Low-energy shock waves disrupt oral bacteria. Low-energy (extracorporeal) shock waves are characterized by alternating positive and negative pressures. These pressure waves travel through fluid and soft tissues, and their physical effects occur at interface surfaces. Extracorporeal shock-wave therapy (ESWT) has numerous applications in medicine and has been used to break up calcium deposits in the kidney (lithotripsy), as well as to disintegrate calcium deposits in the pancreas and gallbladder. To date, no studies have been performed to determine whether low-energy shock waves could have an effect on bacteria. However, this was the topic of a research project published in
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Original Articles
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DOI: 10.2319/011108-15.1
Objective: This study tested the hypothesis that the quality of treatment outcomes and overall patient satisfaction are of equal importance in influencing a general dentist to refer a patient to an orthodontist for treatment. The investigation also attempted to determine what specific aspects of an orthodontically treated occlusion comprise an outstanding result in the opinion of the general dentist.
Materials and Methods: Self-administered surveys containing 35 questions were distributed to a random sample of 1000 general dentists in the midwestern United States.
Results: Three-quarters responded that the quality of previous orthodontic treatment and patient/ parental satisfaction were of equal importance in the orthodontic referral decision. If additional factors were considered, the quality of the treated result as judged by the general dentist was far more important than the location of the orthodontist's office, the reputation of the orthodontist, or the anticipated cost of treatment. With regard to desired postorthodontic occlusal and functional characteristics, the majority of the dentists ranked canine guidance as most important. Other characteristics were Class I molar and canine relationships, even contact of all teeth in centric occlusion, amount of overjet and overbite, absence of spacing, and absence of balancing interferences.
Conclusions: The decision of the general dentist to refer a patient to one orthodontist over another is based on a number of interactive factors. It behooves the orthodontic clinician to provide high-quality treatment, to interact well with his or her patients and their families, and to maintain good communications with general practitioners in the community.Abstract
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DOI: 10.2319/071307-328.1
Objective: To examine, in adolescents with mild to moderate malocclusion, the relationship between self-concept and demographic characteristics, a clinical assessment of malocclusion, self-perception of malocclusion, and self-perception of facial attractiveness.
Methods and Materials: Fifty-nine consecutive patients ages 9 to 15 years scheduled for initial records in a graduate orthodontic clinic consented to participate. Each subject independently completed the Multidimensional Self-Concept Scale (MSCS), the Facial Image Scale, and the Index of Treatment Need–Aesthetic Component (IOTN-AC). Peer Assessment Rating (PAR) scores were obtained from the patients' diagnostic dental casts. Forward multiple-regression analysis with a backward overlook was used to analyze the effect of the demographic, clinical, and self-perception measures on each of the six self-concept (MSCS) domains.
Results: Self-perception of the dentofacial region was the only statistically significant predictor (P < .05) for the Global, Competence, Affect, Academic, and Physical domains of self-concept, while age, parental marital status, and the adolescent's self-perception of the dentofacial region were statistically significant predictors (P < .05) of Social Self-Concept.
Conclusion: The self-perceived level of the attractiveness or “positive” feelings toward the dentofacial region is more strongly related to self-concept than the severity of the malocclusion as indicated by the PAR score or by the adolescent's perception of their malocclusion.Abstract
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DOI: 10.2319/122707-605.1
Objective: To compare the facial characteristics of two different groups of attractive women with those of reference women.
Materials and Methods: The three-dimensional coordinates of 50 facial landmarks were collected in 71 healthy reference women (18–30 years old) and in 24 coetaneous “attractive” women selected during two different beauty competitions; soft tissue facial angles, distances, areas, and volumes were computed and compared using analysis of variance.
Results: When compared with reference women, both groups of attractive women shared several similar facial characteristics: relatively large forehead (P < .001), reduced mandible (P = .008), and rounded face (reduced surface-to-volume ratio, P = .002). They had a more acute soft tissue profile, an increased upper facial width (P < .001) and middle facial depth, larger mouth, and more voluminous lips (P = .005) than reference women.
Conclusions: Both groups of attractive women had several facial characteristics suggesting babyness. Nonetheless, each group of women was characterized by a different development of these features. Esthetic reference values can be a useful tool for clinicians, but should always consider the characteristics of individual faces.Abstract
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DOI: 10.2319/012008-35.1
Objective: To determine by low-dose computed tomography (CT) protocol the dental and periodontal effects of rapid maxillary expansion (RME).
Materials and Methods: The sample comprised 17 subjects (7 males and 10 females), with a mean age at first observation of 11.2 years. Each patient underwent expansion of 7 mm. Multislice CT scans were taken before rapid palatal expansion (T0), at the end of the active expansion phase (T1), and after a retention period of 6 months (T2). On scanned images, measurements were performed at the dental and periodontal levels. Mean differences between measurements at T0, T1, and T2 were examined through analysis of variance (ANOVA) for repeated measures with post-hoc tests.
Results: All interdental transverse measurements were significantly increased at both T1 and T2 with respect to T0. In the evaluation of T0-T1 changes, periodontal measurements were significant on the buccal aspect of banded teeth with a reduction in alveolar bone thickness corresponding to the mesial (−0.5 mm; P < .05) and distal (−0.4 mm; P < .05) roots of the right first molar and to the mesial root of the left first molar (−0.3 mm; P < .05). In the evaluation of overall T0-T2 changes, the lingual bone plate thickness of both first molars was found to be significantly increased (+0.6 mm; P < .05).
Conclusions: RME therapy induces a significant increase in the transverse dimension of the maxillary arch in growing subjects without causing permanent injury to the periodontal bony support of anchoring teeth discernible on CT imaging.Abstract
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DOI: 10.2319/100307-475.1
Objectives: To investigate the effects of different storage periods of alginate impressions on digital model accuracy.
Materials and Methods: A total of 105 impressions were taken from a master model with three different brands of alginates and were poured into stone models in five different storage periods. In all, 21 stone models were poured and immediately were scanned, and 21 digital models were prepared. The remaining 84 impressions were poured after 1, 2, 3, and 4 days, respectively. Five linear measurements were made by three researchers on the master model, the stone models, and the digital models. Time-dependent deformation of alginate impressions at different storage periods and the accuracy of traditional stone models and digital models were evaluated separately.
Results: Both the stone models and the digital models were highly correlated with the master model. Significant deformities in the alginate impressions were noted at different storage periods of 1 to 4 days. Alginate impressions of different brands also showed significant differences between each other on the first, third, and fourth days.
Conclusions: Digital orthodontic models are as reliable as traditional stone models and probably will become the standard for orthodontic clinical use. Storing alginate impressions in sealed plastic bags for up to 4 days caused statistically significant deformation of alginate impressions, but the magnitude of these deformations did not appear to be clinically relevant and had no adverse effect on digital modeling.Abstract
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DOI: 10.2319/083107-405.1
Objective: To elucidate relationships between the dental roots and surrounding tissues in order to prevent complications after placement of a miniscrew.
Materials and Methods: Twenty human mandibles and maxillas were used for this study. In the 200 sections of each mandible and maxilla, nine items were measured to investigate the relationships between the dental roots.
Results: The interroot distance increased from anterior to posterior teeth and from the cervical line to the root apex in both the maxilla and the mandible. In the maxilla, the greatest interroot distance was between the second premolar and the first molar. In the mandible, the greatest interroot distance was between the first and second molars. The maxillary buccolingual bone width exceeded 10 mm from 7 mm (between canine and first premolar), 5 mm (between second premolar and first molar), and 4 mm (between first and second molars) above the cervical line. The mandibular buccolingual bone width exceeded 10 mm from 7 mm (between second premolar and first molar) and 4 mm (between first and second molars) below the cervical line.
Conclusions: The safest zone for placement of a miniscrew in the maxilla was between the second premolar and the first molar, from 6 to 8 mm from the cervical line. The safest zone for placement of a miniscrew in the mandible was between the first and second molars, less than 5 mm from the cervical line.Abstract
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DOI: 10.2319/121007-579.1
Objectives: To test the hypotheses that (1) there is no difference in the pain experience during the week following initial placement of two orthodontic appliances (SmartClip™ and Victory™; 3M Unitek, Monrovia, Calif); and (2) there is no difference in the pain experience during removal and insertion of orthodontic archwires with these brackets.
Materials and Methods: Sixty-six consecutive patients were treated with a self-ligating bracket system (SmartClip™) or a conventional appliance (Victory™) on the basis of computer-generated random allocation. After appliance placement and engagement of a 0.016″ nickel-titanium archwire, pain experience was recorded after 4, 24, and 72 hours and after 7 days with the use of a visual analog system (VAS) questionnaire. At a subsequent visit, participants documented pain experiences during removal and insertion of 0.019 × 0.025″ archwires on an additional 100 mm VAS questionnaire. Independent t-tests and analyses of covariance were used to analyze normally distributed data; the Mann-Whitney U-test was used for skewed distributions.
Results: Forty-eight (72.2%) and fifty-one (77.3%) subjects completed the first and second parts of the study, respectively. Bracket type had no influence on pain experience at 4 hours (P = .958), 24 hours (P = .289), 72 hours (P = .569), and 7 days (P = .756) following appliance placement. However, bracket type significantly influenced pain experience during archwire removal (P = .001) and insertion (P = .013).
Conclusions: Hypothesis 1 cannot be rejected. The bracket type had no effect on subjective pain experience during the first week after initial placement of two preadjusted orthodontic appliances. Hypothesis 2 was rejected. Significantly greater discomfort was experienced during archwire insertion and removal with the SmartClip™ appliance.Abstract
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DOI: 10.2319/091907-450.1
Objectives: To test the hypothesis that experimentally created physiologically nonbalanced occlusion will not affect the thickness of the temporomandibular joint (TMJ) discs in rats.
Material and Methods: Twenty-four 8-week-old Sprague-Dawley rats were equally divided into a control group that was left untreated and an experimental group where a nonbalanced occlusion was created. Elastic rubber bands, 1 mm in diameter, were inserted and 1 week later were replaced by plastic material between the first and the second molars of the left maxillary and the right mandibular dentitions to move the first molars about 0.8 mm mesially. This created and maintained a physiologically nonbalanced occlusion. The animals were euthanized 8 weeks later, and the TMJ disc thickness was measured on histologically prepared slices using an electronic meter. Two-way univariate analysis of variance was used to compare the groups (α level = .05).
Results: The intermediate zone was thicker in the experimental group than in the control group (P = .003), but no differences were found between groups regarding the anterior and posterior bands. There were no significant sex-related effects on this observation.
Conclusion: The hypothesis is rejected. The results indicate that the intermediate zone of rat TMJ disc has the ability to adapt to the alteration of the space between condyle and fossa caused by occlusion changes. Further studies on larger groups that are followed for longer times are needed.Abstract
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DOI: 10.2319/092007-452.1
Objective: To investigate the dental arch width of the Southern Chinese across buccal cusps, central fossae, or lingual cusps and compare these values with study findings in different populations and using different definitions.
Materials and Methods: The dental arch dimensions of study casts of an unselected sample from a 12-year-old Hong Kong Oral Health Survey of 12-year-old children (n = 358; 210 boys and 148 girls) were measured.
Results: When compared with Caucasians, the Southern Chinese were characterized by a wider dental arch width. However, variations were great. All maxillary and mandibular male arch widths were significantly larger than female arch widths, except at the incisor regions.
Conclusion: This study yielded a database about dental arch widths by which different studies on these widths can be compared.Abstract
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DOI: 10.2319/100107-468.1
Objective: To test the null hypotheses: (1) there is no difference in the caries protective effect of ozone and Cervitec/Fluor Protector during multibracket (MB) appliance therapy, and (2) DIAGNOdent and quantitative light-induced fluorescence (QLF) are not superior to a visual evaluation of initial caries lesions.
Materials and Methods: Twenty right-handed patients with a very poor oral hygiene who required full MB appliance therapy were analyzed during 26 months. In a split-mouth-design, the four quadrants of each patient were either treated with ozone, a combination of Cervitec and Fluor Protector, or served as untreated controls. The visible plaque index (VPI) and white spot formation were analyzed clinically. DIAGNOdent and QLF were used for a quantitative assessment of white spot formation.
Results: The average VPI in all four dental arch quadrants amounted to 55.6% and was independent of the preventive measure undertaken. In the quadrants treated with Cervitec/Fluor Protector, only 0.7% of the areas developed new, clinically visible white spots. This was significantly (P < .05) less than in the quadrants treated with ozone (3.2%). The lesions detected with QLF only partially corresponded to the clinically detected white spots, while DIAGNOdent proved to be unable to detect any changes at all.
Conclusions: The caries protective effect of Cervitec/Fluor Protector during MB therapy was superior to ozone, and a visual evaluation of initial caries lesions was superior to both DIAGNOdent and QLF.Abstract
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DOI: 10.2319/091407-437.1
Objective: To propose a safe and reproducible injection point for botulinum toxin-A (BTX-A) as a supplementary method for the treatment of gummy smile, as determined by assessment of the morphologic characteristics of three lip elevator muscles.
Materials and Methods: A total of 50 hemi-faces from 25 adult cadavers (male 13, female 12; ages, 47 to 88 years) were used in this study. Topographic relations and the directions of the lip elevator muscles (ie, levator labii superioris [LLS], levator labii superioris alaeque nasi [LLSAN], and zygomaticus minor [ZMi]), were investigated. Possible injection points were examined through the study of predetermined surface landmarks.
Results: The insertion of the LLS was covered partially or entirely by the LLSAN and the ZMi, and the three muscles converged on the area lateral to the ala. The mean angle between the facial midline and each muscle vector was 25.8 ± 4.8 degrees for the LLS, 55.7 ± 6.4 degrees for the ZMi, and −20.2 ± 3.2 degrees for the LLSAN; no significant differences were noted between male and female subjects or between left and right sides. The three vectors passed near a triangular region formed by three surface landmarks. The center of this triangle, named the “Yonsei point”, was suggested as an appropriate injection point for BTX-A. The clinical effectiveness of the injection point was demonstrated in selected cases with or without orthodontic treatment.
Conclusions: Under careful case selection, BTX-A may be an effective treatment alternative for patients with excessive gingival display caused by hyperactive lip elevator muscles.Abstract
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DOI: 10.2319/020408-68.1
Objective: To quantify the treatment effects of interradicular miniscrew anchorage and to confirm the validity of the clinical usage of interradicular miniscrews in the distal movement of maxillary molars in nonextraction treatment.
Materials and Methods: Twenty-four maxillary molars were moved to the distal using miniscrews placed in the interradicular space between the second premolar and the first molar at an oblique angle of 20 to 30 degrees to the long axis of the proximal tooth. The teeth were evaluated as to how the molars were moved to the distal with the use of lateral cephalograms and dental casts.
Results: Maxillary molars were moved to the distal by 2.8 mm with distal tipping of 4.8 degrees and intruded by 0.6 mm. Maxillary incisors were moved to the distal by 2.7 mm with palatal tipping of 4.3 degrees. Molar extrusion and/or consequent mandibular rotation was not observed in any patient.
Conclusion: Miniscrews placed in the maxillary interradicular space provide successful molar distal movement of 2.8 mm without patient compliance and with no undesirable side effects such as incisor proclination, clockwise mandibular rotation, or root resorption.Abstract
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DOI: 10.2319/010708-8.1
Objective: To analyze the clinical outcome of a prospective two-center study of second-generation palatal implants 6 months after functional loading.
Material and Methods: From 2005 to 2006, 30 patients aged 12 to 41 years were included in the study. In all patients, orthodontic treatment required stationary anchorage. The palatal implants (Straumann, Basel, Switzerland) were placed in the median region of the anterior palate.
Results: All implants were initially stable at the time of placement. However, two (6.7%) were lost during the unloaded healing period. The remaining 28 (93.3%) were subjected to functional loading after a mean healing period of 12 weeks. Typical signs of slight superficial inflammation were observed in the peri-implant mucosa (n = 28). During the orthodontic loading phase, the implants were equipped with either a modified pendulum appliance for distalization or a transpalatal arch for stationary anchorage to the posterior teeth. No implant loosening or loss was registered during the active treatment period.
Conclusions: The failure rate of palatal implants of the second generation was low (6.7%). Slight inflammatory reactions of peri-implant tissue caused neither implant loss nor pain.Abstract
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DOI: 10.2319/112107-546.1
Objective: To establish a protocol for assessing orthodontically induced tooth root resorption (OITRR) in human premolars using micro-computed tomography.
Materials and Methods: Ten extracted maxillary first premolars were obtained from eight healthy adolescent patients; five of these premolars were extracted before any orthodontic movement was applied to them, and the other five premolars were involved in nonextraction orthodontic treatment for 1 year before treatment plan modification lead to extraction treatment. Using reconstructed scanned images, we measured several key resorption lacunae parameters, including the number, volume, and depth on each surface, as well as its extension coronoapically.
Results: Orthodontic treatment resulted in a significantly greater tooth root resorption lacunae volume, number, maximum depth, and coronoapical extension as well as in areas of dentin demineralization subjacent to the resorption lacunae than in normal premolars.
Conclusions: We have established a protocol to evaluate OITRR quantitatively and have provided a method to predict further resorption based on dentine demineralization.Abstract
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DOI: 10.2319/022408-110.1
Objective: To investigate the surface morphology, structure, elemental composition, and key mechanical properties of various sizes and tempers of Australian wires.
Materials and Methods: Three types of Australian wire were used: 0.016″ regular, 0.018″ regular+, and 0.018″ special+ (A.J. Wilcock, Whittlesea, Victoria, Australia). Each type of wire was subjected to scanning electron microscopy (SEM) analysis, x-ray energy dispersive spectroscopy (EDS) investigation, Vickers hardness testing, and tensile testing. The modulus of elasticity and ultimate tensile strength were determined. Hardness, modulus, and strength data were analyzed with one-way analysis of variance (ANOVA) and Tukey testing at the .05 level of significance.
Results: All three types of Australian wire were found to possess considerably rough surfaces with striations, irregularities, and excessive porosity. All three wire types had high levels of carbon and a similar hardness, which ranged within 600 VHN (Vickers hardness number), and a similar modulus of elasticity (173 to 177 GPa). The 0.018″ special+ had a significantly lower tensile strength (1632 MPa) than the 0.016″ regular and the 0.018″ regular+ wire (2100 MPa).
Conclusions: Australian wires did not show variation implied by the size or temper of the wires.Abstract
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DOI: 10.2319/083007-401.1
Objective: To examine the effects of three different parameters—pH value, type of archwire, and length of immersion—on release of metal ions from orthodontic appliances.
Materials and Methods: Simulated fixed orthodontic appliances that corresponded to one-half of the maxillary arch were immersed in artificial saliva of different pH values (6.75 ± 0.15 and 3.5 ± 0.15) during a 28-day period. Three types of archwires were used: stainless steel (SS), nickel-titanium (NiTi), and thermo NiTi. The quantity of metal ions was determined with the use of a high-resolution mass spectrophotometer (HR-ICP/MS).
Results: The release of six different metal ions was observed: titanium (Ti), chromium (Cr), nickel (Ni), iron (Fe), copper (Cu), and zinc (Zn). Repeated measures statistical analysis of variance (ANOVA) was used. Results showed that (1) the appliances released measurable quantities of all ions examined; (2) the change in pH had a very strong effect (up to 100-fold) on the release of ions; and (3) the release of ions was dependent on wire composition, but it was not proportional to the content of metal in the wire. The largest number of ions was released during the first week of appliance immersion.
Conclusion: Levels of released ions are sufficient to cause delayed allergic reactions. This must be taken into account when type of archwire is selected, especially in patients with hypersensitivity or compromised oral hygiene.Abstract
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DOI: 10.2319/101107-487.1
Objective: To test the null hypothesis that no statistically significant difference in frictional resistance is noted when round or rectangular archwires are used in conjunction with low-friction ligatures (small, medium, or large) or conventional ligatures.
Materials and Methods: A total of 10 stainless steel brackets, a 0.022-in slot, and various orthodontic archwires, ligated with low-friction ligatures or conventional ligatures, were tested to compare frictional resistance. The archwires employed were 0.014-in and 0.016-in nickel titanium (NiTi), 0.018-in stainless steel (SS), 0.016 × 0.022-in NiTi, 0.016 × 0.022-in SS, 0.017 × 0.025-in titanium molybdenum alloy (TMA), 0.017 × 0.025-in NiTi, 0.017 × 0.025-in SS, 0.019 × 0.025-in SS, and 0.019 × 0.025-in NiTi. Each bracket/archwire combination was tested 10 times in the dry state at an ambient temperature of 34°C.
Results: Low-friction ligatures with round archwires showed statistically significantly lower frictional resistance than did conventional ligatures. When coupled with 0.016 × 0.022-in NiTi and SS, no statistically significant difference was observed among the four groups. When coupled with 0.017 × 0.025-in archwires, low-friction ligatures showed statistically significantly greater frictional resistance than was seen with conventional ligatures. When coupled with 0.019 × 0.025-in NiTi, low-friction ligatures showed statistically significantly greater frictional resistance than did conventional ligatures, but no difference among the four groups was observed with the 0.019 × 0.025-in SS. No significant difference was assessed among low-friction ligatures of different sizes.
Conclusion: Low-friction ligatures show lower friction when compared with conventional ligatures when coupled with round archwires, but not when coupled with rectangular ones.Abstract
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DOI: 10.2319/112807-560.1
Objective: To evaluate the shear bond strength and fracture mode difference between amorphous calcium phosphate (ACP)–containing adhesive and conventional resin-based composite material used as an orthodontic lingual retainer adhesive.
Materials and Methods: Forty crowns of extracted lower human incisors were mounted in acrylic resin, leaving the buccal surface of the crowns parallel to the base of the molds. The teeth were randomly divided into two groups: experimental and control, containing 20 teeth each. Conventional lingual retainer composite (Transbond-LR, 3M-Unitek) and ACP-containing orthodontic adhesive (Aegis-Ortho) were applied to the teeth surface by packing the material into the cylindrical plastic matrices with a 2.34-mm internal diameter and a 3-mm height (Ultradent) to simulate the lingual retainer bonding. For shear bond testing, the specimens were mounted in a universal testing machine, and an apparatus (Ultradent) attached to a compression load cell was applied to each specimen until failure occurred. The shear bond data were analyzed using Student's t-test. Fracture modes were analyzed by χ2 test.
Results: The statistical test showed that the bond strengths of group 1 (control Transbond-LR, mean: 24.77 ± 9.25 MPa) and group 2 (ACP-containing adhesive, mean: 8.49 ± 2.53 MPa) were significantly different from each other. In general, a greater percentage of the fractures were adhesive at the tooth-composite interface (60% in group 1 and 55% in group 2), and no statistically significant difference was found between groups.
Conclusion: The ACP-containing Aegis-Ortho adhesive resulted in a significant decrease in bond strength to the etched enamel surface.Abstract
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DOI: 10.2319/072507-345.1
Objective: To test the hypothesis that there is no difference between the action of at-home and in-office vital bleaching on the shear bond strength of metallic brackets bonded with composite resin 24 hours after bleaching.
Materials and Methods: Forty-five human upper premolars were randomly divided into three groups: (1) control, (2) 10% carbamide peroxide at-home bleached, and (3) 35% hydrogen peroxide in-office bleached. Twenty-four hours after bleaching the teeth were pumiced, bonded with metallic brackets, and stored in distilled water. One day after bonding the shear bond strength of the brackets was determined.
Results: The mean shear bond strength of Group 1 (control) and Group 2 (carbamide peroxide bleached) were not statistically different. Group 3 (hydrogen peroxide bleached) had a significantly lower mean shear bond strength than Group 1 and Group 2.
Conclusions: The hypothesis is rejected. Use of 10% carbamide peroxide bleaching does not significantly alter shear bond strength values. On the other hand, use of 35% hydrogen peroxide bleaching significantly reduces these values and diminishes the amount of resin remnant on the tooth surface after bracket debonding.Abstract
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DOI: 10.2319/012208-37.1
Objective: To evaluate the effects of water and saliva contamination on shear bond strength of brackets bonded with a moisture-tolerant light cure system.
Materials and Methods: Brackets were bonded to 240 bovine lower incisors divided into 12 groups. Four bonding procedures were evaluated, including (1) TSEP/Transbond XT, (2) TMIP/ Transbond XT, (3) TSEP/Transbond PLUS, and (4) TMIP/Transbond PLUS, each under three different bonding conditions: without contamination, with water contamination, and with saliva contamination. Shear bond strength was measured with a universal testing machine. The adhesive remnant on the teeth was quantified with the use of image analyzing equipment.
Results: Without contamination, bond strengths for the four procedures were similar (P > .05). TSEP/Tranbond PLUS and TMIP/Transbond PLUS left significantly less adhesive on the teeth after debonding than TSEP/Transbond XT and TMIP/Transbond XT (P < .008). Bond strength and adhesive remaining for TMIP/Transbond XT contaminated with water or saliva showed significantly worse performance than the other procedures evaluated (P < .008). Contamination (with water or saliva) did not affect either bond strength or adhesive remaining on the teeth for TSEP/ Transbond XT, TSEP/Transbond PLUS, or TMIP/Transbond PLUS (P > .017), although for TMIP/ Transbond XT, both variables showed significant reductions after contamination (P < .017).
Conclusion: TSEP/Transbond PLUS, TMIP/Transbond PLUS, and TSEP/Transbond XT showed greater tolerance to wet conditions than was shown by TMIP/Transbond XT.Abstract
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DOI: 10.2319/100207-472.1
Objective: To evaluate bonding efficacy of activated Transbond Plus Self-Etching Primer (TPSEP) used at different time points with Transbond XT to bond metallic orthodontic brackets to bovine incisors.
Materials and Methods: The inferior incisors of 210 bovines were randomly divided into seven groups (n = 30). TPSEPs were mixed, activated, and kept activated for 30 (group 30), 21 (group 21), 15 (group 15), 7 (group 7), 3 (group 3), or 1 (group 1) days before bonding, and in one group (group 0) TPSEP was used immediately after mixed. At day zero, incisors in each group were bonded in exactly the same way. After applying TPSEP, brackets were bonded with Transbond XT, according to the manufacturer's instructions. After 24 hours, shear bond strength (SBS) tests were performed for all samples at a crosshead speed of 0.5 mm/min, and the Adhesive Remnant Index was scored.
Results: There were no significant differences between the SBS of groups 0, 1, 3, 7, and 15 (P > .05) However, those groups had higher SBS (P < .05) compared with groups 21 and 30. No significant difference (P > .05) was observed between groups 21 and 30. Despite the decrease in SBS for groups 21 and 30, bond strength values were still satisfactory.
Conclusion: After activation, the TPSEP mix can be stored for a period of 15 days without losing its adhesive properties.Abstract
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DOI: 10.2319/102607-508.1
Objective: To test the null hypothesis that there is no significant difference between the microleakage of adhesive interferences at the occlusal and gingival margins of both ceramic and metallic brackets bonded with light-cured resin-modified glass ionomer and a conventional adhesive.
Materials and Methods: Sixty freshly extracted human maxillary premolar teeth were randomly divided into four groups of 15 teeth each. Metal and ceramic brackets were bonded to groups 1 and 2 with resin-modified glass ionomer adhesive (RMGIA). Metal and ceramic brackets were bonded to group 3 and group 4 with a conventional adhesive (CA) system. A dye-penetration method was used for microleakage evaluation. Microleakage from the occlusal and gingival margins was determined by a stereomicroscope for the enamel-adhesive and bracket-adhesive interfaces. Statistical analysis was performed using the Kruskal-Wallis test and the Mann-Whitney U-test with a Bonferroni correction.
Results: The gingival side of all groups exhibited higher microleakage scores compared with the occlusal side for both adhesive interfaces. All bracket and adhesive combinations displayed statistically significant differences in microleakage between the enamel-adhesive and adhesive-bracket interfaces at the occlusal and gingival sides of the brackets (P < .001). When the adhesive systems were compared, the RMGIA showed more microleakage than the CA between the different interfaces.
Conclusions: The hypothesis is rejected. RMGIA results in more microleakage between enamel-adhesive interfaces.Abstract
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DOI: 10.2319/111607-534.1
Objective: To compare the microleakage of the enamel-adhesive-bracket complex at the occlusal and gingival margins of brackets bonded with high-intensity light curing lights and conventional halogen lights.
Materials and Methods: Forty-five freshly extracted human maxillary premolar teeth were randomly separated into three groups of 15 teeth each. Stainless steel brackets were bonded in all groups according to the manufacturer's recommendations. Specimens (15 per group) were cured for 40 seconds with a conventional halogen light, 20 seconds with light-emitting diode (LED), and 6 seconds with plasma arc curing light (PAC). After curing, the specimens were further sealed with nail varnish, stained with 0.5% basic-fuchsine for 24 hours, sectioned and examined under a stereomicroscope, and scored for microleakage for the enamel-adhesive and bracket-adhesive interfaces from both the occlusal and gingival margins. Statistical analyses were performed using Kruskal-Wallis and Mann-Whitney U-tests with a Bonferroni correction.
Results: The type of light curing unit did not significantly affect the amount of microleakage at the gingival or occlusal margins of investigated interfaces (P >.05). The gingival sides in the LED and PAC groups exhibited higher microleakage scores compared with those observed on occlusal sides for the enamel-adhesive and adhesive-bracket interfaces. The halogen light source showed similar microleakage at the gingival and occlusal sides between both adhesive interfaces.
Conclusions: High-intensity curing units did not cause more microleakage than conventional halogen lights. This supports the use of all these curing units in routine orthodontic practice.Abstract
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DOI: 10.2319/122407-599.1
Objective: To compare the in vitro reliability and accuracy of linear measurements between cephalometric landmarks on cone beam computed tomography (CBCT) 3D volumetric images with varying basis projection images to direct measurements on human skulls.
Materials and Methods: Sixteen linear dimensions between 24 anatomic sites marked on 19 human skulls were directly measured. The skulls were imaged with CBCT (i-CAT, Imaging Sciences International, Hatfield, Pa) at three settings: (a) 153 projections, (b) 306 projections, and (c) 612 projections. The mean absolute error and modality mean (± SD) of linear measurements between landmarks on volumetric renderings were compared to the anatomic truth using repeated measures general linear model (P ≤ .05).
Results: No difference in mean absolute error between the scan settings was found for almost all measurements. The average skull absolute error between marked reference points was less than the distances between unmarked reference sites. CBCT resulted in lower measurements for nine dimensions (mean difference range: 3.1 mm ± 0.12 mm to 0.56 mm ± 0.07 mm) and a greater measurement for one dimension (mean difference 3.3 mm ± 0.12 mm). No differences were detected between CBCT scan sequences.
Conclusions: CBCT measurements were consistent between scan sequences and for direct measurements between marked reference points. Reducing the number of projections for 3D reconstruction did not lead to reduced dimensional accuracy and potentially provides reduced patient radiation exposure. Because the fiducial landmarks on the skulls were not radio-opaque, the inaccuracies found in measurement could be due to the methods applied rather than to innate inaccuracies in the CBCT scan reconstructions or 3D software employed.Abstract
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DOI: 10.2319/122707-604.1
Objective: To test the hypothesis that there is no difference in the stability of the hard and soft tissue changes following a surgical mandibular setback using a sagittal split ramus osteotomy or an intraoral vertical ramus osteotomy.
Materials and Methods: The samples consisted of 45 female patients with mandibular prognathism, who were divided into two groups. Twenty-three underwent a sagittal split ramus osteotomy (SSRO) with rigid fixation by titanium mini-screws and maxillomandibular fixation (MMF) for 14.0 ± 0.7 days. Twenty-two underwent intraoral vertical ramus osteotomy (IVRO) without rigid fixation, and MMF was released 21.5 ± 3.3 days after surgery. Data were collected from standardized cephalometric radiographs taken at the start of preoperative orthodontic treatment (T1), immediately after surgery (MMF, T2), and the completion of postoperative treatment (T3). Angular measurements were compared on each of T1, T2, and T3.
Results: There were no significant differences in the pretreatment hard and soft tissue morphology between the SSRO and IVRO. However, when fixation was released, the mandible was posteriorly positioned in the IVRO group. In the soft tissue profile, the mental region was located backward in the IVRO group at postoperative stage (T3).
Conclusions: The hypothesis is rejected. The soft tissue profile of the IVRO group especially showed a retromandibular position after postoperative treatment in comparison with the SSRO group. This tendency of the IVRO group would contribute to the database for treatment planning and prediction.Abstract
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DOI: 10.2319/010708-7.1
Objective: To examine pulpal vitality in teeth suffering dental trauma during orthodontic therapy with fixed appliances.
Materials and Methods: Pulpal condition was evaluated in 59 teeth that had suffered dental trauma during orthodontic treatment (TO-group), in 800 orthodontically treated teeth without previous dental trauma (O-group), and in 193 orthodontically untreated teeth with previous dental trauma (T-group). Pulpal vitality was examined clinically and with radiographs. Degree of pulp obliteration was rated as absent, partial, or total. All teeth in the TO-group showed a positive sensibility test prior to resumption of orthodontic therapy.
Results: Teeth in the TO-group revealed a significantly higher frequency of pulp necrosis than teeth in the O-group or teeth in the T-group (P < .001, respectively). In the TO-group, teeth with extrusive or lateral luxation (P = .031) and teeth with intrusive luxation (P = .015) injuries showed a significantly higher rate of pulp necrosis than teeth with fracture of enamel. In addition, teeth with total pulp obliteration showed a significantly higher frequency of pulp necrosis than teeth without pulp obliteration (P = .013).
Conclusion: Teeth with severe periodontal injury during orthodontic therapy and subsequent total pulp obliteration have an increased risk of pulp necrosis during additional orthodontic treatment stages.Abstract
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DOI: 10.2319/020408-63.1
Objective: To determine whether Herbst treatment is more efficient in adolescent than in adult Class II division 1 subjects.
Materials and Methods: All Class II division 1 patients with a full secondary dentition who had been treated at the orthodontic department of the University of Giessen with a Herbst appliance between 1990 and 2000 were considered. The complete records of 77 patients were available. According to their skeletal maturity, as assessed on hand-wrist radiographs, the subjects were divided into an adolescent group (MP3-F to MP3-H; n = 49; mean age 13.5 years) and an adult group (R-IJ to R-J; n = 28; mean age 20.7 years). Pretreatment and posttreatment dental casts were evaluated using the Peer Assessment Rating (PAR) Index. The reductions in PAR scores of the two groups were compared.
Results: Before treatment, both groups had a severe Class II division 1 malocclusion. The average PAR score of the adolescent patients was slightly lower (27.8) than that of the adult patients (28.8). After treatment, good results were reached for both groups, and the average PAR scores of the two groups were comparable (adolescents: 4.5; adults: 4.8). The average reductions in PAR score were 82.7% (23.3 points) for the adolescent group and 82.9% (24.0 points) for the adults, indicating great improvement in both groups.
Conclusions: Because good treatment results were achieved, with substantial improvement of the pretreatment situation in both groups, Herbst treatment can be considered equally efficient in adolescent and in adult Class II division 1 subjects.Abstract
Case Reports
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DOI: 10.2319/111307-393.1
Cleidocranial dysostosis is a rare congenital skeletal disorder, associated with clavicular hypoplasia or aplasia, delayed closure of cranial fontanels, brachycephalic skull, delayed exfoliation of primary dentition, eruption of permanent teeth, and multiple supernumerary and morphologic abnormalities of the maxilla and mandible. The disorder is caused by mutation in the CBFA1 gene, on the short arm of chromosome 6p21. The prevalence of cleidocranial dysostosis is estimated one per million, without sex or ethnic group predilection. The purpose of this paper is to describe the orthodontic treatment in a patient with cleidocranial dysostosis. Therapy may include removal of supernumerary teeth, surgical exposure of impacted teeth, and orthodontic treatment.Abstract
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DOI: 10.2319/111507-531.1
Exposure to nickel-containing orthodontic appliances may cause intra- or extraoral allergic reactions. Nickel is the most typical antigen implicated in causing allergic contact dermatitis, which is a Type IV delayed hypersensitivity immune response. This report presents an unusual reaction to nickel during the orthodontic treatment of an adult female patient. The patient had no previous history of allergy and had been wearing fixed metal upper appliances while in orthodontic treatment to assist the eruption of her impacted teeth. The adverse hypersensitivity reactions appeared only after the surgical exposure and included severe signs of eczematic and urticarial reactions of the face with redness, irritation, itching, eczema, soreness, fissuring, and desquamation as well as intraoral diffuse red zones. Diagnostic patch testing performed by the allergist revealed sensitization to nickel (++++ score). Treatment was achieved with nickel-free appliances.Abstract
Review Articles
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DOI: 10.2319/081307-377.1
Objective: To evaluate the effectiveness of adhesives used to attach bands to teeth during fixed appliance treatment.
Material and Methods: Electronic databases, conference proceedings and the Internet were searched. There was no restriction with regard to publication status or language of publication. Randomized controlled trials (RCTs) and controlled clinical trials (CCTs) (including split-mouth studies) of adhesives used to attach orthodontic bands to molar teeth were selected. Patients with full arch fixed orthodontic appliance(s) who had bands attached to molars were included. All review authors were involved in study selection, validity assessment, and data extraction. Disagreements were resolved by discussion. Comparisons were made between the main types of adhesive.
Results: Five RCTs and three CCTs were identified, all of split-mouth design. Four trials compared chemically cured zinc phosphate and chemically cured glass ionomer; three trials compared chemically cured glass ionomer cement with light-cured compomer; and one trial compared chemically cured glass ionomer with a chemically cured glass polyphosphonate. Data analysis was often inappropriate within the studies. Meta-analysis was not feasible.
Conclusions: There is insufficient high-quality evidence with regard to the most effective adhesive for attaching orthodontic bands to molar teeth. Further RCTs are required.Abstract
Guest Editorial
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In this journal in 1947, Wendell L. Wylie,1 one of the most respected orthodontists of his generation, posed for the time a profound question: Ought clinicians to regard malocclusion as a malady (a disease or an ailment) or a malformation (a deformity)? The response to this question lay literally in the hands of the orthodontic specialty. If malocclusion was to be regarded as a malady, then it required treatment as provided for a disease state; if it was taken to be some form of malformation, then this dental condition should be modified to improve the form and function
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
Influence of personalized replacement protocol and low-level laser therapy combined with vibration on tooth movement rate and tooth movement accuracy in clear aligner treatment: a randomized clinical trial
Zeyao Miao,
Liling Ren,
Haijuan Zhang,
Chengdong Zheng,
Yuxuan Yang,
Jinyuan Zhu,
Yandong Han, and
Shuang Wang
eISSN: 1945-7103 | ISSN: 0003-3219
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