the level of difficulty due to the increased involvement of orthodontic and surgical procedures involved, the correct timing of applying the complete treatment strategy, and the need of additional procedures to treat several dental anomalies present in teeth adjacent to the cleft, such as dental form and size anomalies, localized enamel hypoplasia, abnormal teeth number, and dental formation disturbances.
Our modified GOSLON+ yardstick allow us to categorize patients with UCLP in several discrete groups according to maxillary growth. Our treatment algorithms allow us to deliver appropriate treatment of the adolescent and young adult patients requiring effective orthodontic intervention for all surgical needs in our patient-based hospital settings in Colombia.
To CES University, who allowed me to experience all procedures described in this chapter.
To Universidad de Antioquia for their support.
To Clínica Noel Foundation to allow me access to all records used in this chapter.
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Presently, SEMDP is focused on drought and heavy precipitation monitoring over Southeast Asia and the Pacific. Space-based data and derived products form critical part of meteorological services’ operations for weather monitoring; however, satellite products are still not fully utilized for climate applications. Using SEMDP satellite-derived precipitation products, it would be possible to monitor extreme precipitation events with uniform spatial coverage and over various time periods – pentad, weekly, 10 days, monthly and longer time-scales. In this chapter, SEMDP satellite-derived precipitation products over the Asia-Pacific region produced by the Earth Observation Research Center/Japan Aerospace Exploration Agency (EORC/JAXA) and the Climate Prediction Center/National Oceanic and Atmospheric Administration (CPC/NOAA) are introduced. Case studies for monitoring (i) drought in Australia in July-October 2007 and September 2018 and (ii) heavy precipitation over Australia in December 2010 and Thailand and the Peninsular Malaysia in November-December 2014 which caused widespread flooding are also presented. Satellite observations are compared with in situ data to demonstrate value of satellite-derived estimates of precipitation for drought and heavy rainfall monitoring.",book:{id:"7767",slug:"rainfall-extremes-distribution-and-properties",title:"Rainfall",fullTitle:"Rainfall - Extremes, Distribution and Properties"},signatures:"Yuriy Kuleshov, Toshiyuki Kurino, Takuji Kubota, Tomoko Tashima and Pingping Xie",authors:[{id:"102903",title:"Prof.",name:"Yuriy",middleName:null,surname:"Kuleshov",slug:"yuriy-kuleshov",fullName:"Yuriy Kuleshov"}]},{id:"51411",doi:"10.5772/63960",title:"Coastal Tsunami Warning with Deployed HF Radar Systems",slug:"coastal-tsunami-warning-with-deployed-hf-radar-systems",totalDownloads:1736,totalCrossrefCites:6,totalDimensionsCites:10,abstract:"We describe the evolution of coastal HF radar observations of tsunamis, first proposed in 1979 and developed after the 2004 Indonesia and 2011 Japan tsunamis to allow routine monitoring to detect an approaching tsunami. Oceanographic tsunami theory is summarized, both for the fundamental equations of motion and in the ray optics and Green's Law approximations; the latter can be applied when water depths are slowly varying. Observations of the current velocities caused by the 2011 Japan tsunami off the Japanese, the US West, and Chilean coasts are described and examples are shown. These observations led to the development of an empirical tsunami detection method, which is outlined. Examples of offline tsunami detections are given and detection times are compared with arrival times at neighboring tide gauges. We describe the observation and offline detection of the June 2013 meteotsunami off the New Jersey coast using coastal radar systems and tide gauges. Methods to model and simulate tsunami velocities are described and videos of the resulting velocity/height maps are given. We describe preliminary methods for evaluating the suitability of radar sites for tsunami detection using simulated tsunami velocities. Factors affecting tsunami detectability are discussed and methods are described for the alleviation of false alarms.",book:{id:"5316",slug:"tsunami",title:"Tsunami",fullTitle:"Tsunami"},signatures:"Belinda Lipa, Donald Barrick and James Isaacson",authors:[{id:"184807",title:"Dr.",name:"Belinda",middleName:null,surname:"LIpa",slug:"belinda-lipa",fullName:"Belinda LIpa"}]},{id:"51183",doi:"10.5772/63956",title:"Tsunamis in Sweden: Occurrence and Characteristics",slug:"tsunamis-in-sweden-occurrence-and-characteristics",totalDownloads:1725,totalCrossrefCites:2,totalDimensionsCites:8,abstract:"In the last 13,000 years, there are 17 tsunami events recorded in Sweden. This chapter highlights the characteristics of two high-magnitude events from the deglacial period and three events from Late Holocene age.",book:{id:"5316",slug:"tsunami",title:"Tsunami",fullTitle:"Tsunami"},signatures:"Nils-Axel Mörner",authors:[{id:"15619",title:"Dr.",name:"Nils-Axel",middleName:null,surname:"Morner",slug:"nils-axel-morner",fullName:"Nils-Axel Morner"}]},{id:"64194",doi:"10.5772/intechopen.80037",title:"Geo-Statistical Assessment of the Intensity, Duration, Frequency and Trend of Drought over Gangetic West Bengal, Eastern India",slug:"geo-statistical-assessment-of-the-intensity-duration-frequency-and-trend-of-drought-over-gangetic-we",totalDownloads:1568,totalCrossrefCites:4,totalDimensionsCites:5,abstract:"This chapter presents spatio-temporal (1901–2002) appraisal of the intensity, duration, frequency and trend of drought over Gangetic West Bengal (GWB), Eastern India using standardized precipitation index (SPI). The study reveals that, after 1950s the magnitude of deficit precipitation has increased substantially. Stepping up of the mean intensity of most intense drought events; average drought duration; severe and extreme drought frequency in this agricultural tract at the latter half of the twentieth century are also some alarming events. The western degraded plateau is more sensitive to extreme droughts but, the impact is expected to be rigorous over the adjacent areas. In an nutshell this work provides the evidences demonstrating the intensification of aridity in the northern Rarh plain and moribund delta which may corresponds to degradation and lowering of water resources especially ground water which may also lead to increase of socio-economic vulnerability to drought. Such altered hydrolo-meteorological system hence calls for review of the agricultural practices and water use in this counterpart.",book:{id:"7484",slug:"topics-in-hydrometerology",title:"Topics in Hydrometerology",fullTitle:"Topics in Hydrometerology"},signatures:"Krishna Gopal Ghosh",authors:[{id:"257980",title:"Dr.",name:"Krishna Gopal",middleName:null,surname:"Ghosh",slug:"krishna-gopal-ghosh",fullName:"Krishna Gopal Ghosh"}]},{id:"67666",doi:"10.5772/intechopen.86774",title:"Statistical Analysis of Rainfall Patterns in Jeddah City, KSA: Future Impacts",slug:"statistical-analysis-of-rainfall-patterns-in-jeddah-city-ksa-future-impacts",totalDownloads:1200,totalCrossrefCites:1,totalDimensionsCites:5,abstract:"Recently, the Kingdom of Saudi Arabia (KSA) has been facing significant changes in rainstorm patterns (rainstorm intensities, frequencies, distributions) causing many flash flood events. The city of Jeddah is located in a coastal plain area, in the middle of the western side of the KSA, which represents a clear case of changing rainstorm patterns. Jeddah has been hit by many rainstorm events, which increased dramatically since 2009 (e.g., one in 2009, one in 2011, one in 2015, and another one happened in 2017). However, in 2018 about six rainstorms occurred. Two major flash flood events occurred in the city in November 2009 and in January 2011. There were significant impacts of these two events causing severe flooding. During these events, 113 persons were announced dead (in the 2009 event), and infrastructures and properties were damaged (roads and highways, more than 10,000 homes and 17,000 vehicles). In addition to that, dam failure occurred in the 2011 event. This situation gives clear evidence in changing the climate system that could cause more storms in the future across the KSA. Generally, Jeddah city has a lack of short-duration data in rainfall stations. In addition to that, there are a limited number of studies that have been done in determining rainstorm patterns. Consequently, the approach of the current study will focus on understanding and determining rainstorm patterns in the period between 2011 and 2017 depending on some digital rainfall stations that have been installed recently in Jeddah city. Rainstorm pattern and the method of distribution are the most crucial factors affecting peak flow and volume calculations. Our findings showed that there are two pattern types for the rainstorms in Jeddah city. Finally, a comparison with SCS-type II distribution was carried out.",book:{id:"7767",slug:"rainfall-extremes-distribution-and-properties",title:"Rainfall",fullTitle:"Rainfall - Extremes, Distribution and Properties"},signatures:"Mazen M. Abu Abdullah, Ahmed M. Youssef, Fawzy Nashar and Emad Abu AlFadail",authors:[{id:"188462",title:"Dr.",name:"Ahmed",middleName:null,surname:"Youssef",slug:"ahmed-youssef",fullName:"Ahmed Youssef"},{id:"289794",title:"Mr.",name:"Mazen",middleName:"Mustafa",surname:"Abu Abdulla",slug:"mazen-abu-abdulla",fullName:"Mazen Abu Abdulla"},{id:"296737",title:"Mr.",name:"Fawzy",middleName:null,surname:"Nashar",slug:"fawzy-nashar",fullName:"Fawzy Nashar"},{id:"296738",title:"Mr.",name:"Emad",middleName:null,surname:"Abu AlFadail",slug:"emad-abu-alfadail",fullName:"Emad Abu AlFadail"}]}],mostDownloadedChaptersLast30Days:[{id:"75865",title:"The Role of Statistical Methods and Tools for Weather Forecasting and Modeling",slug:"the-role-of-statistical-methods-and-tools-for-weather-forecasting-and-modeling",totalDownloads:409,totalCrossrefCites:1,totalDimensionsCites:1,abstract:"The need to understand the role of statistical methods for the forecasting of climatological parameters cannot be trivialized. This study gives an in depth review on the different variations of the Mann-Kendall (M-K) trend test and how they can be applied, regression techniques (Simple and Multiple), the Angstrom-Prescott model for solar radiation, etc. The study then goes ahead to apply some of them with data obtained from the Nigerian Meteorological Agency (NiMet), and applying tools like the python programming language and Wolfram Mathematica. Results show that the maximum ambient temperature for Calabar is increasing (Z = 2.52) significantly after the calculated p-value <0.05 (significant level). The seasonal M-K test was also applied for the dry and wet seasons and both were found to be increasing (Z = 3.23 and Z = 4.04 respectively) after their calculated p-values <0.05. The relationship between refractivity and other meteorological parameters relating to it was discerned using partial differential equations giving the gradient of each with refractivity; this was compared with results from the correlation matrix to show that the water vapor contents of the atmosphere contributes significantly to the variation of refractivity. Multiple linear regression has also been adopted to give an accurate model for the prediction of refractivity in the region after the residual error between the calculated refractivity and predicted refractivity was minimal.",book:{id:"8485",slug:"weather-forecasting",title:"Weather Forecasting",fullTitle:"Weather Forecasting"},signatures:"Emmanuel P. Agbo",authors:[{id:"337554",title:"Mr.",name:"Emmanuel P.",middleName:"Paul",surname:"Agbo",slug:"emmanuel-p.-agbo",fullName:"Emmanuel P. Agbo"}]},{id:"70625",title:"Response of the Coastal Ocean to Tropical Cyclones",slug:"response-of-the-coastal-ocean-to-tropical-cyclones",totalDownloads:722,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"The Northwest Pacific and the South China Sea region are the birthplaces of most monsoon disturbances and tropical cyclones and are an important channel for the generation and transmission of water vapor. The Northwest Pacific plays a major role in regulating interdecadal and long-term changes in climate. China experiences the largest number of typhoon landfalls and the most destructive power affected by typhoons in the world. The hidden dangers of typhoon disasters are accelerating with the acceleration of urbanization, the rapid development of economic construction and global warming. The coastal cities are the most dynamic and affluent areas of China’s economic development. They are the strong magnetic field that attracts international capital in China, and are also the most densely populated areas and important port groups in China. Although these regions are highly developed, they are vulnerable to disasters. When typhoons hit, the economic losses and casualties caused by gale, heavy rain and storm surges were particularly serious. This chapter reviews the response of coastal ocean to tropical cyclones, included sea surface temperature, sea surface salinity, storm surge simulation and extreme rainfall under the influence of tropical cyclones.",book:{id:"8974",slug:"current-topics-in-tropical-cyclone-research",title:"Current Topics in Tropical Cyclone Research",fullTitle:"Current Topics in Tropical Cyclone Research"},signatures:"Zhiyuan Wu and Mack Conde",authors:null},{id:"51562",title:"About the Concept of the Environment Recycling—Energy (ERE) in the Romanian Steel Industry",slug:"about-the-concept-of-the-environment-recycling-energy-ere-in-the-romanian-steel-industry",totalDownloads:1816,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"This paper takes as its starting point an analysis of the ecological functioning of the electric arc furnace (EAF). Thus, we present a classification of emissions generated by EAF, including limits of variation in chemical composition of “dust” issued by EAF in various countries and limit values for permissible concentrations of these emissions.The paper presents and analyzes various abstraction and treatment-related emissions for hipo-polluting operation of EAF. In this chapter, the correlations between macro system represented by metallurgical environment and interacting systems: System-Energy-Recycling Environment (ERE), Ecological system (ECO), and Recycling, Reclamation System (REC-REV) are presented. These correlations are presented in the spirit of sustainable development concepts (DC) and total quality (TQ).",book:{id:"5219",slug:"greenhouse-gases-selected-case-studies",title:"Greenhouse Gases",fullTitle:"Greenhouse Gases - Selected Case Studies"},signatures:"Adrian Ioana and Augustin Semenescu",authors:[{id:"177153",title:"Dr.",name:"Adrian",middleName:null,surname:"Ioana",slug:"adrian-ioana",fullName:"Adrian Ioana"},{id:"193573",title:"Prof.",name:"Augustin",middleName:null,surname:"Semenescu",slug:"augustin-semenescu",fullName:"Augustin Semenescu"}]},{id:"51481",title:"Effect of Dopants on the Properties of Zirconia‐Supported Iron Catalysts for Ethylbenzene Dehydrogenation with Carbon Dioxide",slug:"effect-of-dopants-on-the-properties-of-zirconia-supported-iron-catalysts-for-ethylbenzene-dehydrogen",totalDownloads:1530,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"Due to the harmful effects of carbon dioxide to the environment, a lot of work has been carried out aiming to find new applications, which can decrease the emissions or to capture and use it. An attractive application for carbon dioxide is the synthesis of chemicals, especially for producing styrene by ethylbenzene dehydrogenation, in which it increases the catalyst activity and selectivity. In order to find efficient catalysts for the reaction, the effect of cerium, chromium, aluminum, and lanthanum on the properties of zirconia‐supported iron oxides was studied in this work. The modified supports were prepared by precipitation and impregnated with iron nitrate. The obtained catalysts were characterized by thermogravimetry, Fourier transform infrared spectroscopy, X‐ray diffraction, specific surface area measurement, and temperature‐programmed reduction. The catalysts showed different textural and catalytic properties, which were associated to the different phases in the solids, such as monoclinic or tetragonal zirconia, hematite, maghemite, cubic ceria, monoclinic or hexagonal lantana, and rhombohedral chromia, the active phases in ethylbenzene dehydrogenation. The most promising dopant was cerium, which produces the most active catalyst at the lowest temperature, probably due to its ability of providing lattice oxygen, which activates carbon dioxide and increases the reaction rate.",book:{id:"5219",slug:"greenhouse-gases-selected-case-studies",title:"Greenhouse Gases",fullTitle:"Greenhouse Gases - Selected Case Studies"},signatures:"Maria do Carmo Rangel, Sirlene B. Lima, Sarah Maria Santana\nBorges and Ivoneide Santana Sobral",authors:[{id:"94651",title:"Dr.",name:"Maria",middleName:null,surname:"Do Carmo Rangel",slug:"maria-do-carmo-rangel",fullName:"Maria Do Carmo Rangel"}]},{id:"66825",title:"WMO Space-Based Weather and Climate Extremes Monitoring Demonstration Project (SEMDP): First Outcomes of Regional Cooperation on Drought and Heavy Precipitation Monitoring for Australia and Southeast Asia",slug:"wmo-space-based-weather-and-climate-extremes-monitoring-demonstration-project-semdp-first-outcomes-o",totalDownloads:990,totalCrossrefCites:8,totalDimensionsCites:13,abstract:"To improve monitoring of extreme weather and climate events from space, the World Meteorological Organization (WMO) initiated the space-based weather and climate extremes monitoring demonstration project (SEMDP). Presently, SEMDP is focused on drought and heavy precipitation monitoring over Southeast Asia and the Pacific. Space-based data and derived products form critical part of meteorological services’ operations for weather monitoring; however, satellite products are still not fully utilized for climate applications. Using SEMDP satellite-derived precipitation products, it would be possible to monitor extreme precipitation events with uniform spatial coverage and over various time periods – pentad, weekly, 10 days, monthly and longer time-scales. In this chapter, SEMDP satellite-derived precipitation products over the Asia-Pacific region produced by the Earth Observation Research Center/Japan Aerospace Exploration Agency (EORC/JAXA) and the Climate Prediction Center/National Oceanic and Atmospheric Administration (CPC/NOAA) are introduced. Case studies for monitoring (i) drought in Australia in July-October 2007 and September 2018 and (ii) heavy precipitation over Australia in December 2010 and Thailand and the Peninsular Malaysia in November-December 2014 which caused widespread flooding are also presented. Satellite observations are compared with in situ data to demonstrate value of satellite-derived estimates of precipitation for drought and heavy rainfall monitoring.",book:{id:"7767",slug:"rainfall-extremes-distribution-and-properties",title:"Rainfall",fullTitle:"Rainfall - Extremes, Distribution and Properties"},signatures:"Yuriy Kuleshov, Toshiyuki Kurino, Takuji Kubota, Tomoko Tashima and Pingping Xie",authors:[{id:"102903",title:"Prof.",name:"Yuriy",middleName:null,surname:"Kuleshov",slug:"yuriy-kuleshov",fullName:"Yuriy Kuleshov"}]}],onlineFirstChaptersFilter:{topicId:"838",limit:6,offset:0},onlineFirstChaptersCollection:[],onlineFirstChaptersTotal:0},preDownload:{success:null,errors:{}},subscriptionForm:{success:null,errors:{}},aboutIntechopen:{},privacyPolicy:{},peerReviewing:{},howOpenAccessPublishingWithIntechopenWorks:{},sponsorshipBooks:{sponsorshipBooks:[],offset:8,limit:8,total:0},allSeries:{pteSeriesList:[{id:"14",title:"Artificial Intelligence",numberOfPublishedBooks:11,numberOfPublishedChapters:91,numberOfOpenTopics:6,numberOfUpcomingTopics:0,issn:"2633-1403",doi:"10.5772/intechopen.79920",isOpenForSubmission:!0},{id:"7",title:"Biomedical Engineering",numberOfPublishedBooks:12,numberOfPublishedChapters:108,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2631-5343",doi:"10.5772/intechopen.71985",isOpenForSubmission:!0}],lsSeriesList:[{id:"11",title:"Biochemistry",numberOfPublishedBooks:33,numberOfPublishedChapters:333,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2632-0983",doi:"10.5772/intechopen.72877",isOpenForSubmission:!0},{id:"25",title:"Environmental Sciences",numberOfPublishedBooks:1,numberOfPublishedChapters:19,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2754-6713",doi:"10.5772/intechopen.100362",isOpenForSubmission:!0},{id:"10",title:"Physiology",numberOfPublishedBooks:14,numberOfPublishedChapters:145,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-8261",doi:"10.5772/intechopen.72796",isOpenForSubmission:!0}],hsSeriesList:[{id:"3",title:"Dentistry",numberOfPublishedBooks:11,numberOfPublishedChapters:144,numberOfOpenTopics:2,numberOfUpcomingTopics:0,issn:"2631-6218",doi:"10.5772/intechopen.71199",isOpenForSubmission:!0},{id:"6",title:"Infectious Diseases",numberOfPublishedBooks:13,numberOfPublishedChapters:125,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-6188",doi:"10.5772/intechopen.71852",isOpenForSubmission:!0},{id:"13",title:"Veterinary Medicine and Science",numberOfPublishedBooks:11,numberOfPublishedChapters:113,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2632-0517",doi:"10.5772/intechopen.73681",isOpenForSubmission:!0}],sshSeriesList:[{id:"22",title:"Business, Management and Economics",numberOfPublishedBooks:1,numberOfPublishedChapters:23,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2753-894X",doi:"10.5772/intechopen.100359",isOpenForSubmission:!0},{id:"23",title:"Education and Human Development",numberOfPublishedBooks:0,numberOfPublishedChapters:12,numberOfOpenTopics:1,numberOfUpcomingTopics:1,issn:null,doi:"10.5772/intechopen.100360",isOpenForSubmission:!0},{id:"24",title:"Sustainable Development",numberOfPublishedBooks:1,numberOfPublishedChapters:19,numberOfOpenTopics:5,numberOfUpcomingTopics:0,issn:"2753-6580",doi:"10.5772/intechopen.100361",isOpenForSubmission:!0}],testimonialsList:[{id:"13",text:"The collaboration with and support of the technical staff of IntechOpen is fantastic. The whole process of submitting an article and editing of the submitted article goes extremely smooth and fast, the number of reads and downloads of chapters is high, and the contributions are also frequently cited.",author:{id:"55578",name:"Antonio",surname:"Jurado-Navas",institutionString:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRisIQAS/Profile_Picture_1626166543950",slug:"antonio-jurado-navas",institution:{id:"720",name:"University of Malaga",country:{id:null,name:"Spain"}}}},{id:"6",text:"It is great to work with the IntechOpen to produce a worthwhile collection of research that also becomes a great educational resource and guide for future research endeavors.",author:{id:"259298",name:"Edward",surname:"Narayan",institutionString:null,profilePictureURL:"https://mts.intechopen.com/storage/users/259298/images/system/259298.jpeg",slug:"edward-narayan",institution:{id:"3",name:"University of Queensland",country:{id:null,name:"Australia"}}}}]},series:{item:{id:"13",title:"Veterinary Medicine and Science",doi:"10.5772/intechopen.73681",issn:"2632-0517",scope:"Paralleling similar advances in the medical field, astounding advances occurred in Veterinary Medicine and Science in recent decades. These advances have helped foster better support for animal health, more humane animal production, and a better understanding of the physiology of endangered species to improve the assisted reproductive technologies or the pathogenesis of certain diseases, where animals can be used as models for human diseases (like cancer, degenerative diseases or fertility), and even as a guarantee of public health. Bridging Human, Animal, and Environmental health, the holistic and integrative “One Health” concept intimately associates the developments within those fields, projecting its advancements into practice. This book series aims to tackle various animal-related medicine and sciences fields, providing thematic volumes consisting of high-quality significant research directed to researchers and postgraduates. It aims to give us a glimpse into the new accomplishments in the Veterinary Medicine and Science field. By addressing hot topics in veterinary sciences, we aim to gather authoritative texts within each issue of this series, providing in-depth overviews and analysis for graduates, academics, and practitioners and foreseeing a deeper understanding of the subject. Forthcoming texts, written and edited by experienced researchers from both industry and academia, will also discuss scientific challenges faced today in Veterinary Medicine and Science. In brief, we hope that books in this series will provide accessible references for those interested or working in this field and encourage learning in a range of different topics.",coverUrl:"https://cdn.intechopen.com/series/covers/13.jpg",latestPublicationDate:"August 17th, 2022",hasOnlineFirst:!0,numberOfPublishedBooks:11,editor:{id:"38652",title:"Prof.",name:"Rita",middleName:null,surname:"Payan-Carreira",slug:"rita-payan-carreira",fullName:"Rita Payan-Carreira",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRiFPQA0/Profile_Picture_1614601496313",biography:"Rita Payan Carreira earned her Veterinary Degree from the Faculty of Veterinary Medicine in Lisbon, Portugal, in 1985. She obtained her Ph.D. in Veterinary Sciences from the University of Trás-os-Montes e Alto Douro, Portugal. After almost 32 years of teaching at the University of Trás-os-Montes and Alto Douro, she recently moved to the University of Évora, Department of Veterinary Medicine, where she teaches in the field of Animal Reproduction and Clinics. Her primary research areas include the molecular markers of the endometrial cycle and the embryo–maternal interaction, including oxidative stress and the reproductive physiology and disorders of sexual development, besides the molecular determinants of male and female fertility. She often supervises students preparing their master's or doctoral theses. She is also a frequent referee for various journals.",institutionString:null,institution:{name:"University of Évora",institutionURL:null,country:{name:"Portugal"}}},editorTwo:null,editorThree:null},subseries:{paginationCount:3,paginationItems:[{id:"19",title:"Animal Science",coverUrl:"https://cdn.intechopen.com/series_topics/covers/19.jpg",isOpenForSubmission:!0,editor:{id:"259298",title:"Dr.",name:"Edward",middleName:null,surname:"Narayan",slug:"edward-narayan",fullName:"Edward Narayan",profilePictureURL:"https://mts.intechopen.com/storage/users/259298/images/system/259298.jpeg",biography:"Dr. Edward Narayan graduated with Ph.D. degree in Biology from the University of the South Pacific and pioneered non-invasive reproductive and stress endocrinology tools for amphibians - the novel development and validation of non-invasive enzyme immunoassays for the evaluation of reproductive hormonal cycle and stress hormone responses to environmental stressors. \nDr. Narayan leads the Stress Lab (Comparative Physiology and Endocrinology) at the University of Queensland. A dynamic career research platform which is based on the thematic areas of comparative vertebrate physiology, stress endocrinology, reproductive endocrinology, animal health and welfare, and conservation biology. \nEdward has supervised 40 research students and published over 60 peer reviewed research.",institutionString:null,institution:{name:"University of Queensland",institutionURL:null,country:{name:"Australia"}}},editorTwo:null,editorThree:null},{id:"20",title:"Animal Nutrition",coverUrl:"https://cdn.intechopen.com/series_topics/covers/20.jpg",isOpenForSubmission:!0,editor:{id:"175967",title:"Dr.",name:"Manuel",middleName:null,surname:"Gonzalez Ronquillo",slug:"manuel-gonzalez-ronquillo",fullName:"Manuel Gonzalez Ronquillo",profilePictureURL:"https://mts.intechopen.com/storage/users/175967/images/system/175967.png",biography:"Dr. Manuel González Ronquillo obtained his doctorate degree from the University of Zaragoza, Spain, in 2001. He is a research professor at the Faculty of Veterinary Medicine and Animal Husbandry, Autonomous University of the State of Mexico. He is also a level-2 researcher. He received a Fulbright-Garcia Robles fellowship for a postdoctoral stay at the US Dairy Forage Research Center, Madison, Wisconsin, USA in 2008–2009. He received grants from Alianza del Pacifico for a stay at the University of Magallanes, Chile, in 2014, and from Consejo Nacional de Ciencia y Tecnología (CONACyT) to work in the Food and Agriculture Organization’s Animal Production and Health Division (AGA), Rome, Italy, in 2014–2015. He has collaborated with researchers from different countries and published ninety-eight journal articles. He teaches various degree courses in zootechnics, sheep production, and agricultural sciences and natural resources.\n\nDr. Ronquillo’s research focuses on the evaluation of sustainable animal diets (StAnD), using native resources of the region, decreasing carbon footprint, and applying meta-analysis and mathematical models for a better understanding of animal production.",institutionString:null,institution:{name:"Universidad Autónoma del Estado de México",institutionURL:null,country:{name:"Mexico"}}},editorTwo:null,editorThree:null},{id:"28",title:"Animal Reproductive Biology and Technology",coverUrl:"https://cdn.intechopen.com/series_topics/covers/28.jpg",isOpenForSubmission:!0,editor:{id:"177225",title:"Prof.",name:"Rosa Maria Lino Neto",middleName:null,surname:"Pereira",slug:"rosa-maria-lino-neto-pereira",fullName:"Rosa Maria Lino Neto Pereira",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bS9wkQAC/Profile_Picture_1624519982291",biography:"Rosa Maria Lino Neto Pereira (DVM, MsC, PhD and) is currently a researcher at the Genetic Resources and Biotechnology Unit of the National Institute of Agrarian and Veterinarian Research (INIAV, Portugal). 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Professor Derbel has published many articles in journals and collaborates intensively with IntechOpen Access Publisher as an editor.",institutionString:"Clinique les Oliviers",institution:null},{id:"300144",title:"Dr.",name:"Meriem",middleName:null,surname:"Braiki",slug:"meriem-braiki",fullName:"Meriem Braiki",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/300144/images/system/300144.jpg",biography:"Dr. Meriem Braiki is a specialist in pediatric surgeon from Tunisia. She was born in 1985. She received her medical degree from the University of Medicine at Sousse, Tunisia. She achieved her surgical residency training periods in Pediatric Surgery departments at University Hospitals in Monastir, Tunis and France.\r\nShe is currently working at the Pediatric surgery department, Sidi Bouzid Hospital, Tunisia. Her hospital activities are mostly concerned with laparoscopic, parietal, urological and digestive surgery. She has published several articles in diffrent journals.",institutionString:"Sidi Bouzid Regional Hospital",institution:null},{id:"229481",title:"Dr.",name:"Erika M.",middleName:"Martins",surname:"de Carvalho",slug:"erika-m.-de-carvalho",fullName:"Erika M. de Carvalho",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/229481/images/6397_n.jpg",biography:null,institutionString:null,institution:{name:"Oswaldo Cruz Foundation",country:{name:"Brazil"}}},{id:"186537",title:"Prof.",name:"Tonay",middleName:null,surname:"Inceboz",slug:"tonay-inceboz",fullName:"Tonay Inceboz",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/186537/images/system/186537.jfif",biography:"I was graduated from Ege University of Medical Faculty (Turkey) in 1988 and completed his Med. PhD degree in Medical Parasitology at the same university. I became an Associate Professor in 2008 and Professor in 2014. I am currently working as a Professor at the Department of Medical Parasitology at Dokuz Eylul University, Izmir, Turkey.\n\nI have given many lectures, presentations in different academic meetings. I have more than 60 articles in peer-reviewed journals, 18 book chapters, 1 book editorship.\n\nMy research interests are Echinococcus granulosus, Echinococcus multilocularis (diagnosis, life cycle, in vitro and in vivo cultivation), and Trichomonas vaginalis (diagnosis, PCR, and in vitro cultivation).",institutionString:"Dokuz Eylül University",institution:{name:"Dokuz Eylül University",country:{name:"Turkey"}}},{id:"71812",title:"Prof.",name:"Hanem Fathy",middleName:"Fathy",surname:"Khater",slug:"hanem-fathy-khater",fullName:"Hanem Fathy Khater",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/71812/images/1167_n.jpg",biography:"Prof. Khater is a Professor of Parasitology at Benha University, Egypt. She studied for her doctoral degree, at the Department of Entomology, College of Agriculture, Food and Natural Resources, University of Missouri, Columbia, USA. She has completed her Ph.D. degrees in Parasitology in Egypt, from where she got the award for “the best scientific Ph.D. dissertation”. She worked at the School of Biological Sciences, Bristol, England, the UK in controlling insects of medical and veterinary importance as a grant from Newton Mosharafa, the British Council. Her research is focused on searching of pesticides against mosquitoes, house flies, lice, green bottle fly, camel nasal botfly, soft and hard ticks, mites, and the diamondback moth as well as control of several parasites using safe and natural materials to avoid drug resistances and environmental contamination.",institutionString:null,institution:{name:"Banha University",country:{name:"Egypt"}}},{id:"99780",title:"Prof.",name:"Omolade",middleName:"Olayinka",surname:"Okwa",slug:"omolade-okwa",fullName:"Omolade Okwa",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/99780/images/system/99780.jpg",biography:"Omolade Olayinka Okwa is presently a Professor of Parasitology at Lagos State University, Nigeria. She has a PhD in Parasitology (1997), an MSc in Cellular Parasitology (1992), and a BSc (Hons) Zoology (1990) all from the University of Ibadan, Nigeria. She teaches parasitology at the undergraduate and postgraduate levels. She was a recipient of a Commonwealth fellowship supported by British Council tenable at the Centre for Entomology and Parasitology (CAEP), Keele University, United Kingdom between 2004 and 2005. She was awarded an Honorary Visiting Research Fellow at the same university from 2005 to 2007. \nShe has been an external examiner to the Department of Veterinary Microbiology and Parasitology, University of Ibadan, MSc programme between 2010 and 2012. She is a member of the Nigerian Society of Experimental Biology (NISEB), Parasitology and Public Health Society of Nigeria (PPSN), Science Association of Nigeria (SAN), Zoological Society of Nigeria (ZSN), and is Vice Chairperson of the Organisation of Women in Science (OWSG), LASU chapter. She served as Head of Department of Zoology and Environmental Biology, Lagos State University from 2007 to 2010 and 2014 to 2016. She is a reviewer for several local and international journals such as Unilag Journal of Science, Libyan Journal of Medicine, Journal of Medicine and Medical Sciences, and Annual Research and Review in Science. \nShe has authored 45 scientific research publications in local and international journals, 8 scientific reviews, 4 books, and 3 book chapters, which includes the books “Malaria Parasites” and “Malaria” which are IntechOpen access publications.",institutionString:"Lagos State University",institution:{name:"Lagos State University",country:{name:"Nigeria"}}},{id:"273100",title:"Dr.",name:"Vijay",middleName:null,surname:"Gayam",slug:"vijay-gayam",fullName:"Vijay Gayam",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/273100/images/system/273100.jpeg",biography:"Dr. Vijay Bhaskar Reddy Gayam is currently practicing as an internist at Interfaith Medical Center in Brooklyn, New York, USA. He is also a Clinical Assistant Professor at the SUNY Downstate University Hospital and Adjunct Professor of Medicine at the American University of Antigua. He is a holder of an M.B.B.S. degree bestowed to him by Osmania Medical College and received his M.D. at Interfaith Medical Center. His career goals thus far have heavily focused on direct patient care, medical education, and clinical research. He currently serves in two leadership capacities; Assistant Program Director of Medicine at Interfaith Medical Center and as a Councilor for the American\r\nFederation for Medical Research. As a true academician and researcher, he has more than 50 papers indexed in international peer-reviewed journals. He has also presented numerous papers in multiple national and international scientific conferences. His areas of research interest include general internal medicine, gastroenterology and hepatology. He serves as an editor, editorial board member and reviewer for multiple international journals. His research on Hepatitis C has been very successful and has led to multiple research awards, including the 'Equity in Prevention and Treatment Award” from the New York Department of Health Viral Hepatitis Symposium (2018) and the 'Presidential Poster Award” awarded to him by the American College of Gastroenterology (2018). He was also awarded 'Outstanding Clinician in General Medicine” by Venus International Foundation for his extensive research expertise and services, perform over and above the standard expected in the advancement of healthcare, patient safety and quality of care.",institutionString:"Interfaith Medical Center",institution:{name:"Interfaith Medical Center",country:{name:"United States of America"}}},{id:"93517",title:"Dr.",name:"Clement",middleName:"Adebajo",surname:"Meseko",slug:"clement-meseko",fullName:"Clement Meseko",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/93517/images/system/93517.jpg",biography:"Dr. Clement Meseko obtained DVM and PhD degree in Veterinary Medicine and Virology respectively. He has worked for over 20 years in both private and public sectors including the academia, contributing to knowledge and control of infectious disease. Through the application of epidemiological skill, classical and molecular virological skills, he investigates viruses of economic and public health importance for the mitigation of the negative impact on people, animal and the environment in the context of Onehealth. \r\nDr. Meseko’s field experience on animal and zoonotic diseases and pathogen dynamics at the human-animal interface over the years shaped his carrier in research and scientific inquiries. He has been part of the investigation of Highly Pathogenic Avian Influenza incursions in sub Saharan Africa and monitors swine Influenza (Pandemic influenza Virus) agro-ecology and potential for interspecies transmission. He has authored and reviewed a number of journal articles and book chapters.",institutionString:"National Veterinary Research Institute",institution:{name:"National Veterinary Research Institute",country:{name:"Nigeria"}}},{id:"158026",title:"Prof.",name:"Shailendra K.",middleName:null,surname:"Saxena",slug:"shailendra-k.-saxena",fullName:"Shailendra K. Saxena",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRET3QAO/Profile_Picture_2022-05-10T10:10:26.jpeg",biography:"Professor Dr. Shailendra K. Saxena is a vice dean and professor at King George's Medical University, Lucknow, India. His research interests involve understanding the molecular mechanisms of host defense during human viral infections and developing new predictive, preventive, and therapeutic strategies for them using Japanese encephalitis virus (JEV), HIV, and emerging viruses as a model via stem cell and cell culture technologies. His research work has been published in various high-impact factor journals (Science, PNAS, Nature Medicine) with a high number of citations. He has received many awards and honors in India and abroad including various Young Scientist Awards, BBSRC India Partnering Award, and Dr. JC Bose National Award of Department of Biotechnology, Min. of Science and Technology, Govt. of India. Dr. Saxena is a fellow of various international societies/academies including the Royal College of Pathologists, United Kingdom; Royal Society of Medicine, London; Royal Society of Biology, United Kingdom; Royal Society of Chemistry, London; and Academy of Translational Medicine Professionals, Austria. He was named a Global Leader in Science by The Scientist. He is also an international opinion leader/expert in vaccination for Japanese encephalitis by IPIC (UK).",institutionString:"King George's Medical University",institution:{name:"King George's Medical University",country:{name:"India"}}},{id:"94928",title:"Dr.",name:"Takuo",middleName:null,surname:"Mizukami",slug:"takuo-mizukami",fullName:"Takuo Mizukami",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/94928/images/6402_n.jpg",biography:null,institutionString:null,institution:{name:"National Institute of Infectious Diseases",country:{name:"Japan"}}},{id:"233433",title:"Dr.",name:"Yulia",middleName:null,surname:"Desheva",slug:"yulia-desheva",fullName:"Yulia Desheva",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/233433/images/system/233433.png",biography:"Dr. Yulia Desheva is a leading researcher at the Institute of Experimental Medicine, St. Petersburg, Russia. She is a professor in the Stomatology Faculty, St. Petersburg State University. She has expertise in the development and evaluation of a wide range of live mucosal vaccines against influenza and bacterial complications. Her research interests include immunity against influenza and COVID-19 and the development of immunization schemes for high-risk individuals.",institutionString:'Federal State Budgetary Scientific Institution "Institute of Experimental Medicine"',institution:null},{id:"238958",title:"Mr.",name:"Atamjit",middleName:null,surname:"Singh",slug:"atamjit-singh",fullName:"Atamjit Singh",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/238958/images/6575_n.jpg",biography:null,institutionString:null,institution:null},{id:"252058",title:"M.Sc.",name:"Juan",middleName:null,surname:"Sulca",slug:"juan-sulca",fullName:"Juan Sulca",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/252058/images/12834_n.jpg",biography:null,institutionString:null,institution:null},{id:"191392",title:"Dr.",name:"Marimuthu",middleName:null,surname:"Govindarajan",slug:"marimuthu-govindarajan",fullName:"Marimuthu Govindarajan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/191392/images/5828_n.jpg",biography:"Dr. M. 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