Where were you when you heard the shocking and sad news about Vince Kokich's unexpected and untimely passing? I think we can all recall where we were and what we were doing during key newsworthy events during our lives, many of which were tied to startling deaths of people who were vibrant contributors to society and to ourselves personally. For me, these events include watching men walk on the moon, seeing Nixon resign office on television, following the OJ Simpson car chase, being told that a plane had just crashed into the World Trade Center and, although I was only
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DOI: 10.2319/031013-205.1
To evaluate the effect of the extraction of deciduous canines on palatally displaced canines (PDCs), to analyze the impact of the age of the patient on this interceptive treatment, and to assess the outcome of one-sided extraction of a maxillary primary canine on the midline of the maxilla. This study included 48 PDCs in 24 consecutive patients with bilateral PDCs. The mean age of the patients at diagnosis was 11.6 years (standard deviation 1.2 years). After randomization, one deciduous canine of each patient was assigned to extraction, and the contralateral side served as control. The patients were then followed at 6-month intervals for 18 months with panoramic and intraoral occlusal radiographs. The rates of successful eruption of the PDCs at extraction and control sites were 67% and 42%, respectively, at 18 months. The difference between the sites was statistically significant, and the effect was significantly more pronounced in the younger participants. A significant decrease in arch perimeter occurred at extraction sites compared to control sites during the observation period. No midline shift toward the extraction side was observed in any patient. The extraction of the deciduous canine is an effective measure in PDC cases, but it must be done in younger patients in combination with early diagnosis, at the age of 10–11 years. Maintenance of the perimeter of the upper arch is an important step during the observation period, and a palatal arch as a space-holding device is recommended.ABSTRACT
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DOI: 10.2319/022413-155.1
To assess potential associations between maxillary canine impaction (MCI) and agenesis status as well as between MCI and gender. The records of 182 orthodontic patients with agenesis (excluding the third molars) and 630 orthodontic patients without agenesis were examined. Diagnosis of MCI was based on pretreatment panoramic radiographs. Maxillary canines that had not erupted as a result of physical barrier or deflection in the eruption path at the dental age of at least 12 years were considered impacted. Logistic regression analysis was used to test for the associations of interest. MCI was detected in 5.6% (n = 35) of the nonagenesis group (28 female and 7 male participants) and in 18.1% (n = 33) of the agenesis group (20 female and 13 male participants). Bilateral impaction was detected in 12 patients (34.3%) of the nonagenesis group and in 11 patients (33.3%) of the agenesis group. There was evidence that maxillary lateral incisor agenesis (odds ratio = 5.1, 95% confidence interval [CI] 2.5–10.5, P < .001) and second premolar agenesis (odds ratio = 2.6, 95% CI 1.0–6.6, P = .042) were significant MCI predictors after adjusting for gender. The odds of MCI were 69% higher in female versus male subjects after adjusting for agenesis status (95% CI 0.97–2.92, P = .063). This study indicates that there is evidence that agenesis status is a strong predictor of MCI, whereas gender is a weak predictor of MCI. Caution should be exercised in interpreting the results because of the observational nature of the present study.ABSTRACT
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DOI: 10.2319/041513-290.1
To evaluate the periodontal health and tooth vitality of palatally impacted and buccal ectopic maxillary canines after completion of orthodontic treatment. Fifteen patients who had unilateral, palatally impacted canines and 15 patients who had unilateral, buccal ectopic canines comprised the subjects of the study. Clinical and radiographic data was collected by recalling the patients in both groups after a mean period of 3.82 ± 1.54 years following completion of their orthodontic treatment. In both groups, the contralateral, normally placed canines served as controls. Palatally impacted canines had greater pocket depths, higher gingival levels, higher electric pulp testing scores, and reduced bone levels compared to their contralaterals. Buccal ectopic canines had increased plaque and gingival bleeding index, greater pocket depths, reduced attached gingival width, higher gingival levels, increased clinical crown lengths, and higher electric pulp testing scores compared to their contralaterals. Buccal ectopic canines had lower electric pulp testing scores and higher bone levels compared to palatally impacted canines. All ectopic canines had increased plaque and gingival bleeding index, greater pocket depths, reduced attached gingival width, higher gingival levels, increased crown lengths, higher electric pulp testing scores, and reduced bone levels compared to their contralaterals.ABSTRACT
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DOI: 10.2319/030513-183.1
To test the null hypotheses that children with unilateral agenesis of the mandibular second premolar (MnP2) do not show (1) greater distal angulation of the unerupted antimere and (2) delayed tooth formation compared with children without agenesis. Panoramic radiographs of 38 patients with unilateral aplasia of MnP2 were retrospectively examined and compared to a non-agenesic control group of 82 patients. Ages ranged from 8 to 15 years. Contralateral mandibular deciduous second molars were present for all participants. Each unerupted MnP2 was traced, and its developmental stage and angulation were recorded (measured with the distal angle and the premolar-molar angle). Dental age was evaluated using the Haavikko method. Student's t-test was performed to identify significant differences between the compared groups. The significance level for statistical testing was set at P < .05. The results indicated a 9.5° decrease in the distal angle and a 13.2° increase in the premolar-molar angle for the unerupted MnP2 in the agenesis sample. This was a highly statistically significant difference (P < .001 and P < .0001, respectively) compared with the MnP2 inclinations in the control sample. The delay in dental age was significantly greater in patients with agenesis (2.1 years) compared with the delay in the control group (1.5 years) (P < .001). Both null hypotheses are rejected. The results of this study statistically support the hypothesis that aplasia of MnP2, distally displaced MnP2s, and delayed tooth formation are part of a genetically related pattern of dental anomalies.ABSTRACT
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DOI: 10.2319/030813-195.1
To compare the cephalometric characteristics of Down syndrome (DS) subjects with those of normal subjects. Cephalometric radiographs of 60 Saudi DS subjects and 60 controls with specific inclusion criteria were used. Descriptive statistics were used to describe the quantitative and categorical variables, and the Student's t-test for two independent samples was used to compare the mean values of quantitative variables. SBa and SN were higher in controls than in DS subjects, whereas the NSBa was significantly higher in DS subjects than in controls. SNA, Co-A, ANB, and A-Na perp of controls were higher than the DS subjects. However, SN-MP, PP-MP, ANS-Me/N-Me, Y-axis, and Ar-Go-Me of the DS subjects were higher than those of the controls. In addition, U1-NA, U1-NA mm, L1-NB, and L1-NB mm of the DS subjects were also higher than the controls with a more acute U1-L1 angle in DS. NLA was larger in controls than in DS, whereas LL-E and UL-E of the DS subjects were higher than the controls. Differences between DS subjects and controls can be found when examining cephalometric radiographs. Anterior and posterior cranial base lengths are shorter with a backward inclination of the posterior cranial base in DS subjects. DS subjects present with a retrognathic maxilla and shorter effective length, with an increased LFH and a hyperdivergent mandible. Bimaxillary dental protrusion can also be expected in DS subjects with prominent lips and a reduced nasolabial angle.ABSTRACT
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DOI: 10.2319/112112-890.1
To investigate discrepancies in results of facial asymmetry analysis using different cone beam computed tomography (CBCT) image reorientation methods and the effectiveness of soft tissue as a reorientation reference for analysis of facial asymmetry. An asymmetric group of 30 patients with 4 mm or more of chin point (menton [Me]) deviation and a symmetric group of 30 patients with less than 4 mm of deviation of Me were chosen as study subjects. Three orientation methods were used to calculate and compare Me deviation values of the 60 subjects. Two methods used only skeletal landmarks for reference, and one method included the soft tissue landmarks around the eye. Preferences of an expert group for the facial midline as determined by each reorientation method were also examined. The examinations showed significant discrepancies in Me deviation values between the three reorientation methods. The expert group showed the greatest preference for the facial midline reorientation method that incorporated soft tissue landmarks of the eye. These study findings suggest that the inclusion of soft tissue landmarks, especially those around the eyes, is effective for three-dimensional CBCT image reorientation for facial asymmetry analysis.ABSTRACT
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DOI: 10.2319/041513-291.1
To study the longitudinal changes in 19 soft tissue cephalometric traits (according to the Bergman cephalometric soft tissue facial analysis). Cephalograms and photographs of 40 subjects (20 male, 20 female, from the Burlington Growth Centre) that were obtained at ages 6, 9, 12, 14, 16, and 18 years were used. Subjects were orthodontically untreated whites and had Class I dentoskeletal relationships (ideal overjet and overbite). Images were obtained with the lips in a relaxed position or lightly touching. Three groups of soft tissue traits were identified: (1) traits that increased in size with growth (nasal projection, lower face height, chin projection, chin-throat length, upper and lower lip thickness, upper lip length, and lower lip–chin length); (2) traits that decreased in size with growth (interlabial gap and mandibular sulcus contour [only in females]); and (3) traits that remained relatively constant during growth (facial profile angle, nasolabial angle, lower face percentage, chin-throat/lower face height percentage, lower face–throat angle, upper incisor exposure, maxillary sulcus contour, and upper and lower lip protrusion). Current findings identify areas of growth and change in individuals with Class I skeletal and dental relationships with ideal overjet and overbite and should be considered during treatment planning of orthodontic and orthognathic patients.ABSTRACT
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DOI: 10.2319/042313-315.1
To assess objectively patient compliance with removable orthodontic appliances and the effect of possible influential factors. Wearing times of 45 White patients were recorded with the aid of the TheraMon microsensor. Patient compliance was assessed relative to wear prescription and other parameters, such as age and sex. There was high individual variation in most measured variables and in all groups/subgroups. During a median observation period of 186 days (range, 55–318 days) the actual wear time was 9.0 h/d (range, 0.0–16.0 h/d) and did not differ between distinct prescriptions (P = .49). Eight patients wore their appliances less than 2 h/d, and six of them did not wear their appliances at all. Overall, the median wear per day relative to prescription was 62.5% (range, 0.0–89.3%) for the 14 h/d and 112.5% (range, 0.0–200.0%) for the 8 h/d prescription wear (P = .01) groups. There was a strong negative correlation of age (median: 12.5 years) with the daily percentage of actual wear time per day relative to wear prescription (14 h/d prescription: n = 21, rho = −0.61, P = .00; 8 h/d prescription: n = 24, rho = −0.73, P = .00), while sex did not exert a significant influence on compliance (P = .58). Despite the fact that patients and parents were informed about wear time recording, compliance was insufficient with regard to functional treatment (14 h/d prescription), while it was sufficient for retention purposes (8 h/d prescription). Objective measures are necessary to assess compliance with removable orthodontic appliances since patient compliance is a highly variable issue.ABSTRACT
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DOI: 10.2319/030813-197.1
To investigate the extent, experience, and trends associated with digital model use, as well as the advantages of using a particular study model type (digital or plaster) in postgraduate orthodontic programs in the United States and Canada. An electronic survey consisting of 14 questions was sent to 72 program directors or chairpersons of accredited orthodontic postgraduate programs in the United States and Canada. Fifty-one responded for a 71% response rate. Sixty-five percent of the schools use plaster study models compared with 35% that use digital models. The most common advantages of plaster models were a three-dimensional feel and the ability for them to be mounted on an articulator. The most common advantages of digital models were the ease of storage and retrieval, and the residents' exposure to new technology. About one third of the plaster model users reported that they wanted to switch to digital models in the future, with 12% planning to do so within 1 year. Based on our study, 35% of accredited orthodontic postgraduate programs in the United States and Canada are using digital study models in most cases treated in their programs, and the trend is for increased digital model use in the future.ABSTRACT
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DOI: 10.2319/022213-154.1
To evaluate and compare, retrospectively, the skeletal and dental effects of mandibular symphyseal distraction osteogenesis (MSDO) achieved through the use of tooth-borne versus hybrid distractors. Pretreatment (T1), predistraction (T2), postdistraction (T3), and posttreatment (T4) orthodontic records were collected and analyzed for 47 patients (20 tooth-borne, 27 hybrid). At each time point, records included intraoral photographs, study models, postero-anterior cephalometric radiographs, and lateral cephalometric radiographs. Submental vertex radiographs were taken at T2, T3, and T4. Changes in a total of 18 measurements were analyzed to compare patients undergoing tooth-borne versus hybrid distraction. The cumulative effects of orthodontics and MSDO produced similar gains in measured arch widths, with a decreased irregularity index in both groups (P > .05). However, there were differences in the timing during which the expansion was achieved. The hybrid distractor group gained space during the distraction phase of treatment. The tooth-borne group showed greater gains during pre- and postdistraction orthodontics. Comparisons of intercanine and interbone marker widths demonstrated a more parallel separation of bone during distraction with the hybrid distractor (P < .001). Distraction with the tooth-borne distractor was disproportionate, with greater separation of the canines in alveolar bone than of the bone markers in basal bone. During postdistraction orthodontics, the tooth-borne distractor group showed statistically greater increases in measurements. Both skeletal and dental expansion was achieved with both appliances. Greater skeletal expansion was achieved with a hybrid distractor. Greater dental expansion was achieved with a tooth-borne distractor.ABSTRACT
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DOI: 10.2319/032613-240.1
To evaluate the dentofacial effects of the Forsus Fatigue Resistant Device (FRD) used with miniscrew anchorage (FRDMS) and compare them with those of conventional FRD and an untreated Class II control group. The sample consisted of 48 Class II subjects. Sixteen patients (13.68 ± 1.09 years of age) were treated with FRDMS, whereas 17 subjects (14.64 ± 1.56 years of age) were treated with only FRD. Also, a control sample of 15 untreated Class II subjects (14.13 ± 1.50 years of age) was constructed. Angular and linear measurements were made on 96 lateral cephalograms. Paired t, one-way analysis of variance, and Tukey tests were used for statistical analysis. Class I molar relationship and overjet correction were achieved in an average period of 6.5 ± 1.97 and 5.5 ± 1.80 months in the FRDMS and FRD groups, respectively. No skeletal effect was determined in both treatment groups. Greater overbite correction was found in the FRD group. Retrusion and extrusion of maxillary incisors, distalization of maxillary molars, and extrusion of mandibular molars were significant in both treatment groups. Labial tipping of mandibular incisors was significantly greater in the FRD group than in the FRDMS group. Overjet and molar correction was totally dentoalveolar. Unfavorable labial tipping of mandibular incisors was effectively minimized with the usage of miniscrews.ABSTRACT
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DOI: 10.2319/011313-36.1
To assess the volumetric changes and the maxillary response of the naso-maxillary complex (NMC) following rapid maxillary expansion (RME). Thirty consecutive patients (14 males and 16 females) with a mean age at first observation of 9.5 ± 1.8 years for males and of 11.8 ± 1.7 years for females, presenting a posterior unilateral or bilateral crossbite and requiring RME, were selected for the study. Each patient underwent expansion to correct the transverse occlusal relationships. Computed tomography scans were taken before RME (T1) and at the end of the active expansion phase (T2). Measurements were performed on scanned images. The Kolmogorov-Smirnov test was performed; the mean differences between measurements at T1 and T2 were compared using the t-test (α = .05). All volumetric, maxillary, transverse skeletal anterior and posterior variables as well as all dental anterior and posterior linear and angular variables representing the NMC displayed statistically highly significant increases after RME (P < .001). After RME the total volume of the NMC increased by 12%, the nasal volume by 17%, and the maxillary volume by 10.6%. The maxillary and the nasal contributions represented 69.75% and 30.25%, respectively.ABSTRACT
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DOI: 10.2319/111312-870.1
To identify differences in occlusal curvatures and maxillary arch dimensions between subjects with signs and symptoms of temporomandibular disorders TMDs and asymptomatic subjects. One hundred subjects 78 female and 22 male who consented to participate in this research were examined for signs and symptoms of TMDs according to the guidelines of the Research Diagnostic Criteria for Temporomandibular Disorders RDCTMD. In addition, occlusal measurements were performed for all subjects on plaster models. All statistical analyses were performed with SPSS version 19. Significant associations were revealed between the depth of the curve of Spee COS and temporomandibular joint TMJ sounds. Furthermore, maxillary arch width was negatively correlated to the steepness of the curve of Wilson. No differences were found between subjects with and without a history of orthodontic treatment. Subjects with TMJ sounds tend to have a flatter COS compared to subjects without TMJ sounds.ABSTRACT
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DOI: 10.2319/041113-277.1
To compare three-dimensional tooth movements resulting from relatively higher and lower stresses in a split-mouth design. Eight volunteers whose maxillary first premolars were removed for orthodontic treatment participated. Each subject's maxillary canines were retracted by randomly assigned constant stresses of 78 kPa and 4 kPa via segmental mechanics. Dental casts depicting 8–10 visits per subject over 84 days and a three-axis microscope were used to measure movements serially. Descriptive statistics and mixed linear modeling were applied for data analyses (α = .05). Teeth moved by 78 kPa had significantly faster (P = .0005) distal movement (0.066 ± 0.020 mm/day) compared to teeth moved by 4 kPa (0.031 ± 0.012 mm/day). Lateral movement and distopalatal rotation were also significantly faster (fourfold and 10-fold, respectively) with higher than with lower stress (P < .0001). Average extrusion-intrusion, crown torque, and tip were small (≤ |0.25| mm, |2.29|°, and |1.98|°, respectively), fluctuated, and not significantly different between high and low stresses. No lag phase of tooth movement was evident. Maxillary canines were retracted faster by 78 kPa than by 4 kPa. Controlled translation was possible with 4 kPa, but 78 kPa outstripped appliance constraints, causing distopalatal rotation.ABSTRACT
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DOI: 10.2319/040413-262.1
To reassess the inclination of lower incisors and evaluate possible associations with gender, age, symphyseal parameters, and skeletal pattern. Twelve hundred and seventy-two (605 females, 667 males) cephalograms of untreated subjects of a craniofacial growth study (age: 8–16 years) were evaluated. Correlations between the angulation of the lower incisors and age, symphyseal distances (height, width, and depth), symphyseal ratios (height-width, height-depth), and skeletal angles (divergence of the jaws and gonial angle) were investigated for all ages separately and for both sexes independently. The inclination of lower incisors increased over age (8 years: girls = 93.9° [95% CI, 92.3°–95.7°], boys = 93.3° [95% CI, 91.8°–94.9°]; 16 years: girls = 96.1° [95% CI, 94.1°–98.2°], boys = 97.1° [95% CI, 95.6°–98.6°]). Inclination of lower incisors correlated with the divergence of the jaws for all ages significantly or highly significantly, except for boys and girls 9 years of age and girls 11 and 12 years of age, for which only a tendency was observed. Similarly, a strong correlation to gonial angle could be observed. No correlation could be found between the inclination of lower incisors and any symphyseal parameters (absolute measurements and ratios), except for symphyseal depth. Lower incisor inclination is linked to the subject's sex, age, and skeletal pattern. It is not associated with symphyseal dimensions, except symphyseal depth. Factors related to natural inclination of lower incisors should be respected when establishing a treatment plan.ABSTRACT
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DOI: 10.2319/012813-85.1
To investigate differences in the gingival crevicular fluid (GCF) composition between adolescent and adult patients undergoing orthodontic treatment with fixed appliances. Ten adolescents (14.4 ± 1.43) and 10 adults (28.5 ± 7.83) with Class I malocclusions and minor upper incisor crowding were allocated to two different age groups. Brackets were bonded only in the upper arch over the 20-week period of the experiment. Samples of GCF were collected from the labial sides of the upper incisors (experimental sites) and lower incisors (control sites) of each subject at five time points. Aliquots from diluted GCF were screened for the presence of receptor activator of nuclear factor kappa B ligand (RANKL), osteoprotegerin (OPG), interleukin-1 (IL-1), interleukin-1 receptor antagonist (IL-1RA), and metalloproteinase-9 (MMP-9) using a microarray technique. The values were statistically analyzed. In adults, the ratio of IL-1 to IL-1RA decreased significantly (P = .033) in experimental sites 3 weeks after appliance placement and first archwire activation. In adolescents, the ratio of RANKL to OPG peaked 6 weeks after the insertion of the first rectangular archwire. This ratio peak found in adolescents was a consequence of a decrease in the mean concentration of OPG. No significant changes over time were observed in the concentration of MMP-9. This study demonstrates age trends in the GCF levels of IL-1, IL-1RA, RANKL, and OPG that may be used to track differences in tissue response between adults and adolescents undergoing orthodontic treatment.ABSTRACT
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DOI: 10.2319/040813-271.1
To evaluate the changes of mini-implant stability over the initial healing period in humans. A sample of 19 consecutively treated patients (mean age 15.5 ± 7.3 years) was examined. In each patient, a mini-implant of a size of 2 × 9 mm was inserted into the anterior palate. Implant stability was assessed using resonance frequency analysis (RFA) immediately after insertion (T0), 2 weeks later (T1), 4 weeks later (T2), and 6 weeks later (T3). Insertion depth (ID) and the maximum insertion torque (IT) were measured. Data were tested for correlations between RFA, ID, and IT. All RFA values were tested for statistically significant differences between the different times. The mean ID was 7.5 ± 0.6 mm, and the mean IT was 16.8 ± 0.6 Ncm. A correlation was found between RFA and ID (r = .726, P < .0001), whereas no correlations between RFA and IT or between IT and ID were observed. From T0 to T1, the stability (36.1 ± 6.1 implant stability quotient [ISQ]) decreased nonsignificantly by 4.9 ± 6.1 ISQ values (P > .05). Between T1 and T2, the stability decreased highly significantly (P < .001) by 7.9 ± 5.9 ISQ values. From T2 on, RFA remained nearly unchanged (−1.7 ± 3.5 ISQ; P > .05). Mini-implant stability is subject to changes during the healing process. During weeks 3 and 4, a significant decrease of the stability was observed. After 4 weeks, the stability did not change significantly.ABSTRACT
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DOI: 10.2319/040113-250.1
To determine the effect of mode of ligation and bracket material on resistance to sliding (RS) by comparing various esthetic brackets of conventionally ligated and self-ligating (SL) designs under an increasing applied moment in the second-order dimension. Eight different commercially available esthetic brackets of SL and conventional elastomeric-ligated (CL) designs were mounted on a testing apparatus to simulate canine retraction using sliding mechanics and the application of a moment on 0.019″×0.025″ stainless steel archwire. The samples examined were the CL brackets Clarity™, Inspire Ice™, SpiritMB™, and Mystique™, and the SL brackets ClaritySL™, In-OvationC™, In-OvationR™, and Smartclip™. The RS at calculated moments of 2000 g-mm and 4000 g-mm was determined and compared between the various brackets. Descriptive measures and one-way analysis of variance were used to calculate means and statistical differences among the bracket types. The CL monocrystalline bracket displayed significantly greater (P < .05) RS than all other brackets tested. Among the other brackets, the range of RS values was 145.8–191.7 g and 291.9–389.2 g at moments of 2000 g-mm and 4000 g-mm, respectfully, though these differences were not significant (P < .05). All brackets tested displayed greater levels of RS (P < .05) at 4000 g-mm than at 2000 g-mm. With the exception of the CL monocrystalline bracket, all brackets displayed comparable amounts of RS regardless of mode of ligation or bracket slot material.ABSTRACT
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DOI: 10.2319/113012-911.1
To evaluate the release of metal ions from fixed orthodontic appliances. A new system for in vitro testing of dental materials was constructed and consisted of a thermostatic glass reactor that enabled immersion of the studied material. Experimental conditions reflected the human oral cavity, with a temperature of 37°C and a saliva flow rate of 0.5mL/min. The simulated fixed orthodontic appliance made of stainless steel was evaluated. Sampling was performed at several time points during the 28-day study, and the metal ion concentration was determined by inductively coupled plasma optical emission spectrometry. The total mass of released metal ions from the appliance during 4 weeks of the experiment was as follows nickel 18.7 μg, chromium 5.47 μg, copper 31.3 μg. The estimated doses of nickel, chromium, and copper determined by extrapolation of experimental data released during the treatment period were far below the toxic dose to humans. This shows that orthodontic treatment might not be a significant source of exposure to these metal ions.ABSTRACT
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DOI: 10.2319/021713-138.1
To compare the archwires inserted during the final stages of the orthodontic treatment with the generated moments at 0.018- and 0.022-inch brackets. The same bracket type, in terms of prescription, was evaluated in both slot dimensions. The brackets were bonded on two identical maxillary acrylic resin models, and each model was mounted on the orthodontic measurement and simulation system. Ten 0.017 × 0.025-inch TMA and ten 0.017 × 0.025-inch stainless steel archwires were evaluated in the 0.018-inch brackets. In the 0.022-inch brackets, ten 0.019 × 0.025-inch TMA and ten 0.019 × 0.025-inch stainless steel archwires were measured. A 15° buccal root torque (+15°) and then a 15° palatal root torque (−15°) were gradually applied to the right central incisor bracket, and the moments were recorded at these positions. A t-test was conducted to compare the generated moments between wires within the 0.018- and 0.022-inch bracket groups separately. The 0.017 × 0.025-inch archwire in the 0.018-inch brackets generated mean moments of 9.25 Nmm and 14.2 Nmm for the TMA and stainless steel archwires, respectively. The measured moments in the 0.022-inch brackets with the 0.019 × 0.025-inch TMA and stainless steel archwires were 6.6 Nmm and 9.3 Nmm, respectively. The 0.017 × 0.025-inch stainless steel and β-Ti archwires in the 0.018-inch slot generated higher moments than the 0.019 × 0.025-inch archwires because of lower torque play. This difference is exaggerated in steel archwires, in comparison with the β-Ti, because of differences in stiffness. The differences of maximum moments between the archwires of the same cross-section but different alloys were statistically significant at both slot dimensions.ABSTRACT
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Clinical bond failure rates of adhesive precoated self-ligating brackets using a self-etching primer
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DOI: 10.2319/022013-149.1
To comparatively assess the failure rate of adhesive precoated (APC) self-ligating metal brackets bonded with two different enamel surface preparation techniques: self-etching primer (SEP) and conventional two-step etch and primer method (CM). Fifty-seven patients with complete permanent dentition were included in this study. A total of 1140 APC self-ligating brackets (3M Unitek, Monrovia, Calif) were bonded using a split-mouth design. For each patient, SEP (Transbond Plus SEP, 3M Unitek) and CM (37% phosphoric acid) were used in alternate quadrants. All brackets were bonded by the same investigator after pumicing and rinsing of all of the teeth. The number, site, and date of first-time bracket failures were monitored throughout orthodontic treatment (mean, 22 months). The survival rates of the brackets were estimated by Kaplan-Meier and log-rank tests (P < .05). The adhesive remnant index was used to determine the bond failure interface. The bond failure rates were 2.97% and 2.18% for the CM and SEP, respectively. No statistically significant difference in failure rates was found between the groups. The bond failure sites were predominantly at the enamel-adhesive interface in both groups. This long-term in vivo study showed that the combined use of SEP and the APC bracket system can be used effectively for bonding brackets after pumicing the enamel surfaces in clinical orthodontics.ABSTRACT
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DOI: 10.2319/012413-75.1
To examine the ability of a removable thermoplastic appliance (RTA) to adsorb hygienic solutions and inhibit bacterial growth and to examine the efficacy of three hygiene protocols in reducing bacterial biofilm adherence to RTA. Solution adsorption and bacterial growth inhibition were examined in vitro using paper vs RTA discs. Subsequently, 11 patients treated with RTA (mean age, 29.1 ± 4.7 years) were assigned into a sequence of three hygiene protocols: regular RTA brushing (baseline), immersion RTAs in chlorhexidine mouthwash (CHX), and using a vibrating bath with cleaning solution (VBC). For each patient, 12 upper RTAs were examined (2 baseline RTAs, 5 CHX RTAs, and 5 VBC RTAs), for a total of 132 RTAs. All RTAs were stained with gentian violet, and biofilm presence was measured using a photodensitometer. The RTA discs did not adsorb CHX or cleaning solution. The later agent did not show antibacterial features. Baseline RTAs showed significant biofilm adherence (P < .001) on the posterior palatal side of the aligner and on the anterior incisal edge. CHX and VBC hygienic protocols significantly (P < .001) reduced baseline biofilm adherence by 16% and 50%, respectively. Hygienic improvement was maintained over 140 days when CHX and VBC were used. However, VBC was three times more efficient than CHX. This study highly recommends the use of a VBC protocol. Biofilm deposits on the RTA, especially on incisal edges and attachment dimples, could lead to inadequate tooth/RTA and attachment/RTA overlap and consequently impair tooth alignment.ABSTRACT
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DOI: 10.2319/012313-73.1
To determine the influence of two adhesion boosters on shear bond strength and on the bond failure location of indirectly bonded brackets. Sixty bovine incisors were randomly divided into three groups (n = 20), and their buccal faces were etched using 37% phosphoric acid. In group 1 (control), brackets were indirectly bonded using only Sondhi adhesive. In groups 2 and 3, the adhesion boosters Enhance Adhesion Booster and Assure Universal Bonding Resin, respectively, were applied before bonding with Sondhi. Maximum bond strength was measured with a universal testing machine, and the location of bond failure was evaluated using the Adhesive Remnant Index (ARI). One-way analysis of variance followed by the Tukey test (P < .05) was used to compare the shear bond strength among groups, and the differences in ARI scores were evaluated using the Kruskal-Wallis test (P < .05). The Pearson correlation coefficient was calculated to determine whether there was any correlation between bond strength and ARI scores. The mean shear bond strength in group 3 was significantly higher (P < .01) than in the other groups. Evaluation of the locations of bond failure revealed differences (P < .05) among the three groups. There was a moderate correlation between bond strength and ARI scores within group 3 (r = 0.5860, P < .01). In vitro shear bond strength was acceptable in all groups. The use of the Assure adhesion booster significantly increased both the shear bond strength of indirectly bonded brackets and the amount of adhesive that remained on the enamel after bracket debonding.ABSTRACT
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DOI: 10.2319/030313-179.1
To quantitatively analyze the surface roughness of the slot floors of three types of modern plastic brackets and to measure static frictional force during sliding mechanics in vitro. Control groups comprised stainless steel brackets and monocrystalline ceramic brackets. Test groups comprised three types of 0.022-in slot, Roth prescription, plastic, maxillary right central incisor brackets. Test groups included glass fiber-reinforced polycarbonate, filler-reinforced polycarbonate, and hybrid polymer with inserted metal slot brackets. The static frictional resistance caused by sliding movements with an archwire (stainless steel) in vitro was quantitatively analyzed. Both scanning electron microscope and three-dimensional optical surface profiling were used. Scanning electron microscope and three-dimensional optical surface profiler revealed that all as-received brackets had irregular slot floor surfaces, and both irregularity and roughness increased after the archwire sliding test. The ceramic brackets in the control group showed significantly lower surface roughness values and higher frictional values during the archwire sliding test compared with the other brackets. The glass or filler-reinforced plastic brackets exhibited significantly higher static frictional values than the metallic slot type brackets (P < .001). The hybrid polymer with inserted metal slot brackets showed relatively lower surface roughness and frictional values compared with the stainless steel control bracket. Glass or filler-reinforced plastic brackets showed higher frictional resistance than metallic slot–type brackets. A plastic bracket with inserted metal slot may be the best choice among plastic brackets for low frictional resistance and to avoid damage from sliding movements of the archwire.ABSTRACT
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Letters From Our Readers
The authors of this article are to be congratulated on their efforts to develop a validated measure to assess pain in orthodontic patients. However, I believe that the expert panels involved in evaluating the face and content validity of the questionnaire should not have consisted only of clinicians (although some were undergoing or had recently undergone orthodontic treatment). Surely the relevant experts are young people, in the intended age range for the questionnaire, who are wearing fixed appliances. The experiences of these ‘real experts’ should ideally be sought at all stages of questionnaire development.To: Editor, The Angle Orthodontist
DDS., MSc., PhD., CDABO, Leo A. Rogers Chair
Thank you for sharing the letter with comments from Dr. Philip Benson. His comments are appreciated and he offers good suggestions to better the current Modified McGill Pain Questionnaire-Short Form (MMPQ-SF11) for adolescent orthodontic patients in future. We are in agreement with him and this is reflected in the Discussion section of our paper, see p. 911: “…Nevertheless, the current study had limitations that should be addressed in future studies. For example, a next step to further validate the MMPQ-SF11 as an age appropriate instrument to measure pain would be an assessment of face validityTo: Editor, The Angle Orthodontist
Academic Opportunities
This listing of academic opportunities is provided as a free service to the profession and the community. Rank: Orthodontic Instructor and Pre-Doctoral Researcher Indiana University School of Dentistry Department of Orthodontics and Oral Facial Genetics 1121 W. Michigan St., DS 102, Indianapolis, IN 46202 Contact: Office of Faculty Affairs, dsexecaf@iupui.edu Rank: Associate/Full Professor, Full-time, Tenure Track/Tenured. Require: DDS/DMD w/MS in orthodontics or certificate MS and PhD from CDA/ADA accredited school. ABO preferred/Board eligible and slated for the exam. Tufts University School of Dental Medicine Apply: Carroll Ann Trotman, BDS, MA, MS Professor and Chair, Department of Orthodontics TuftsINDIANA
Reviewers
The continuing excellence of The Angle Orthodontist is a result of the devotion and outstanding dedication of our world-wide group of reviewers. Our volunteer reviewers give generously of their time to advance the science of orthodontics. We are all grateful for their contributions to the ever improving quality of care to our patients and scientific advancement. If our cut-off dates exclude anyone, we apologize and are indebted to each and every one of our reviewers. Hussam Abdel-Kader Yasser Abdelnaby Mostafa Abtahi ES Abu Alhaija Zeynep Acar Marc Ackerman Sai Adusumilli Sug-Joon Ahn Hyo-Won Ahn Farzaneh Ahrari Emmanuel Ajayi Mehmet Akcam
Author Index
Abramovitz I. (see Becker A. et al.) 2013;83:870–876. Abu Alhaija E.S. (see Al-Khateeb S. et al.) 2013;83:259–265. Acar A. (see Panou E. et al.) 2013;83:824–831. Ackerman M.B., Six keys for making orthodontics a sustainable dental specialty. 2013;83:1102–1103. Ademci E. (see Sağır S. et al.) 2013;83:973–980. Ahluwalia K.S. (see Kohda N. et al.) 2013;83:476–483. Ahluwalia R. (see Singh B. et al.) 2013;83:468–475. Ahn H.W., Cho I.S., Cho K.C., Choi J.Y., Chung J.W., Baek S.H., Surgical treatment modality for facial esthetics in an obstructive sleep apnea patient with protrusive upper lip and acute nasolabial angle. 2013;83:355–363. Ahn H.W., Moon S.C., BaekA
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eISSN: 1945-7103 | ISSN: 0003-3219
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