Dr. David C. Hamilton passed away January 26, 2005, after an extended illness with a rare blood disorder. Dave was a tireless and creative worker his whole life, with unfinished projects still underway at the time of his death. Dave was past president of the AAO, Great Lakes Association of Orthodontists, Pennsylvania Association of Orthodontists and a Great Lakes Trustee to the AAO for many years. In the 1960s Dave was the primary facilitator for the start of the AAO disability and life insurance plans and largely responsible for the design of the policies along with the underwriters, Trealor-Heisel Company.
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The purpose of this study was to determine if facial or dentoalveolar growth takes place after the occurrence of the radiographic handwrist stage R-J (completed fusion of the proximal epiphysis and diaphysis of the radius), which generally defines the completion of facial growth. Handwrist roentgenograms and lateral head films (LHFs) from 56 subjects (31 male and 25 female) aged 14 to 21 years were examined. Eight cephalometric distances (3 sagittal, 4 vertical, and 1 diagonal) and their changes during 2 different examination periods (from 1 year before to 2 years after the occurrence of R-J) were assessed. The investigation revealed that after the occurrence of R-J vertical dentoalveolar growth changes between 0.5 and 1.75 mm took place in the mandible and in the maxilla in 20% and 10% of the subjects, respectively. Comparing the 2 periods the frequency of the measured growth changes before and after R-J was, on average, almost equal. Because chronological age cannot be used for the assessment of facial growth termination, a reliable indicator for the assessment of facial growth termination is of major importance. After the occurrence of the handwrist stage R-J, most subjects revealed growth changes of less than 1 mm. Especially in the field of tooth implantology, it is important to forecast even small vertical dentoalveolar growth changes. The detected amount of growth after the insertion of an implant can cause esthetic and functional problems.Abstract
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The purpose of the present study was to determine the diagnostic and treatment planning value of digital models when compared with plaster study casts. In addition, the level of orthodontic experience of the examiner was assessed to determine whether this would have an influence on the decision-making process. Thirty randomly selected orthodontic patients from the Department of Orthodontics at the University of Alabama were selected for the study. From the 30 record sets, seven were selected attempting to mirror cases required for presentation to the American Board of Orthodontics. The seven evaluators were divided into two groups on the basis of their level of orthodontic experience. Initially, each evaluator assessed each patient record. Each evaluator was given a standardized questionnaire which recorded the evaluator's diagnosis based on use of the digital study models (T1). Regardless of whether the evaluator requested a review of the plaster study casts, the evaluator was given the plaster study casts. The evaluator then, using the plaster casts, filled out another identical questionnaire (T2). A chi-square test was used to determine any group differences in the frequency of changed diagnostic characteristics, treatment mechanical procedures, or proposed treatment plans after evaluating plaster study models. The statistical significance selected was P = .05 level of significance. The results showed that 12.8% of diagnostic characteristics, 12% of treatment mechanic procedures, and 6% of proposed treatment plans changed after T2. The results of the present study indicate that in the vast majority of situations digital models can be successfully used for orthodontic records.Abstract
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The purpose of this study was to evaluate the association between unilateral degenerative joint disease (UDJD) and lower facial asymmetry. Twenty symptomatic patients and 20 asymptomatic volunteers were studied. Posteroanterior radiographs and bilateral mandibular laminographs were used to evaluate lower face and mandibular asymmetry. The two-way analysis of variance test was used to compare the groups. The posteroanterior radiographs did not reveal vertical asymmetry for the patients. The group with the left side affected exhibited deviation of the mandibular dental midline, the menton, and the antigonion toward the affected side. The laminographs of the same group revealed decreased condylar height and increased antigonial notching in the affected side. The results suggest that subjects with UDJD may manifest lower face asymmetry. This can be of clinical value when adult patients exhibiting asymmetry are to be treated.Abstract
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The aims of this study were to classify normal occlusion samples into specific skeletal types and to analyze the dentoalveolar compensation in a normal occlusion in order to provide the clinically applicable differential diagnostic criteria for an individual malocclusion patient. Lateral cephalograms of 294 normal occlusion samples, who were selected from 15,836 adults through a community dental health survey, were measured. Using a principal component analysis, two factors representing the anteroposterior and vertical skeletal relationships were extracted from 18 skeletal variables. Cluster analysis was then used to classify the skeletal patterns into nine types. Nine types of polygonal charts with a profilogram were created. Discriminant analysis with a stepwise entry of variables was designed to identify several potential variables for skeletal typing, which could be linked with computerized cephalometric analysis for an individual malocclusion patient. Discriminant analysis assigned 87.8% classification accuracy to the predictive model. It was concluded that because the range of a normal occlusion includes quite diverse anteroposterior and vertical skeletal relationships, classifying the skeletal pattern and establishing an individual dentoalveolar treatment objective might facilitate clinical practice.Abstract
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Renal osteodystrophy is a common complication of uremic patients, mainly when they are in long-term regular dialysis treatment. The craniofacial skeleton is one of the peculiar targets of renal osteodystrophy, the more dramatic pattern of which is a form of leontiasis. To assess facial deformities in uremic conditions and to understand the possible relation with hyperparathyroidism, the three-dimensional coordinates of 50 soft tissue facial landmarks were obtained by an electromagnetic digitizer in 10 male and 10 female patients (aged 53–81 years) with chronic renal insufficiency and regular dialysis treatment. Similar three-dimensional coordinates were also collected for 34 healthy individuals of the same age, ethnicity, and sex. From the landmarks, facial distances, angles, and volumes were calculated according to a geometrical model of the face. Data were compared with those collected in the normal subjects by computing z-scores. Facial volumes of the chronic renal insufficiency patients were significantly larger than those of the control subjects. The increment was particularly evident in the facial middle third (maxilla), leading to a significant inversion of the mandibular-to-maxillary ratio. The lips tended to be more prominent (reduced interlabial angle). Some of these facial modifications (facial and nose height, maxillary dimensions, mandibular shape) were significantly related to the clinical characteristics of the patients (duration of renal insufficiency, duration of dialysis, parathormone (PTH) plasma levels). In regular dialysis treatment, some of the facial modifications are related to hyperparathyroidism, which supports the need for a strict metabolic control also in the early phase of uremia.Abstract
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Soft tissue analyses are basic tools in planning orthodontic treatment. However, the perception of a well-balanced Japanese facial profile has not yet been established, particularly with respect to changes in facial convexity. The purpose of this study was to assess and determine the range of antero-posterior (A-P) lip positions of the top three most favored, well-balanced profiles from a series of various facial silhouettes with changing facial convexity. The average profile was constructed from the profiles of 30 Japanese males and females with Class I occlusions. Changes in facial convexity were established by altering the A-P chin position by protruding or retruding the chin in increments of 5° and 10° from the average profile. A series of 11 profiles were developed from each of the four changes in facial convexity. The lips were then protruded or retruded in one-mm increments from the average profile. Forty orthodontists were asked to rate the top three most favored, well-balanced profiles. We found that the raters tended to prefer more retruded lip positions as facial convexity decreased, for both males and females. The raters also tended to prefer slightly more protruded lip positions as the facial convexity increased. Because chin position is inherent in each patient, others may equate a retrusive or protrusive chin with certain personalities, thus, it is important for orthodontists to take into account the balance between the lips and the chin.Abstract
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A group of 48 ethnically diverse patients with bimaxillary protrusion was used to study the pretreatment cephalometric traits of this malocclusion and the effect of orthodontic correction. All patients were treated with four premolar extractions and retraction of the anterior teeth. Pre- and posttreatment lateral cephalograms were evaluated using a series of 18 linear and angular measurements, and the effect of orthodontic correction was determined using paired t-tests. Cephalometric standards were developed for bimaxillary protrusions, which clarify the overall presentation of this malocclusion for clinicians. Patients with bimaxillary protrusion demonstrated increased incisor proclination and protrusion, a vertical facial pattern, increased procumbency of the lips, a decreased nasolabial angle, and thin and elongated upper and lower anterior alveoli. This study also showed that the extraction of four premolars can be extremely successful in reducing the dental and soft tissue procumbency seen in patients with bimaxillary protrusion, thus providing a stronger evidence-based rationale for this treatment modality.Abstract
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The aim of this study was to evaluate the degree of tooth wear in posterior deciduous teeth of 100 subjects in the second phase of mixed dentition who were born in the 1950s (50sG) and 100 subjects born in the 1990s (90sG). The degree of abrasion for each posterior deciduous tooth was scored ranging from 0 to 3. The comparison of the degree of abrasion showed significant differences between the two groups for all examined teeth (upper and lower deciduous canines and first and second primary molars) all of which appeared to be more abraded in the 50sG. The findings of the present study indicate that subjects who were born in the 1950s exhibited a significantly greater degree of tooth wear on the posterior deciduous teeth when compared with contemporary subjects, along with a well-recognized lower prevalence of malocclusions. Changes in dietary habits and a diet based on processed foods may be postulated as factors involved with a decrease of dental attrition in contemporary populations. An increase in the prevalence of mouth breathing (tested in the present study) appears to be associated with a decrease in tooth wear in the contemporary population as well.Abstract
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The aim of this study was to investigate the effects of an early treatment oriented orthodontic program on treatment need at age 12 years in a public health care system. The subjects consisted of one whole age cohort in a municipality in Finland, 87 children in total. All children were examined at ages eight, 10, and 12 years. Treatment need was assessed on casts using a modified Dental Health Component of the Index of Orthodontic Treatment Need and a 10-Grade Scale based on the Treatment Priority Index. Early treatment was started on children having definite treatment need according to both indices. The agreement between indices was good at ages eight and 12 years and moderate at age 10 years. Treatment need changed significantly from eight to 12 years. Of the 29 children with definite treatment need at age eight years, only two had treatment need at age 12 years. Of the 38 children with no treatment need at age eight years, 28 remained in this category and only two children had definite need for treatment at age 12 years. The duration of treatment ranged from one to 61 months, although 59% of the treatments lasted two years or less. We conclude that systematically planned early orthodontic treatment may have contributed to the significant reduction in treatment need from eight to 12 years of age.Abstract
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The description of motion using a finite helical axis (FHA) is independent of the chosen coordinate system because the values of the helical axis parameters do not change with coordinate transformations. However, an intuitive understanding of tooth movement expressed by the FHA can be slightly difficult for orthodontists who have never used it. The purpose of this study was to clarify the basic behavior of the FHA to increase our understanding of the FHA during tooth movement. Parameters of the FHA were calculated in two different simulations of canine retraction. In simulation 1, as the tipping angle of the canine was increased from 5° to 30°, the direction vector of the FHA v approached the x-axis (tipping axis), thus increasing the rotation angle about the FHA θ. These results demonstrated that the direction vector of the FHA can indicate the axis of rotation that is most affected in three-dimensional transformation. In simulation 2, bodily tooth movement of the canine was increased from one to five mm, and the shortest distance from the origin to the FHA d increased in a linear manner. In this case, the percent increase in bodily tooth movement could be determined by the d value. This study showed that the use of FHA makes it possible to determine the torques applied to the tooth and the true bodily tooth movement during orthodontic treatment, and this may lead to a better understanding of how to move teeth.Abstract
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This study was conducted to investigate the influence of supplemented evening primrose oil (EPO) on osteoclast expression during experimental tooth movement in rats. Forty-eight 10-week-old male Sprague-Dawley rats were divided into experimental and control groups. Animals in the experiment group were fed a 7.25 g/kg daily dose of EPO orally by gastric intubation for 20 days before orthodontic tooth movement. The animals in the control group received an equivalent volume of distilled water by the same method. On day 21, a 40-g mesial tipping force was applied to the maxillary right first molar of each rat. After loading, six animals in each group were sacrificed on days 0, 3, 7, and 14 with the appliance in situ. On day 3, the number of osteoclasts on the appliance side of the experimental group was significantly increased compared with the control group (P < .05). On day 7, the number of osteoclasts on the nonappliance side of the experimental group was significantly increased compared with the control group (P < .05). This study indicates that oral administration of EPO can increase the number of osteoclasts and may accelerate orthodontic tooth movement.Abstract
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This prospective study investigated the influence of functional unilateral posterior crossbite on mastication movements. The study group included 16 patients (nine girls and seven boys) with functional unilateral posterior crossbite involving three or more posterior teeth. A control group comprised 15 individuals (nine girls and six boys) with normal occlusion and the mean age of both groups was 9.17 years. The mandibular masticatory movements were registered, using computer axiography, for 30 seconds during chewing to determine the preference side of chewing. The patterns of the first, third, and fifth chewing cycles were compared with the preference side to establish whether they would predict the chewing preference side. The extent of the maximal lateral and vertical displacements of the mandible during chewing were compared between study and control groups. This study found that overall the left side was the preferred mastication side in 43.7% of individuals in the study and 46.7% in the control group. There was no relationship between the side of the crossbite and the masticatory preference side (Mc Nemar test, P = .5). No correlation was present between the patterns of chewing movements in the first, third, or fifth cycles. Both study and control groups showed similar maximal lateral and vertical mandible displacement.Abstract
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A new geometry of orthodontic retraction spring was experimentally studied through an electronic device (platform for measuring forces), using strain gauges that were adapted to cantilever beams. The sample consisted of 36 titanium-molybdenum springs, divided into three groups of 12 springs each. The springs were produced with different cross sections of 0.016 × 0.022 inch and 0.017 × 0.025 inch and with different angles between the extremities (120° and 130°). The springs were adapted to the platform in three different positions so that the force system developed by them could be known (horizontal forces, vertical forces, alpha-beta moments, and moment-to-force ratio M:F). The analysis of factorial variance and the Tukey honestly significant difference test were applied to verify the differences between the averages caused by three possible variation sources and the interactions between them. Regression analysis was also performed to obtain the spring rate. The results show the interactions between the three geometric variables, force magnitudes, and also the spring rates, which are compatible with the ones mentioned in the literature related to the subject. The spring rate was within the levels that are appropriate for clinical use (varying from β = 33.1 gf/mm to β = 43.9 gf/mm).Abstract
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The purpose of this study was to compare the anchorage effects of different palatal osseointegrated implants using a finite element analysis. Three types of cylinder implants (simple implant, step implant, screw implant) were investigated. Three finite element models were constructed. Each consisted of two maxillary second premolars, their associated periodontal ligament (PDL) and alveolar bones, palatal bone, palatal implant, and a transpalatal arch. Another model without an implant was used for comparison. The horizontal force (mesial 5N, palatal 1N) was loaded at the buccal bracket of each second premolar, and the stress in the PDL, implant, and implant surrounding bone was calculated. The results showed that the palatal implant could significantly reduce von Mises stress in the PDL (maximum von Mises stress was reduced 24.3–27.7%). The von Mises stress magnitude in the PDL was almost same in the three models with implants. The stress in the implant surrounding bone was very low. These results suggested that the implant is a useful tool for increasing anchorage. Adding a step is useful to lower the stress in the implant and surrounding bone, but adding a screw to a cylinder implant had little advantage in increasing the anchorage effect.Abstract
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The purpose of this study was to assess the effect of light-tip distance on the shear bond strength and failure site of brackets cured with three different light curing units: a high-intensity halogen (Astralis 10, 10-second curing), a light-emitting diode (LED, e-Light, six-second curing), and a plasma arc (PAC System, four-second curing). One hundred and thirty-five bovine permanent mandibular incisors were randomly allocated to nine groups of 15 specimens each. Stainless steel brackets were bonded with a composite resin to the teeth, and each curing light was tested at zero, three, and six mm from the bracket. After bonding, all samples were stored in distilled water at room temperature for 24 hours and subsequently tested for shear bond strength. When the three light curing units were compared at a light-tip distance of zero mm, the three lights showed no significantly different shear bond strengths. At light-tip distances of three and six mm, no significant differences were found between the halogen and plasma arc lights, but both lights showed significantly higher shear bond strengths than the LED light. When evaluating the effect of the light-tip distance on each light curing unit, the halogen light showed no significant differences between the three distances. However, the LED light produced significantly lower shear bond strengths at a greater light-tip distance, and the plasma arc lamp showed significantly higher shear bond strengths at a greater light-tip distance. In hard-to-reach areas, the use of PAC system is suggested, whereas the LED evaluated in this study is not recommended.Abstract
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The purpose of this study was to determine whether the application of two antibacterial mouth rinses to etched and unetched enamel affects the shear bond strength (SBS) of an orthodontic composite resin. Eighty-five lower human incisors were divided into five groups, ie, group 1: control group, no mouth rinse was used; groups 2 and 3: mouth rinses were applied to the intact enamel surface before etching; groups 4 and 5: mouth rinses were applied to the etched enamel. A bonding agent and a composite resin were applied to the teeth surface. For shear bond testing, the specimens were mounted in a universal testing machine, and an apparatus attached to a compression load cell was applied to each specimen until failure occurred. The data were analyzed using analysis of variance and Tukey honestly significance tests. Fracture modes were analyzed by Mann-Whitney U-test. There was no statistically significant difference between the SBS values of group 1 (31.64 ± 3.62 MPa) and group 4—five experimental applications (P ≥ .05). However, the SBS value of group 3 (36.56 ± 5.95 MPa) was significantly larger than those of group 4 (30.00 ± 4.97 MPa) and group 5 (30.26 ± 7.30 MPa). In addition, no significant differences were observed between group 1 and groups 2 (34.33 ± 7.26 MPa) and 3 (36.56 ± 5.95 MPa) (P ≥ .05). Because the application of chlorhexidine and povidone-iodine before acid etching did not cause any decrease in bond strength, it is advisable for use under the orthodontic resin composite to obtain an antibacterial effect or to prevent the risk of bacteremia.Abstract
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A new antibacterial and fluoride-releasing bonding system consists of a self-etching primer that contains an antibacterial monomer and a bonding agent that contains sodium fluoride. This study was to determine the effect of using this new adhesive on the shear bond strength of orthodontic brackets. Forty molar teeth were randomly divided into two groups. Group 1 consisted of 20 teeth that were etched for 15 seconds with 35% phosphoric acid, washed with a water spray for 10 seconds, and dried to a chalky white appearance, and the sealant was applied to the etched surface. The precoated brackets were placed on the teeth and light cured. Group 2 consisted of 20 teeth that were etched with 35% phosphoric acid for 15 seconds as suggested by the manufacturer when bonding to intact enamel. The teeth were washed with a water spray for 10 seconds and dried to a chalky white appearance, and the primer containing antibacterial monomer was applied to the etched surface, left for 20 seconds, and sprayed with a mild airstream. The adhesive was applied to each tooth, and the precoated bracket was placed and light cured. There were no significant differences (P = .220) in the shear bond strengths of the two groups. The mean shear bond strength for the antibacterial fluoride-releasing adhesive was 11.7 ± 5.6 MPa and for the control was 9.6 ± 5.0 MPa. The use of an antibacterial fluoride-releasing adhesive system did not affect the shear bond strength of the orthodontic brackets within the first half hour after initial bonding.Abstract
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The objective of this study was to compare the effect of a nonrinse conditioner (NRC) and the conventional acid-etch technique on the shear bond strength and the adhesive remnant on the tooth after debonding brackets bonded with the resin orthodontic adhesive system Transbond XT. A total of 40 human premolars were divided into group I, phosphoric Acid/Transbond XT (n = 25) and group II, NRC/ Transbond XT (n = 15). Shear bond strength was measured with a universal test machine with a crosshead speed of 1 mm/min. The adhesive remnant was quantified using image analysis equipment. Scanning electron microscope (SEM) observations were also carried out to observe enamel surfaces treated with each product. No significant differences were observed in the bond strengths of the two groups evaluated. The amount of adhesive remnant on the tooth after debonding was significantly less when conditioning the enamel with NRC compared with phosphoric acid. SEM observations showed that the NRC produced a more conservative etch pattern than phosphoric acid.Abstract
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The aim of this in vivo study was to evaluate the effects of sandblasting metal brackets on their clinical performance when resin-modified, chemically cured glass ionomer cement was used for bonding. A total of 60 patients with a range of malocclusions were allocated randomly into two groups. For the first 30 cases, teeth were divided into quadrants so that sandblasted, mesh-based metal brackets (SB) were bonded directly to the upper left and lower right quadrants using the resin-modified glass ionomer cement. The mesh-based (no sandblasting) brackets bonded to the other quadrants with the same adhesive were used as control (CO). A split-mouth design was used, and the allocation of the brackets per quadrant was reversed for the second 30 cases. Sandblasting of the bracket bases was accomplished using 25-μm aluminum oxide particles for three seconds. The manufacturer's instructions were followed for bonding. The number, site, and date of first-time bracket failures were monitored throughout active orthodontic treatment, and the observation time was 20 months. The bond failure rates were 4.9% and 4.3% for the SB and CO brackets, respectively. No statistically significant difference was found between the groups for failure rates. The bond failure sites were predominantly at the enamel-adhesive interface in both groups. Sandblasting did not have a positive effect on the clinical performance of the mesh-based metal brackets when bonded with resin-modified glass ionomer cement.Abstract
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A new dental flowable composite, Denfil Flow, was evaluated for the bonding of orthodontic brackets by determining its shear bond strength (SBS) and the mode of bond failure after debonding. Eighty extracted human premolars were divided into two equal groups. Metal brackets were bonded to etched enamel using a composite resin control (Transbond XT) or Denfil Flow. After 72 hours of incubation in saline solution at 37°C, debonding was performed with a shearing force. The SBS and the mode of bond failure were examined. In addition, representative samples from each group were examined by scanning electron microscopy (SEM). No significant difference was observed in the SBS between the groups, and a clinically acceptable SBS was found for the two adhesives. Bond failures occurred mostly in the bracket–adhesive interface, without significant differences between the groups. At SEM analysis, Denfil Flow showed a greater frequency of air bubbles within the resin than did Transbond XT. In conclusion, Denfil Flow displayed the same SBS as traditional composite resins and similar bond failures. Further clinical studies are required.Abstract
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The purpose of this study was to investigate the long-term clinical responses of rapid maxillary expansion as the only treatment performed in Class I malocclusion using the Haas-type appliance. The longitudinal sample consisted of 90 sets of study models from 30 consecutive patients (12 males and 18 females) selected on the basis of the following inclusion criteria: all patients (1) had a Class I malocclusion with transverse maxillary/mandibular skeletal discrepancies, (2) were treated nonextraction in the early/ mid mixed dentition, (3) presented with mandibular dental arches with mild or no crowding, and (4) had no subsequent comprehensive orthodontic treatment implemented in either the maxilla or the mandible. The mean age was 8.2 years when treatment was initiated. Treatment outcomes were evaluated at pretreatment A1, short-term follow-up (one year after A1) A2, and long-term follow-up (four years after A2) A3. The changes in maxillary arch width and arch length were quantified and compared among assessment stages A1, A2, and A3 using the Student's t-test. The results demonstrated a highly significant increase in maxillary arch width in both the short- and long-term follow-ups. The arch width increased significantly during treatment and decreased slightly during the long-term follow-up. The long-term clinical response demonstrated the efficacy and stability of this type of treatment in achieving maxillary arch width. The follow-up examination during the early/mid/permanent dentition confirmed the validity of overtreatment.Abstract
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The aim of this study was to evaluate in vitro the effect of variations in the size of elastomeric ligatures on the static frictional resistance generated by orthodontic sliding mechanics under dry condition. Frictional forces generated by elastomeric ligatures treated with a lubricating material (silicone) were analyzed as well. An Instron testing machine was used to assess the static frictional forces of a 0.019 × 0.025-inch stainless steel rectangular wire that was ligated to a molar convertible tube and to three stainless steel 0.022-inch pre-adjusted brackets with elastomeric ligatures with different dimensions: small, medium, and large. The static friction produced by two prototypes of silicone-lubricated elastomeric ligatures was also measured. The small and medium elastomeric ligatures produced significantly less friction than the large ligatures. No statistically significant difference was found between small and medium ligatures. The decrease in frictional forces of small and medium modules had to be ascribed mainly to the smaller thickness of both ligatures with respect to large ligatures. The lubricated elastomeric ligatures generated significantly smaller frictional forces than nonlubricated elastomeric ligatures with different dimensions. The variation in the dimensions of the elastomeric ligatures is able to influence the static frictional resistance generated by orthodontic sliding mechanics in the buccal segments. The use of small and medium elastomeric ligatures determines a 13–17% decrease in static friction compared with large ligatures. Silicone-lubricated modules can reduce static friction by 23–34% with respect to the small and medium nonlubricated elastomeric ligatures and by 36–43% compared with nonlubricated large ligatures.Abstract
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The purpose of this study was to evaluate the skeletal, dental, and soft-tissue changes in late-adolescent patients treated with Jasper Jumpers applied with sectional arches. The study sample consisted of 30 subjects (15 treated, 15 untreated) with skeletal and dental Class II malocclusion. Our study was carried out on 75 lateral cephalometric films. Among these radiograms, 15 were taken before the leveling stage in the treatment group. Half of the remaining 60 were taken before placement and after removal of the Jasper Jumper appliance in the treatment group and the other half at the beginning and six months after in the control group. The patient selection criteria were Class II malocclusion caused by retrognathic mandible, normal or low-angle growth pattern, and postpeak growth period. The statistical assessment of the data suggests that the sagittal growth potential of the maxilla was inhibited. There were no significant changes in the vertical skeletal parameters. The mandibular incisors were protruded and intruded, whereas the maxillary incisors were retruded and extruded. The upper molars tipped distally as the lower molars tipped mesially. Because of these changes, the occlusal plane rotated in the clockwise direction. Overbite and overjet were reduced, and the soft-tissue profile improved significantly. The results revealed that, in late-adolescent patients, the Jasper Jumper corrected Class II discrepancies mostly through dentoalveolar changes. It is suggested that this treatment method could be an alternative to orthognathic surgery in borderline Class II cases.Abstract
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The aim of this retrospective study was to evaluate and compare the anchorage provided with the Nance appliance (NA) and the fixed frontal bite plane (FBP) during intra-arch distal molar movement. After a sample size calculation, 20 patients were recruited and randomly selected for each group from patients who fulfilled the following criteria: use of an intra-arch Ni-Ti coil appliance with either NA or FBP to provide anchorage during a six-month molar distalization period, no orthodontic treatment before molar distalization, and first and second maxillary molars in occlusion. The outcome measures assessed were anchorage loss, ie, anterior movement of maxillary central incisors, distal movement of maxillary molars, and bite opening effect. The mean age in the NA group was 14.7 years (SD 1.09) and in the FBP group 15.0 years (SD 0.99). The data revealed that the maxillary central incisors moved anteriorly 1.4 mm in the NA group and 1.9 mm in the FBP group. The difference in anchorage loss was not significant. The mean amount of molar distalization within the maxilla was 1.7 mm in the NA group and 1.8 mm in the FBP group. In both groups, the overbite was significantly reduced and the overbite was decreased significantly more in the FBP group. Because neither the NA nor FBP provided stable anchorage, a second treatment phase is recommended to reverse the anchorage loss after distal molar movement. If molar distalization is planned in deep bite cases, the FBP is the anchorage system of choice.Abstract
Case Reports
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This article describes the orthodontic treatment of a 19-year-old female patient with anterior crowding. There was a moderate arch length discrepancy in the lower dental arch, a significant deep overbite, and a “gummy smile.” We inserted an orthodontic mini-implant as anchorage for the intrusion of the upper incisor segment, followed by alignment of the upper and lower dental arches with an edgewise appliance without tooth extraction. The overbite was corrected from +7.2 mm to +1.7 mm by upper incisor intrusion, and the gummy smile was improved. Good occlusion and facial esthetics were achieved, and these results have been maintained for two years after completion of the active treatment.Abstract
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A hexagonal onplant of 7.7 mm diameter was placed on the palatal bone of the maxilla in an 11-year five-month-old female patient with a Class III malocclusion and midface deficiency. Elastic traction (400 g per side) was applied from a facemask to the onplant at 30° to the occlusal plane 12 hours per day for 12 months. The maxilla was found to have displaced forward and downward by 2.9 mm. The mandible was rotated downward and backward. There was a 3° increase in mandibular plane angle and an increase in the lower face height. Clinically, there was a significant improvement in midface esthetics, noted by an increase in fullness of the infraorbital region and correction of the skeletal discrepancy between the maxillary and mandibular jaw relationship. Contrary to the reports that use teeth rather than onplants as anchorage, there was no forward movement of the maxillary molars and minimal extrusion of the maxillary molars. These results suggest that onplants can be used as an extremely stable anchorage for maxillary orthopedic facemask treatment.Abstract
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Morquio syndrome or MPS4A is an autosomal recessive inherited metabolic disease, due to a deficiency of N-acetil-galactosamine-6-sulfatase (OMIM 253000). Hypoplastic odontoid processes causing atlantoaxial subluxation and cervical myelopathy are usual clinical findings. Surgical intervention of craniocervical fusion is often performed to prevent this complication. Clinical and cephalometric findings in a patient affected by Morquio syndrome after craniovertebral surgery are described. Facial growth pattern in the lateral plane changed dramatically. The mandibular gonial angle (ArGoMe), the body of the mandible (GoGn), and the total length of the mandible (CoGn) increased abnormally, whereas the mandibular ramus (CoGo) exhibited normal growth. Knowledge of the possibility of abnormal mandibular growth may contribute in long-term orthodontic management of such subjects.Abstract
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Control of the height of posterior dentoalveolar regions is of great importance for the correction of skeletal open bite. Traditionally, second premolar extraction facilitates the closure of open bite by inducing a counterclockwise mandibular rotation without molar intrusion. This article reports treatment for a 24-year six-month-old female patient with an open bite and large anterior facial height. She complained of occlusal disturbances and difficulty of lip closure because of the open bite. Overjet and overbite were +3.0 mm and −3.0 mm, respectively. To correct open bite and crowding, the bilateral extraction of the maxillary and mandibular second premolars plus multibracket appliances for mesial movement of the molars was selected as the treatment plan. After a two-year treatment, an acceptable occlusion was achieved, the lower anterior facial height was decreased, and the lips showed less tension in a lip closure. An acceptable occlusion was maintained without recurrence of the open bite during a three-year retention period, indicating a long-term stability of the occlusion. The results of this treatment indicated that the correction of open bite with no or less molar intrusion or incisor extrusion is of great importance for achieving stable occlusion and avoiding the relapse of open bite.Abstract
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This article reports the successful treatment of a unilateral maxillary canine and first premolar transposition without the extraction of the premolar in an adult patient. A female patient, 21 years and three months of age, had moderate crowding in the upper arch with complete transposition of the canine and first premolar. After distal movement of the upper molars with a lingual arch and headgear appliance, the upper left first premolar and canine were transposed. Thirty-eight months after the placement of preadjusted appliances, the transposed canine and premolar were reordered in the proper positions. The total active treatment period was 49 months. After two years of retention, the occlusion is generally stable.Abstract
Winged Maxillary Central Incisors with Unusual Morphology: A Unique Presentation and Early Treatment
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Winged incisors are a well-recognized clinical finding. In this report, the disorder is briefly reviewed and a unique case of winging of the two maxillary central incisors having unusual morphology in an eight-year six-month-old boy is presented. The two winged maxillary central incisors were derotated using an anterior sectional wire inserted into a pair of twin brackets, one bonded to each of the two central incisors, and reciprocal anchorage.Abstract
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An adult female patient who presented with a severe Class II division 1 malocclusion was treated by en masse retraction of upper anterior teeth against zygomatic anchorage. This case report describes the surgical and orthodontic procedures followed during the treatment. En masse retraction of the six anterior teeth by using zygomatic bone anchorage proved to be an efficient method for the correction of a severe overjet problem.Abstract
Editorial
The cry for evidence-based treatment continues to grow. Since the literature is one major source of evidence for practitioners, professional journals must provide good evidence. But what is good evidence? You can perform all of your patients' treatment based on case reports you read or heard or on claims by another orthodontist who appears to be very successful. This is evidence-based, but it clearly is one of the lowest forms of evidence. Obviously there are gradations of evidence that run the gauntlet from nearly perfect science to opinion-based clichés. Let's see how the Angle Orthodontist is doing in
DDS, MSD
TMD or temporomandibular disorders are an interrelated, but heterogeneous set of conditions characterized by pain in the TMJ or masticatory muscles, limited vertical range of mandibular motion, and noise in the TMJ during mandibular function. Although various types of treatment are possible for these symptoms, most clinicians attempt conservative approaches before resorting to irreversible techniques. However, conservative approaches require patient cooperation in order to be effective. Some treatments elicit better cooperation than other self-treatments. A study published in the Journal of Orofacial Pain (2004;18:203– 213) evaluated patient compliance with five conservativePatient compliance with TMD treatment varies widely
DDS, Odont. Dr. and
DDS, Dr. med. dent.
We would like to thank the Editor for the opportunity to respond to Dr Masoud's letter commenting on our article, “Amount and Direction of Temporomandibular Joint Growth Changes in Herbst Treatment” published in The Angle Orthodontist 2003;73:493–501. We completely agree with Dr Masoud that we don't know if the fossa would have ended up in a position even further inferior and posterior at T4 (3 years after treatment) if it weren't for the Herbst appliance. To know this we would have needed a T4 control group, which we, regretfully, did not have. Our control group did only cover
There have been several publications examining the long-term effects of functional appliances and specifically the Herbst.1–3 Ruf and Pancherz demonstrated through magnetic resonance imaging the adaptive TMJ changes that could account for increased mandibular prognathism during Herbst treatment.4 They included increased condylar growth, anterior displacement of the glenoid fossa, and anterior positioning of the condyle within the fossa. In the September 2003 issue of The Angle Orthodontist Pancherz et al published an article titled “Amount and Direction of Temporomandibular Joint Growth Changes in Herbst Treatment: A Cephalometric Long-Term Investigation.”5 It concluded: “During
Levels of Interleukin-8 During Tooth Movement Burcu Baloş Tuncer DDS, PhD, Nurdan Özmeriç DDS, PhD, Cumhur Tuncer DDS, PhD, İdil Teoman DDS, PhD, Burcu Çakılcı DDS, Ayşegül Yücel MD, PhD, Reha Alpar DDS, PhD, and Köksal Baloş DDS, PhD. Angle Orthod. 2005;75(4): 539–544. Please add: ACKNOWLEDGMENT This research was funded by Gazi University Research Grant (03/2002-12).
Predictability of mesiodistal movement of upper and lower molars with clear aligners: a systematic review
Carmen García-Marín,
Andrea Otero-Pregigueiro, and
Alejandro Iglesias-Linares
Lip incompetence resolved by active vertical control in nonsurgical treatment of a protrusion case with vertical maxillary excess
Johnny JL Liaw,
Jae Hyun Park,
Fang Fang Tsai,
Betty MY Tsai, and
Wendy WT Liao
Changes in glenoid fossa of adult female patients with Class II division 1 malocclusion during premolar extraction treatment and mini-implant anchorage: a cone-beam computed tomography study
Xiao-Chuan Fan,
Lin-Sha Ma,
Marco Aoqi Rausch,
Li Chen,
Qing Zhang,
Diwakar Singh,
Xiaohui Rausch-Fan, and
Xiao-Feng Huang
Differences in the cooperation of teenagers for orthodontic treatment: Z Generation versus Y Generation
Nitsan Miron,
Nir Shpack,
Michael V. Joachim, and
Amir Laviv
Miniscrew-assisted slow palatal expansion with bone borne expander in adult patients: a case control study on consecutively treated patients
Niki Arveda,
Marco Migliorati,
Anna De Mari,
Filippo Forin Valvecchi,
Irene Schiavetti,
Fabio Annarumma,
Giovanni Battista, and
Hussein Aghazada
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