Things change. Continued existence as a dental specialty requires orthodontics' commitment to innovation and hinges on orthodontics' ability to adapt to the evolving needs of the patients being cared for, to the aspirations of new entrants in the field and to the privations of veteran practitioners entrenched in practice. When industry develops a product or service in a manner that is not expected by the market, it is termed a disruptive innovation. In sharp contrast, sustaining innovations are those continuous improvements in existing products or services that enhance competition between practices. History teaches us that in orthodontics some of the
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Original Articles
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DOI: 10.2319/022813-170.1
ABSTRACT
Objective:
To compare the efficiency in anchorage preservation of conventional and self-ligating brackets after the extraction of first maxillary premolars using differential moment mechanics.
Materials and Methods:
Thirty-eight patients requiring extraction of maxillary first premolars and maximum anchorage during space closure were evaluated based on bracket type. Group 1, comprising 23 patients, was bonded with preadjusted conventional brackets (CBs) with a slot of 0.022-inch × 0.030-inch. Group 2 comprised 15 patients who were bonded with 0.022 inch preadjusted self-ligating brackets (SLBs). Patients in both groups received a nickel titanium (NiTi) intrusion arch and a 150 g NiTi closing coil spring for separate canine retraction, followed by a continuous mushroom loop archwire to retract the incisors. Lateral cephalograms were available at the start of treatment (T1) and at the completion of space closure (T2). Statistical comparisons were performed with paired and unpaired Student's t-tests.
Results:
No significant differences were found between the groups in maxillary molars anchorage loss (3.87 ± 1.35 mm and 3.65 ± 1.73 mm for the CB and SLB groups, respectively). Only the mean vertical movement of the tip of the incisor was significantly different between the groups (CB = −0.92 ± 1.46 mm; SLB = 0.56 ± 1.65 mm).
Conclusion:
There were no significant differences in the amount of anchorage loss of the maxillary first molars between SLB and CB systems during space closure using differential moments.
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DOI: 10.2319/021413-133.1
ABSTRACT
Objective:
To examine the effect of maxillary incisor proclination due to orthodontic treatment upon the sagittal position of point A and evaluate the effect of this possible movement of point A on sella-nasion-point A (SNA) angle.
Materials and Methods:
A study group was formed from 25 subjects (12 male and 13 female) who had Class II division 2 malocclusion with retroclined upper incisors, and a control group was formed from 25 subjects (12 male and 13 female) who had minor crowding in the beginning of the treatment and required no or minimal maxillary anterior tooth movement. Treatment changes in maxillary incisor inclination, sagittal position of point A, SNA angle, and movement of incisor root apex and incisal edge were calculated on pretreatment and posttreatment lateral cephalographs.
Results:
Maxillary incisors were significantly proclined (17.33°) in the study group and not significantly proclined (1.81°) in the control group. This proclination resulted in 2.12-mm backward movement of the root apex and 5.76-mm forward movement of the incisal edge of maxillary incisors. Point A moved 1.04 mm backward (P = .582) and 0.48 mm (P = .811) forward in the study and control groups, respectively. Incisor root apex and incisal edge almost remained stable in the control group. No significant change was observed in the value of the SNA angle in both the study and control groups.
Conclusions:
Proclination of maxillary incisors accompanied by backward movement of incisor root apex caused posterior movement of point A. However, this posterior movement does not significantly affect the SNA angle.
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DOI: 10.2319/011913-48.1
ABSTRACT
Objective:
To compare lower incisor dentoalveolar compensation and mandible symphysis morphology among Class I and Class III malocclusion patients with different facial vertical skeletal patterns.
Materials and Methods:
Lower incisor extrusion and inclination, as well as buccal (LA) and lingual (LP) cortex depth, and mandibular symphysis height (LH) were measured in 107 lateral cephalometric x-rays of adult patients without prior orthodontic treatment. In addition, malocclusion type (Class I or III) and facial vertical skeletal pattern were considered. Through a principal component analysis (PCA) related variables were reduced. Simple regression equation and multivariate analyses of variance were also used.
Results:
Incisor mandibular plane angle (P < .001) and extrusion (P = .03) values showed significant differences between the sagittal malocclusion groups. Variations in the mandibular plane have a negative correlation with LA (Class I P = .03 and Class III P = .01) and a positive correlation with LH (Class I P = .01 and Class III P = .02) in both groups. Within the Class III group, there was a negative correlation between the mandibular plane and LP (P = .02). PCA showed that the tendency toward a long face causes the symphysis to elongate and narrow. In Class III, alveolar narrowing is also found in normal faces.
Conclusions:
Vertical facial pattern is a significant factor in mandibular symphysis alveolar morphology and lower incisor positioning, both for Class I and Class III patients. Short-faced Class III patients have a widened alveolar bone. However, for long-faced and normal-faced Class III, natural compensation elongates the symphysis and influences lower incisor position.
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DOI: 10.2319/101612-808.1
ABSTRACT
Objective:
To investigate the effects of bracket bevel design and oral environmental factors (saliva, temperature) on frictional resistance.
Materials and Methods:
Five types of brackets, namely a conventional bracket (Omni-arch), an active self-ligating bracket (Clippy), and three passive self-ligating brackets (Carriere, Damon, and Tenbrook T1) coupled with a 0.014-inch austenitic nickel-titanium archwire were tested. In the experimental model, which used a group of five identical brackets, the center bracket was displaced 3 mm to mimic the binding effects. The friction experiments were performed at three temperatures (20°C, 37°C, 55°C) in a dry or a wet (artificial saliva) state. Finally, the surfaces of the bracket slots were observed using scanning electron microscopy (SEM) before and after the friction tests.
Results:
The sliding frictional force was significantly influenced by the bracket slot bevel and saliva whether in the active or passive configuration (P < .05). The frictional force significantly increased as the temperature increased in the active configuration (P < .01). Based on the SEM observations, a correlation was found among the level of frictional force, the bevel angle, and the depth of scratches on bracket bevels.
Conclusion:
Frictional force can be reduced by increasing the bevel angle and by lowering the oral temperature, whereas the presence of saliva increases frictional resistance.
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DOI: 10.2319/030113-174.1
ABSTRACT
Objective:
To investigate the age and sex interaction effect on orthodontic pain in adolescence during the initial phase of fixed orthodontic treatment.
Materials and Methods:
Three hundred participants (mean age 13.85 ± 1.98 years; 152 female, 148 male) met all inclusion criteria and enrolled in the study designed as 2 × 2 factorial trial with two levels each for age (11–14 years; 14–17 years) and sex (male; female). A 0.16-inch superelastic NiTi wire was used in a 0.022-inch slot (Roth's prescription) preadjusted edgewise appliance for initial leveling and alignment of mandibular anterior dentition. The follow-up period was 7 days. Pain was assessed by using 100 mm visual analog scale for one baseline and nine follow-up repeated measurements at prespecified time points. Data were analyzed by using generalized linear mixed effect model analysis.
Results:
Three participants were lost to follow-up, and 17 participants were not considered for analysis due to incomplete or improperly completed questionnaire. Therefore, 280 participants (mean age 13.96 ± 2.01 years; 138 female, 142 male) were analyzed for results. Results showed that age and sex interaction had statistically significant effect on pain (F = 3.56; P = .0151; df 3/218). In the 11–14 year age group, there was no significant difference for pain between male and female. In the 14–17 year age group, girls reported significantly greater pain compared to 14- to 17 year-old boys (t = 2.76; P = .0209). Pain reported by 14- to 17-year-old girls was also significantly greater compared to 11- to 14-year-old boys (t = 2.91; P = .0206).
Conclusions:
Age and sex interaction has significant effect on orthodontic pain during adolescence, and 14- to 17-year-old girls experienced maximum pain.
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DOI: 10.2319/111412-872.1
ABSTRACT
Objective:
To compare the effect of laser irradiation at two different pulse settings and acid etching on the shear bond strength (SBS) of orthodontic brackets to enamel.
Materials and Methods:
Thirty-six premolars were allocated to three groups (n = 12): (1) 37% phosphoric acid etching, (2) erbium-doped yttrium aluminum garnet (Er:YAG) laser etching with medium-short pulse mode (MSP; 100 µs, 120 mj, 10 Hz, 1.2 W), and (3) Er:YAG laser etching with quantum-square pulse mode (QSP; 120 mj, 10 Hz, 1.2 W). Metallic brackets were bonded with Transbond XT. After photopolymerization, the samples were subjected to 5000 thermal cycles and debonded with a universal testing machine, and the SBS values were recorded. Surface morphology was evaluated with profilometric examination, scanning electron microscopy, and atomic force microscopy. The adhesive remnant index (ARI) was evaluated to assess the remaining adhesive.
Results:
The results of SBS testing were analyzed by one-way analysis of variance and Tukey honestly significant diffference tests. The mean SBS values of QSP and MSP laser groups were 11.80 ± 2.7 MPa and 10.10 ± 4.5 MPa, respectively, and the QSP group demonstrated significantly higher SBS (P < .01) than that of the acid-etched group (6.6 ± 2.4 MPa). No significant difference was observed between the SBS values of the two laser groups (P < .05). The difference between the ARI scores of the laser groups and the acid-etched group was statistically significant (P < .05).
Conclusion:
Laser etching at MSP and QSP modes present successful alternatives to acid etching; however, long-term clinical studies are required to verify clinical success.
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DOI: 10.2319/022013-147.1
ABSTRACT
Objectives:
To estimate the in vivo effect of nano-hydroxyapatite (HA) modification of banding glass-ionomer cement on microleakage under orthodontic bands.
Materials and Methods:
Eighty noncarious premolars scheduled for extraction in 20 orthodontic patients were randomly divided into four groups. Grouping was based on the ratio of nano-HA (0%, 5%, 10%, 15% by weight) added to the luting glass-ionomer cement (GIC) Ketac-Cem, which was used for cementation of prefabricated micro-etched orthodontic bands. Dye penetration method was used for microleakage evaluation at the cement-band and cement-enamel interfaces. Statistical evaluation was performed with a Kruskal-Wallis test and a Mann-Whitney U-test, and a Bonferroni-adjusted significance level was calculated.
Results:
Bands cemented with conventional GIC showed the highest microleakage scores in comparison to those cemented with nano-HA-modified GIC. No significant difference was found between teeth banded with 10% and 15% modified GIC.
Conclusions:
Modification of the banding GIC with 15% nano-HA revealed a positive effect on reducing microleakage around orthodontic bands.
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DOI: 10.2319/112712-904.1
ABSTRACT
Objectives:
To evaluate the impact of metal ions commonly shed from orthodontic appliances on the virulence of Streptococcus mutans ATCC®25175™ biofilms.
Materials and Methods:
Biofilms were grown in the presence of Ni2+, Fe3+, Cr3+, Co2+, and a metal ion pool at concentrations similar to those released in saliva of orthodontic patients for 72 hours. Once mature, biofilms were treated for up to 12 hours with 5% glucose.
Results:
Ions interfered with the growth of S mutans by reducing its biomass (Ni2+, Fe3+, Cr3+), raising its rates of sugar metabolism (Ni2+, Fe3+, Cr3+), and raising its secretion of lactate (Ni2+, Fe3+, Cr3+, pool).
Conclusion:
The laboratory data presented here point to the possibility of virulence increase of S mutans by metal ions commonly released during orthodontic therapy.
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DOI: 10.2319/111112-866.1
ABSTRACT
Objective:
To evaluate the coating thickness of four brands of as-received esthetic coated rectangular archwires and their surface characteristics and coating stability after 21 days of oral exposure compared to those of conventional stainless steel (SS) and nickel titanium (NiTi) ones.
Materials and Methods:
The labial surface of the selected archwires was observed with a stereoscope and in a scanning electron microscope, and surface roughness was assessed with an atomic force microscope. The coating thickness of as-received wires and the percentage of coating lost on the labial surface of retrieved wires were measured using Image Pro Plus 4.5 software.
Results:
All groups showed an average coating thickness of less than 0.002 inches. After oral exposure, archwires from two groups lost all coating on the labial surface. On average, 28.71% and 72.90% of the coating was lost in each of the other two groups, and the surface roughness of the remaining coating was higher than postclinical control wires.
Conclusion:
Coated archwires had a low esthetic value as they presented a nondurable coating. The remaining coating showed a severe deterioration and a greater surface roughness than postclinical control counterparts (conventional SS and NiTi wires).
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DOI: 10.2319/010913-25.1
ABSTRACT
Objective:
To assess the effect of wear-time recording on subjective and objective wear time.
Materials and Methods:
This study retrospectively examined a group of 18 patients and a control group of 14 patients at four appointments over 168 days. The patients were treated with removable appliances with embedded TheraMon-microsensors to be worn for 15 hours per day. The study group was not told about the microsensor until the first appointment after fitting of the appliance. At each appointment patients were asked about their subjective wear time and afterward were told about the objective wear time. The existence of the microsensor was revealed to the control group when the appliance was fitted. Objective wear time was also announced at every appointment.
Results:
Mean wear times did not significantly differ between groups at any appointment or regarding overall wear time. Highly significant differences between subjective and objective wear time were found when patients did not know that their wear time had been monitored.
Conclusion:
Mean wear times assessed in this study concur with data of previous studies. Patients tend to overestimate their wear times but become more realistic once they know wear time is being monitored. Objective measurement of wear time allows a more realistic view of compliance by patient and orthodontist. Knowing that wear time is recorded does not necessarily increase the amount of time removable appliances are worn by the patient.
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DOI: 10.2319/021513-134.1
ABSTRACT
Objective:
To investigate the effects of wobbling angle on the stability measures of orthodontic mini-implants (OMIs) during insertion and removal procedures in artificial bone blocks.
Materials and Methods:
A total of 36 OMIs (self-drilling type, cylindrical shape, 7 mm in length, 1.45 mm in diameter) were allocated into three groups according to the amount of wobbling angle (W-0°, W-2°, and W-4° groups; N = 12 per group). The OMIs were installed and subsequently removed from artificial bone blocks (Sawbone) using a driving torque tester with a uniform speed of 28 rpm. Insertion peak time (IPT), maximum insertion torque (MIT), total insertion energy (TIE), near-peak insertion energy (NPIE), maximum removal torque (MRT), and near-peak removal energy (NPRE) were measured.
Results:
The W-4° group showed the longest IPT and highest TIE and NPIE, followed by the W-2° and W-0° groups (W-0° < W-2° < W-4°, all P < .001). The W-2° and W-4° groups showed significant increase in MIT compared with the W-0° group (W-0° < [W-4°,W-2°]; P < .001). Although there was no significant difference in NPRE among the three groups, the W-4° group showed a decrease in MRT compared with the W-0° and W-2° groups (W-4° < {W-2°,W-0°]; P < .05). Although the W-4° group showed a 14.5% (2.9 Ncm) increase in MIT compared with the W-0° group, there was only a 6% (1.3 Ncm) decrease in MRT from the W-0° group to the W-4° group.
Conclusion:
Slight wobbling during the OMI insertion procedure may be acceptable in terms of the stability measures of OMIs during insertion and removal procedures.
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DOI: 10.2319/100812-789.1
ABSTRACT
Objective:
To analyze the effect of low-level laser on bone remodeling during induced tooth movement in rats.
Materials and Methods:
A diode laser (808 nm, 100 mW, 54 J on an area of 0.0028 cm2) was used. The application was continuous, punctual, and with contact. Forty-two 70-day-old Wistar rats had the maxillary left first molar moved using a force level of 25 g. In two experimental subgroups the movement was performed over 7 days and in three subgroups the movement occurred over 14 days. In the 7-day movement subgroups, one subgroup received laser irradiation on day 1 only; the other subgroup received laser irradiation on days 1, 3, and 5. In the 14-day movement subgroups, one subgroup received laser irradiation on day 1 only; the second on days 1, 3, and 5; and the third on days 1, 3, 5, 7, 9, 11, and 13. The control group was also divided into two subgroups, and movement occurred over two different periods of treatment (7 days and 14 days) without laser application; these were used as controls for the respective experimental subgroups. Inter-subgroup comparison was performed with Kruskal-Wallis, followed by Mann-Whitney and analysis of variance, followed by Tukey tests within the 7- and 14-day subgroups.
Results:
The subgroup with three laser applications showed significantly greater osteoclastic activity and bone resorption than the other subgroups in the 7-day movement subgroups.
Conclusions:
Low-level laser application significantly increased the osteoclastic but not the osteoblastic activity during the initial phases of tooth movement. In addition, the osteoclastic activity was dose-dependent.
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DOI: 10.2319/020913-119.1
ABSTRACT
Objectives:
To determine the expression levels of nociceptin following experimental tooth movement.
Materials and Methods:
A total of 72 male Sprague-Dawley rats were divided into two groups: sham and experimental groups. For the experimental group, closed coil springs were used to mimic orthodontic force (80 g) between upper incisors and first molars, and the rats were killed at 0 hours, 4 hours, 12 hours, 1 day, 2 days, 5 days, 7 days, 10 days, and 14 days. All of these procedures were similar for the sham group, except for that no force was applied. The four rats killed at 0 hours without any intervention were used as the baseline control in each group. Trigeminal nucleus caudalis from both the ipsilateral and contralateral sides of force applications were obtained for immunostaining.
Results:
Nociceptin was expressed in both the ipsilateral and contralateral sides of each group. Its expression levels started to increase on day 2, peaked on day 7, and returned to baseline on day 10 in the experimental group, while expression levels started to decrease on day 1 and returned to baseline on day 10 in the sham group. Moreover, the expression levels were similar between the ipsilateral and contralateral sides in each group.
Conclusion:
The expression levels of nociceptin were elevated following experimental tooth movement. The anesthetic agent used in this study (chloral hydrate) may have an antagonism with nociceptin. Due to bilateral innervation of anterior teeth and bilateral projection of nerve fibers, the expression levels of nociceptin were similar between ipsilateral and contralateral sides.
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DOI: 10.2319/021313-130.1
ABSTRACT
Objective:
To investigate the existence of genetic influences on the incidence of mandibular prognathism (MP) in Korean Class III patients.
Materials and Methods:
The probands consisted of 100 Class III patients with MP (51 men and 49 women; mean age, 22.1 ± 5.2 years; SNA, 81.2° ± 3.2°; SNB, 84.1° ± 3.9°) who underwent orthognathic surgery. Using three-generation pedigree charts, questionnaires, and clinical examinations, general information and information regarding MP for a total of 3777 relatives of the probands (1911 men and 1866 women) was ascertained. Familial correlations of MP between possible pairs in the pedigree were estimated. Heritability (h2) of MP under various models was estimated. Segregation analysis was conducted under the assumption of the nonpolygenic multivariate logistic model and finite polygenic mixed model. One-, two-, and three-susceptibility-type models were evaluated.
Results:
Among 3777 relatives, 199 (97 men and 102 women) were affected with MP (5.3%). Correlation coefficients of MP incidence in full siblings and in parent-offspring were .2003 and .2036, respectively (all P < .001). The h2 of MP was estimated as 21.5% after adjusting for sex and founder effects. Two- and three–susceptibility-type models showed that the general model fit better than the other models. MP incidence did not have a major gene transmission model and was influenced by numerous minor effect genes and their additive effects.
Conclusion:
These results suggest that the inherited susceptibility to MP in Korean Class III patients might be due to the summation of minor effects from a variety of different genes and/or influence of environmental factors, rather than Mendelian transmission of major genes.
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DOI: 10.2319/020513-104.1
ABSTRACT
Objective:
To investigate the association between the risk of tooth agenesis and single-nucleotide polymorphisms (SNPs) of MSX1 and PAX9 genes in nonsyndromic cleft patients.
Materials and Methods:
The subjects were 126 Korean nonsyndromic cleft patients. Tooth agenesis type (TAT) was classified as none (0); cleft area (1); cleft area + other area (2); and other area (3) based on agenesis of the maxillary lateral incisor (MXLI) and another tooth within or outside the cleft area. TAT was further grouped into two subcategories (0 and 1) and four subcategories (0, 1, 2, and 3). Three SNPs of MSX1 and 10 SNPs of PAX9 were investigated using Fisher's exact test and logistic regression analysis.
Results:
Although the association between genotype distribution of PAX9-rs7142363 and TAT was significant (P < .05 in four subcategories), genotypic odds ratios (GORs) of SNPs in each TAT were not meaningful. However, for MSX1-rs12532 and PAX9-rs2073247, associations between genotypic distribution and TAT were significant (P < .01 in four subcategories and P < .05 in two subcategories; P < .01 in two subcategories, respectively). In cleft area, GORs of MXLI agenesis in genotypes GA of MSX1-rs12532 and CT of PAX9-rs2073247 were increased by 3.14-fold and 4.15-fold compared with genotype GG of MSX1-rs12532 and CC of PAX9-rs2073247, respectively (P <. 01; P < .05). In cleft area + other area, the GOR of agenesis of MXLI and another tooth in genotype AA of MSX1-rs12532 was increased by fivefold compared with genotype GG (P < .05).
Conclusion:
Genetic disturbances of MSX1 and PAX9 genes are associated with tooth agenesis within and outside the cleft area.
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DOI: 10.2319/012713-83.1
ABSTRACT
Objective:
To assess the relationship between malocclusion severity and quality of life in children.
Materials and Method:
Two hundred and seventy-eight children aged 11 to 14 years were recruited voluntarily from the Dental and Maxillofacial Centre of the Almana General Hospital in Alkhobar, Saudi Arabia. The children were asked to fill out the Arabic version of the Child Perception Questionnaire for 11- to 14-year-old children (CPQ11–14) and were then clinically examined to determine the severity of their malocclusion using the Dental Aesthetic Index (DAI). Multivariate analysis of variance was used to compare the four domains and the total CPQ11–14 scores between the four DAI severity groups.
Results:
Significant differences were found between DAI severity groups for the four domains and the total CPQ11–14 scores. Although children with very severe (handicapping) malocclusion had significantly higher domain and total CPQ11–14 scores than all the other groups (differences of up to 6 and 22 units, respectively, compared to children with no/minor malocclusion), there were no differences between those with no/minor, definite, and severe malocclusion.
Conclusion:
These findings suggest that only very severe malocclusion had an impact on the quality of life of the participants. Orthodontists should focus not only on clinical measures of malocclusion but should also consider the impact of severe malocclusion on patients' quality of life.
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DOI: 10.2319/120712-925.1
ABSTRACT
Objective:
To investigate the relationship between craniofacial measurements obtained from cephalometric radiographs and analogous measurements from profile photographs.
Materials and Methods:
Lateral cephalograms and standardized facial profile photographs were obtained from a sample of 123 subjects (65 girls, 58 boys; age 7–12 years). Intraclass correlation coefficients (ICCs) were calculated from repeated photographic measurements to evaluate method reliability. Analogous cephalometric and photographic measurements were compared to assess Pearson correlation coefficients. Linear regression analyses were conducted between the measurements that achieved correlation coefficients greater than r = 0.7.
Results:
The reliability of the photographic technique was satisfactory. Most measurements showed ICCs above 0.80 and highly significant correlations (P ≤ .001) with cephalometric variables. Among all measurements used, the A'N'B' angle was the most effective in explaining the variability of its analogous cephalometric, mainly for female subjects (r2 = 0.80). The FMA' angle showed the best results for vertical assessment (r2 = 0.65).
Conclusions:
The photographic method has proven to be a repeatable and reproducible tool provided that a standardized protocol is followed. Therefore, it may be considered a feasible and practical diagnostic alternative, particularly if there is a need for a low-cost and noninvasive method.
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DOI: 10.2319/021113-124.1
ABSTRACT
Objective:
To assess the extent to which cephalograms modify therapeutic decisions related to early orthodontic treatment.
Materials and Methods:
Diagnostic records of six patients requiring early treatment were digitized for this purpose. A total of 234 orthodontists were then asked to select therapeutic measures on a treatment-planning sheet at two different times (T1 and T2). Three groups of orthodontists were formed and were provided with case-specific records either including or not including cephalograms and the appended tracing values. Forty-seven orthodontists completed all phases of the questions.
Results:
Statistical analysis revealed only two statistically significant differences between the first (T1) and second (T2) treatment plans, both concerning options of transverse treatment. None of the other results showed any significant changes from T1 to T2 treatment planning.
Conclusion:
It follows that cephalograms did not influence therapeutic decisions for early orthodontic treatment and should not be routinely used in very young patients.
Systematic Reviews
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DOI: 10.2319/010113-2.1
ABSTRACT
Objective:
To compare adverse effects between labial and lingual orthodontic treatments through a systematic review of the literature.
Materials and Methods:
The protocol of this systematic review (CRD42012002455) was registered in the International Prospective Register of Systematic Reviews (PROSPERO). An electronic search was conducted in PubMed, Embase, Web of Science, CENTRAL, SIGLE, ProQuest Dissertations & Theses, and ClinicalTrial.gov for articles published between January 1980 and December 2012. Primary outcomes included pain and caries; secondary outcomes were eating difficulty, speech difficulty, oral hygiene, and treatment duration. Meta-analyses were conducted in Comprehensive Meta-Analysis version 2.2.064.
Results:
Six studies were included, two randomized controlled trials and four clinical controlled trials; of these, four were medium quality and two were low quality in terms of the risk of bias. Five of the six outcomes were evaluated in the included studies, and treatment duration was not; pain, eating difficulty, speech difficulty were statistically pooled. Meta-analysis revealed that the pooled odds ratios were 1.20 (95% confidence interval [CI] = 0.30–4.87) for overall pain, 32.24 (95% CI = 14.13–73.55) for pain in tongue, 0.08 (95% CI = 0.04–0.18) for pain in cheek, 0.11 (95% CI = 0.03–0.42) for pain in lip, 3.59 (95% CI = 1.85–6.99) for eating difficulty, and 8.61 (95% CI = 3.55–20.89) for speech difficulty. Sensitivity analysis showed consistent results except for eating difficulty. No publication bias was detected.
Conclusions:
The likelihood of overall pain was similar between the two modalities. Patients who underwent lingual orthodontic treatment were more likely to suffer from pain in the tongue and less likely to suffer from pain in the cheek and lip. Lingual orthodontic treatment increased the likelihood of speech difficulty. Eating difficulty, oral hygiene, caries, and treatment duration could not be compared in this systematic review.
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DOI: 10.2319/020413-103.1
ABSTRACT
Objective:
To evaluate the evidence on three-dimensional immediate effects of rapid maxillary expansion (RME) treatment on growing patients as assessed by computed tomography/cone beam computed tomography (CT/CBCT) imaging.
Materials and Methods:
The published literature was searched through the PubMed, Embase, and Cochrane Library electronic databases from January 1966 to December 2012. The inclusion criteria consisted of randomized controlled trials, prospective controlled studies, and prospective case-series. Two reviewers extracted the data independently and assessed the quality of the studies.
Results:
The search strategy resulted in 73 abstracts or full-text articles, of which 10 met the inclusion criteria. When treating posterior crossbites with a RME device, the existing evidence points out that the midpalatal suture opening is around 20%–50% of the total screw expansion. There seems to be no consistent evidence on whether the midpalatal sutural opening is parallel or triangular. The effect on the nasal cavity dimensions after RME seems to be apparent and indicates an enlargement between 17% and 33% of the total screw expansion. Circummaxillary sutures, particularly the zygomaticomaxillary and frontomaxillary sutures and also spheno-occipital synchondrosis, appear to be affected by the maxillary expansion. Overall, however, the changes were small and the evidence not conclusive.
Conclusions:
CT imaging proved to be a useful tool for assessment of treatment effects in all three dimensions. The majority of the articles were judged to be of low quality, and therefore, no evidence-based conclusions could to be drawn from these studies.
Case Reports
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DOI: 10.2319/122612-968.1
ABSTRACT
This case report describes the interdisciplinary management of a 58-year-old woman who was missing lower first molars and supraerupted maxillary first molars. The treatment plan included intrusion of the upper first molars and corticotomy-assisted mandibular second molar protraction with the aid of temporary anchorage devices. Miniscrews were effective in intrusion of the maxillary first molars and protraction of the lower second molars. Although good functional outcome was achieved in 41 months, the corticotomy-assisted procedure did not significantly reduce the treatment time.
DOI: 10.2319/012413-76.1
ABSTRACT
Does orthodontic treatment help or hinder a patient's periodontal status? What factors affect the periodontium? Can those factors be managed in a way that remedies existing periodontal issues? A 35-year-old woman presented with severe gingival recession and a unilateral Class II malocclusion. The treatment plan was to correct the malocclusion in a way that torques the roots more onto bone and to change her dental hygiene methods. With an extensive review of the literature, this case review attempts to make sense of the enigma of gingival recession and demonstrates an excellent treatment solution to concomitant orthodontic and periodontal problems.
Guest Editorial
DMD, MBA, FADPD, FACD
Letters From Our Readers
To: Editor, The Angle Orthodontist
I want to thank all the authors for their efforts in the preparation of the interesting article “Labio-lingual root control of lower anterior teeth and canines obtained by active and passive self-ligating brackets” published in the July 2013 issue of The Angle Orthodontist. However, several points seem worthy of mention.
Since the aim of this study is to evaluate how well the active and passive self-ligating bracket systems are able to deliver the planned buccolingual inclinations, the large difference of mandibular canine inclination prescriptions between Damon 3MX (canines 0°) and In-Ovation R (canines −11°)
To: Editor, The Angle Orthodontist
We would like to thank Dr. Zhao for his interest in our paper. In reply, we are taking the occasion to briefly report some results that were omitted from the original manuscript.
1. Regarding the comment concerning differences in prescription between the bracket systems, this question is quite pertinent. However, by looking at the pre- and after-treatment canine labio-lingual inclination it can be seen that for both passive and active SLBs the inclination was the same before as well as after intervention. Thus, the different prescription of the brackets does not seem to play a
Academic Opportunities
This listing of academic opportunities is provided as a free service to the profession and the community.
ALABAMA
Rank: 2 Orthodontic Instructor
University of Alabama at Birmingham School of Dentistry
Dept. of Orthodontics, Birmingham, AL 35294-0007
Contact: Dr. Chung How Kau, (205) 934-1289
FAX: (205) 975-7590 e-mail: ckau@uab.edu
FLORIDA
Rank: Commensurate with training & experience
Nova Southeastern University
Require: DMD/DDS or equivalent and cartificate in orthodontics from CODA accredited program. Advanced degree and or academic/researchAnd/or ABO certification is desirable.
College of Dental Medicine/Orthodontics
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Addtl info contact: Dr.
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