It is well known that orthodontic force application induces aseptic local inflammation due to necrosis in the periodontal ligament (PDL) and that there is no tooth movement without this inflammation process. It is also well known that the inflammation process is important for both the bone as well as the cementum remodeling processes.1–5 If we consider these well-known phenomena together, we can name the process related to orthodontic tooth movement, as well as the Inflammatory Root Resorption Concurrent with Orthodontics (IRRCWO),6 as “Orthodontitis”. Orthodontitis, then, is the inflammation behind tooth movement, where the prefix
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DOI: 10.2319/062113-466
To compare the time efficiency of aligner therapy (ALT) and conventional edgewise braces (CEB) based on large samples of patients treated by the same highly experienced orthodontist, with the same treatment goals for both groups of patients. The retrospective portion of the study evaluated 150 CEB patients who were matched, based on mandibular crowding and number of rotated teeth, to 150 ALT patients. All records were obtained at one orthodontist's office. All of the patients had mild-to-moderate Class I malocclusions (≤5 mm incisor crowding) and were treated nonextraction. Age, gender, total treatment time, total number of appointments, types of appointments, materials used, mandibular crowding, and number of rotated teeth were recorded from the patients' records. The prospective portion of the study timed the various types of appointments for both treatments with a stopwatch. Compared to ALT, CEB required significantly (P < .01) more visits (approximately 4.0), a longer treatment duration (5.5 months), more emergency visits (1.0), greater emergency chair time (7.0 minutes), and greater total chair time (93.4 minutes). However, ALT showed significantly (P < .01) greater total material costs and required significantly more total doctor time than CEB (P < .01). Whether the greater time efficiency of ALT offsets the greater material costs and doctor time required depends on the experience of the orthodontist and the number of ALT case starts.ABSTRACT
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DOI: 10.2319/071113-507.1
To analyze the types of articles and authorship characteristics of three orthodontic journals—American Journal of Orthodontics and Dentofacial Orthopedics (AJODO), The Angle Orthodontist (AO), and European Journal of Orthodontics (EJO)—published between 2008 and 2012 and to assess the differences in content within this period and an earlier period of 1998 to 2002. Each journal's content was accessed through the web edition. From each article, the following parameters were recorded: article type, number of authors, number of affiliations, source of article (referring to the first author's affiliation), and geographic origin. Descriptive statistics were performed and selected parameters were analyzed with the Pearson chi-square or Fisher exact test for independence at the .05 level of significance. Review of differences between the two periods showed that the number of publications was almost double. The percentages of multi-authored articles increased. Fewer studies derived from the United States/Canada and European Union countries. Increases for articles from non–European Union countries, Asia, and other countries were found. Characteristics of the second period showed that the EJO and AO published more research articles, whereas the AJODO regularly published case reports and other articles. Approximately 75% of all studies derived from orthodontic departments. The publications from 1998–2002 and 2008–2012 were significantly different both in terms of numbers and characteristics. Within 2008–2012 there were notable differences between the three journals concerning the type and origin of the publications.ABSTRACT
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DOI: 10.2319/071113-510.1
To evaluate parents' preferences regarding the appearance and attire of orthodontists. Parents attending their child's first orthodontic appointment were asked to choose from among sets of photographs of potential orthodontic providers. Selected factors were varied within the sets, including sex and age of the provider as well as attire (casual, formal, white coat, or scrubs), hairstyle (loose or tied back for women, facial hair or clean shaven for men), and presence of a nametag. A total of 77 parents participated. There were significant differences in choice of provider in terms of the provider's sex (P < .0001), age (P = .0013), dress (P < .0001), hair (P < .0001), and nametag (P = .0065). There were no significant differences in preference attributable to parent characteristics (P > .05). Parents of orthodontic patients demonstrated clear preferences for choosing a provider related to factors that are not within the control of the practitioner (sex and age) as well as factors that can be changed by the practitioner (attire, hairstyle, and wearing a nametag).ABSTRACT
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DOI: 10.2319/071513-516.1
To establish an objective method for evaluating facial attractiveness from a set of orthodontic photographs. One hundred eight malocclusion patients randomly selected from six universities in China were randomly divided into nine groups, with each group containing an equal number of patients with Class I, II, and III malocclusions. Sixty-nine expert Chinese orthodontists ranked photographs of the patients (frontal, lateral, and frontal smiling photos) before and after orthodontic treatment from “most attractive” to “least attractive” in each group. A weighted mean ranking was then calculated for each patient, based on which a three-point scale was created. Procrustes superimposition was conducted on 101 landmarks identified on the photographs. A support vector regression (SVR) function was set up according to the coordinate values of identified landmarks of each photographic set and its corresponding grading. Its predictive ability was tested for each group in turn. The average coincidence rate obtained for comparisons of the subjective ratings with the SVR evaluation was 71.8% according to 18 verification tests. Geometric morphometrics combined with SVR may be a prospective method for objective comprehensive evaluation of facial attractiveness in the near future.ABSTRACT
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DOI: 10.2319/061213-443.1
To study the effect of water storage on the bending properties of fiber-reinforced composite archwires and compare it to nickel-titanium (NiTi), stainless steel (SS), and beta-titanium archwires. Align A, B, and C and TorQ A and B composite wires from BioMers Products, 0.014-, 0.016, and 0.018-inch, and 0.019 × 0.025-inch NiTi, 0.016-inch SS, and 0.019 × 0.025-inch beta-titanium archwires were tested (n = 10/type/size/condition). A 20-mm segment was cut from each end of the archwire; one end was then stored in water at 37°C for 30 days, while the other was stored dry. The segments were tested using three-point bending to a maximum deflection of 3.1 mm with force monitored during loading (activation) and unloading (deactivation). Statistical analysis was completed via two-way analysis of variance with wire and condition (dry and water-stored) as factors. In terms of stiffness and force delivery during activation, in general: beta-titanium was > TorQ B > TorQ A > 0.019 × 0.025-inch NiTi and 0.016-inch SS > Align C > 0.018-inch NiTi > Align B > 0.016-inch NiTi > Align A > 0.014-inch NiTi. Water exposure was detrimental to the larger translucent wires (Align B and C, TorQ A and B) because they were more likely to craze during bending, resulting in decreased forces applied at a given deflection. Align A and the alloy wires were not significantly (P > .05) affected by water storage. Overall, the alloy wires possessed more consistent force values compared to the composite wires. Environmental conditions are more likely to affect fiber-reinforced composite archwires compared to alloy wires.ABSTRACT
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DOI: 10.2319/032813-244.1
To investigate the relationship between primary dysmenorrhea (PD) and orthodontic pain in female patients, and to test the hypothesis that the intensity and duration of orthodontic pain could be roughly predicted by severity of PD. One hundred twenty college females were enrolled and put into one of three groups—mild (Mi), moderate (Mo), or severe (S)—according to level of menstrual pain. Intensity of the orthodontic pain was measured by visual analog scale (VAS) on days 1, 2, 4, 7, 14, and 28 after archwire placement. As the intensity of orthodontic pain declined with time, the three groups demonstrated different changes during the initial week. Mi had the lowest VAS scores, whereas S possessed the highest scores. In contrast, Mo stayed in between. Significantly positive correlations were found between the severity of PD and the intensity of orthodontic pain at each time point within the first 2 weeks. In addition, though the majority of subjects reported disappearance of pain by the end of the second week in both Mi and Mo, a large proportion of females still perceived pain in S. Females with higher levels of menstrual pain tended to perceive orthodontic pain with higher intensity and more prolonged duration. Thus, PD could potentially serve as a reference to predict orthodontic pain in clinical settings.ABSTRACT
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DOI: 10.2319/051313-371.1
To clinically evaluate the prevalence of buccal caries and white spot lesions (WSLs) at debonding in governmental and private orthodontic patients, using the International Caries Detection and Assessment System (ICDAS-II) and the DIAGNOdent Pen, and to study the correlation between the two methods. A cross-sectional study was carried out on the nonextracted premolars and anterior teeth of 89 orthodontic patients. They were recruited into two groups based on the treatment center they attended: governmental group (G; n = 45) and private group (P; n = 44). Immediately after debonding, the examination of buccal caries and WSLs on premolars and anterior teeth was carried out using the ICDAS-II and the DIAGNOdent Pen. Cross-tabulation was applied to study the correlation between the ICDAS-II index and the DIAGNOdent Pen by calculating the Spearman correlation coefficient. The G group showed a significantly higher (P < .0001) prevalence of WSLs and/or buccal caries compared to that of the P group based on evaluation by the two methods. Based on ICDAS-II, 43% of the patients in the P group and 9% in the G group were free from any WSLs. In the G group, 22% of the patients had ≥16 lesions, whereas there were none for the P group. The Spearman correlation coefficient between the two methods was .71. The prevalence of caries and/or WSLs at debonding was significantly higher in the G group compared to the P group. The clinical index (ICDAS-II) showed a good correlation with the DIAGNOdent Pen.ABSTRACT
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DOI: 10.2319/061513-451.1
To assess the reproducibility of cephalometric measurements performed with software for a tablet, with a program for personal computers (PCs), and manually. The pretreatment lateral cephalograms of 20 patients that were acquired using the same digital cephalometer were collected. Tracings were performed with NemoCeph for Windows (Nemotec), with SmileCeph for iPad (Glace Software), and by hand. Landmark identification was carried out with a mouse-driven cursor using NemoCeph and with a stylus pen on the iPad screen using SmileCeph. Hand tracings were performed on printouts of the cephalograms, using a 0.3-mm 2H pencil and a protractor. Cephalometric landmarks and linear and angular measurements were recorded. All the tracings were done by the same investigator. To evaluate reproducibility, for each cephalometric measurement the agreement between the value derived from NemoCeph, that given by SmileCeph and that measured manually was assessed with the intraclass correlation coefficient (ICC). Agreement was rated as low for an ICC ≤0.75, and an ICC > 0.75 was considered indicative of good agreement. Also, differences in measurements between each software and manual tracing were statistically evaluated (P < .05). All the measurements had ICC >0.8, indicative of a high agreement among the tracing methods. Relatively lower ICCs occurred for linear measurements related to the occlusal plane and to N perpendicular to the Frankfurt plane. Differences in measurements between both software programs and hand tracing were not statistically significant for any of the cephalometric parameters. Tablet-assisted, PC-aided, and manual cephalometric tracings showed good agreement.ABSTRACT
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DOI: 10.2319/051213-365.1
To compare the accuracy of measurements obtained from the three-dimensional (3D) laser scans to those taken from the cone-beam computed tomography (CBCT) scans and those obtained from plaster models. Eighteen different measurements, encompassing mesiodistal width of teeth and both maxillary and mandibular arch length and width, were selected using various landmarks. CBCT scans and plaster models were prepared from 60 patients. Plaster models were scanned using the Ortho Insight 3D laser scanner, and the selected landmarks were measured using its software. CBCT scans were imported and analyzed using the Avizo software, and the 26 landmarks corresponding to the selected measurements were located and recorded. The plaster models were also measured using a digital caliper. Descriptive statistics and intraclass correlation coefficient (ICC) were used to analyze the data. The ICC result showed that the values obtained by the three different methods were highly correlated in all measurements, all having correlations >0.808. When checking the differences between values and methods, the largest mean difference found was 0.59 mm ± 0.38 mm. In conclusion, plaster models, CBCT models, and laser-scanned models are three different diagnostic records, each with its own advantages and disadvantages. The present results showed that the laser-scanned models are highly accurate to plaster models and CBCT scans. This gives general clinicians an alternative to take into consideration the advantages of laser-scanned models over plaster models and CBCT reconstructions.ABSTRACT
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DOI: 10.2319/060513-427.1
To evaluate the effects of sliding velocity on friction, particularly at extremely low sliding velocity approximating orthodontic tooth movement. Stainless-steel (SS) 0.022-inch preadjusted brackets and 0.016- and 0.016 × 0.022-inch SS wires and superelastic nickel-titanium 0.016 × 0.022-inch wires were used for this test. The wire was secured in a SS preadjusted bracket with an elastomeric module. One end of the wire was pulled upward 1.5 mm at a speed of 5.0 × 10−7, 1.0 × 10−5, 1.0 × 10−4, 1.0 × 10−3, 1.0 × 10−2, and 1.0 × 10−1 mm/s by the micrometer. The measurements were conducted 10 times and averaged. Tukey-Kramer tests were used to compare the mean differences of each testing measurement among the different sliding velocities. The frictional forces tended to increase as the sliding velocity decreased. The mean frictional force for 5.0 × 10−7 mm/s sliding velocity (approximating orthodontic tooth movement) was 106.8 cN in 0.016 × 0.022-inch SS wires, almost double the 1.0 × 10−1 mm/s sliding velocity. The effects of sliding velocity cannot be ignored when we estimate frictional forces in clinical orthodontics.ABSTRACT
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DOI: 10.2319/070913-502.1
To assess the inter- and intraexaminer reliability of a measurement method for evaluation of eruption angles and position of palatal displaced canines (PDCs) with cone-beam computed tomography (CBCT) images and to test the validity of the measured angles on a dry skull. Twenty patients (eight boys, 12 girls; age 11.4 ± 1.2 years) were randomly chosen among 67 patients from a study evaluating the interceptive effect of extracting the deciduous canine in children with PDCs. In total, 60 images were analyzed, because each patient had three CBCT examinations (baseline, 6-month control, and endpoint). Two observers assessed the following measurements twice: mesioangular and sagittal angle, vertical position, canine cusp tip, and canine apex to dental arch. The validity of the angular measurements was tested against angular measurements on a dry skull using mathematical formulations. The inter- and intraexaminer mean differences for angular and linear measurements were all low and statistically insignificant (P > .05). The mean differences between the physical and 3D measurements were 0.5 ± 0.39 mm for the sagittal angle and 0.22 ± 0.19 mm for the mesioangular angle. Linear and angular measurements on CBCT images are accurate and precise and can be used to assess the precise position of a PDC.ABSTRACT
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DOI: 10.2319/070913-503.1
To assess the prevalence of malocclusion and treatment need in children and adolescents with sickle cell disease (SCD). In this cross-sectional study, the sample size comprised 35 five-year-old children and 36 adolescents of both sexes, aged between 12 to 18 years, with SCD. Dental occlusion was assessed using two indexes: the Malocclusion Index (World Health Organization) and the Dental Aesthetic Index (DAI). The prevalence of malocclusion in the preschool children was 62.9%. The main malocclusions observed in this age group were Class II (37.1%), increased overjet (28.6%), reduced overbite (28.6%), and open bite (17.1%). In the 12- to 18-year-old subjects, the prevalence of malocclusion was 100%, and the most prevalent types of malocclusion were maxillary overjet (63.9%) and maxillary misalignment (58.3%). It is noteworthy that the majority of adolescents (80.6%) had very severe or disabling malocclusions. The results revealed a high prevalence of malocclusion in children and adolescents with SCD. According to DAI score, the majority of the sample presented with very severe malocclusion and a compulsory treatment need.ABSTRACT
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DOI: 10.2319/042013-307.1
To analyze the effect of protein restriction on histomorphometric parameters of bone remodeling in mandibular condyle process and its possible influence in facial development in growing rats. Wistar rats weaned at the age of 21 days were assigned to one of the following groups: control (fed a regular hard diet ad libitum) and protein restricted (PR) (fed a hard diet lacking in protein ad libitum). The animals were euthanized on day 35 after the onset of the experiment. Mandibles were resected, fixed in 10% formalin, hemisected at the symphysis, and then radiographed in order to perform cephalometric studies of the condylar process length and the height of the lower alveolar process. Mandibles were then processed for light microscopy, and histomorphometric determinations were performed on histologic sections of the condylar process subchondral bone. The PR group showed a significantly lower body weight than control group at the end of the experiment. The length of the condylar process was lower in the PR group; however, the diet used in this study did not affect the height of the lower alveolar process. The histomorphometric analysis showed that the PR group exhibited a statistically significant decrease in bone formation and bone volume in condylar process subchondral bone. Protein restriction inhibits bone formation and longitudinal growth in the mandibular condylar process. This result suggest that protein restriction can alter normal facial development.ABSTRACT
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DOI: 10.2319/061913-461.1
To determine the effect of bracket type on halitosis, periodontal status, and microbial colonization. Forty-six patients scheduled for fixed orthodontic treatment (age 11–16 years) were selected from the orthodontic department of Suleyman Demirel University. Patients were divided into two groups with random distribution of brackets; 23 patients were treated with self-ligating brackets (group SLBs), the others with conventional brackets (group CBs). Halitosis measurements and periodontal and microbial records were obtained before the placement of brackets (T0), 1 week later (T1), and 5 weeks after bonding (T2). Periodontal parameters, including plaque index (PI), gingival index (GI), and bleeding on probing index (BOP), were obtained from all the bonded teeth. Halitosis measurements were performed at the same time. Microbial samples were obtained from the buccal surfaces of all the bonded teeth. Data were analyzed by using a repeated-measurement analysis of variance test for the comparison of parameters between groups and times. Periodontal parameters and halitosis results were higher in the CBs group than in the SLBs group (P < .05). In the SLBs group, halitosis and BOP values revealed no pronounced changes between T1 and T2 (P > .05). Intra- and intergroup comparisons showed that there were no statistically significant differences for microbial colonization between all the time intervals (P > .05). Bracket type has an effect on halitosis and periodontal status. Therefore, self-ligating brackets may be advised in order to prevent patients from developing halitosis and to increase the likelihood of good oral hygiene during orthodontic treatment.ABSTRACT
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DOI: 10.2319/072813-562.1
To investigate the common denominators of an esthetically pleasing smile in patients who were considered to be successfully treated upon the submission to American Board Orthodontics (ABO) clinical examination. A total of 462 patients were examined. Ninety subjects that fulfilled the inclusion criteria were included. Standardized digital smile photographs of the subjects were rated by 30 panel members, including orthodontists, general dentists, and parents of orthodontic patients, using a numeric version of the visual analog scale. Three groups were formed using the mean esthetic score ± standard deviation range: unattractive (n = 21), average (n = 47), and attractive (n = 22) smiles. Eleven smile characteristics were digitally measured on the photographs and compared between the groups using one-way analysis of variance and χ2 tests. Additionally, regression analyses were used to investigate the association of the smile characteristics with the esthetic score. A significant difference was found between the three groups for the comparison of smile arc relationship (P < .001). When all the variables used in this study were entered in the regression analysis, a positive association was found (r = 0.658; r2 = 0.434; P < .001). Additionally, two models were defined using stepwise regression. The first model included the smile arc (r = 0.478; r2 = 0.228; P < .001), and the second model had both the smile arc and right gingival display/visible dentition display ratio (r = 0.567; r2 = 0.321; P < .001). A harmonious smile arc relationship and less gingival display during a smile are significantly associated with smile attractiveness in patients considered successfully treated according to ABO standards.ABSTRACT
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DOI: 10.2319/072913-564.1
To quantify smile esthetics following orthodontic treatment and determine whether these changes are correlated to the severity of the initial malocclusion. A standardized smile mesh analysis that evaluated nine lip-tooth characteristics was applied to two groups of successfully treated patients: group 1 (initial American Board of Orthodontics Discrepancy Index [DI] score <20) and group 2 (initial DI score >20). T-tests were used to detect significant differences between the low-DI and high-DI groups for baseline pretreatment measurements, baseline posttreatment measurements, and changes from pre- to posttreatment. A Spearman correlation test compared the initial DI values with the changes in the nine smile measurements. Five of the smile measurements were improved in both groups following orthodontic treatment. Both groups demonstrated improved incisor exposure, an improved gingival smile line, an increase in smile width, a decreased buccal corridor space, and an improvement in smile consonance. Spearman correlation tests showed that initial DI value was not correlated to changes in any of the individual smile measurements. Smile esthetics is improved by orthodontic treatment regardless of the initial severity of the malocclusion. In other words, patients with more complex orthodontic issues and their counterparts with minor malocclusions benefitted equally from treatment in terms of their smile esthetics.ABSTRACT
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DOI: 10.2319/052513-39.1
To compare the primary stability of miniscrews inserted into bone blocks of different bone mineral densities (BMDs) with and without cortical bone, and investigate whether some trabecular properties could influence primary stability. Fifty-two bone blocks were extracted from fresh bovine pelvic bone. Four groups were created based on bone type (iliac or pubic region) and presence or absence of cortical bone. Specimens were micro-computed tomography imaged to evaluate trabecular thickness, trabecular number, trabecular separation, bone volume density (BV/TV), BMD, and cortical thickness. Miniscrews 1.4 mm in diameter and 6 mm long were inserted into the bone blocks, and primary stability was evaluated by insertion torque (IT), mini-implant mobility (PTV), and pull-out strength (PS). Intergroup comparison showed lower levels of primary stability when the BMD of trabecular bone was lower and in the absence of cortical bone (P ≤ .05). The Pearson correlation test showed correlation between trabecular number, trabecular thickness, BV/TV, trabecular BMD, total BMD, and IT, PTV, and PS. There was correlation between cortical thickness and IT and PS (P ≤ .05). Cancellous bone plays an important role in primary stability of mini-implants in the presence or absence of cortical bone.ABSTRACT
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DOI: 10.2319/073013-569.1
To investigate the microstructure, hardness, and electrochemical behavior of four contemporary Ag-based soldering alloys used for manufacturing orthodontic appliances. The Ag-based alloys tested were Dentaurum Universal Silver Solder (DEN), Orthodontic Solders (LEO), Ortho Dental Universal Solder (NOB), and Silver Solder (ORT). Five disk-shaped specimens were produced for each alloy, and after metallographic preparation their microstructural features, elemental composition, and hardness were determined by scanning electron microscopy with energy-dispersive X-ray (EDX) microanalysis, X-ray diffraction (XRD) analysis, and Vickers hardness testing. The electrochemical properties were evaluated by anodic potentiodynamic scanning in 0.9% NaCl and Ringer's solutions. Hardness, corrosion current (Icorr), and corrosion potential (Ecorr) were statistically analyzed by one-way analysis of variance and Tukey test (α = .05). EDX analysis showed that all materials belong to the Ag-Zn-Cu ternary system. Three different mean atomic contrast phases were identified for LEO and ORT and two for DEN and NOB. According to XRD analysis, all materials consisted of Ag-rich and Cu-rich face-centered cubic phases. Hardness testing classified the materials in descending order as follows: DEN, 155 ± 3; NOB, 149 ± 3; ORT, 141 ± 4; and LEO, 136 ± 8. Significant differences were found for Icorr of NOB in Ringer's solution and Ecorr of DEN in 0.9% NaCl solution. Ag-based soldering alloys demonstrate great diversity in their elemental composition, phase size and distribution, hardness, and electrochemical properties. These differences may anticipate variations in their clinical performance.ABSTRACT
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DOI: 10.2319/081413-600.1
To quantitatively determine the bisphenol-A (BPA) leached from orthodontic materials during simulated intraoral exposure. Samples of orthodontic materials were subjected to simulated abrasion, immersion in artificial saliva, thermal shock via temperature cycling, and simulated intraoral exposure. Sample aliquots were collected for up to 2 weeks after artificial saliva immersion, derivatized, then analyzed for BPA by gas chromatography/mass spectroscopy. Quantifiable amounts of leached BPA were observed from a thermoformed orthodontic retainer material (7.63 µg/g of material) and an orthodontic adhesive (2.75 µg/g of material). BPA leaching was only observed within the first 3 days of artificial saliva immersion. Under the test conditions, BPA was observed to leach from two orthodontic materials. While the quantities of leached BPA were below the reference dose for daily intake, existing data of low-dose effects and medical disorders associated with elevated urinary BPA levels suggest that BPA exposure, and thus the use of the leaching materials identified in this study, should be reduced or eliminated.ABSTRACT
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DOI: 10.2319/060313-423.1
To determine the levels of two sensory neuropeptides (substance P [SP] and calcitonin gene-related peptide [CGRP]) and two endogenous opioids (methionine-enkephalin [Met-Enk] and β-endorphin [β-End]) in dental pulp tissue samples subjected to controlled orthodontic intrusive forces. Sixteen healthy premolars were selected from eight patients who were undergoing extraction for orthodontic purposes. Eight were randomly used as controls, and the other eight were assigned to an experimental group (controlled orthodontic intrusive forces applied for 24 hours). After this period, teeth were extracted, and pulp samples were obtained. All samples were processed to quantify the expression levels of SP, CGRP, Met-Enk, and β-End using commercial radioimmunoassay kits. All samples exhibited basal levels of both neuropeptides and endogenous opioids. After 24 hours of the intrusive stimulus, all patients reported a tolerable discomfort localized at the involved premolar. Only SP was significantly increased (P < .05). For the other molecules, no statistically significant differences were observed (P > .05); however, they expressed important increasing trends. The expression levels of SP and CGRP in dental pulp samples from the experimental group support the positive correlation between the symptomatic clinical scenario and increased expression levels of neuropeptides, clarifying the role of neurogenic inflammation in early injury response.ABSTRACT
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DOI: 10.2319/070913-500.1
To assess the net dentofacial effects of the fixed lingual mandibular growth modificator (FLMGM). The study sample comprised 38 patients with Class II/1 malocclusion and retrognathic mandible. All were in the pubertal growth spurt. Whereas FLMGM was applied to the treatment group (n = 21, mean age = 13.2 years), no treatment was performed on the control group (n = 17, mean age = 12.5 years). Skeletal and dentoalveolar changes were assessed on digital lateral cephalograms obtained at the beginning and end of the treatment/observation period of 8 months. Paired and independent t-tests were used to assess the differences within and between groups. Maxillary growth was not affected by FLMGM treatment, which resulted in a significant overjet reduction of 4.1 mm, an increase in total mandibular length (Co-Gn) of 2.3 mm, chin advancement of 1.6°, and upper incisor retroclination of 4.0°. A reduction of 2.4° in ANB was largely due to an increase of 1.8° in SNB. Favorably, the lower incisors were obviously retroclined by 4.5°. The changes in the vertical skeletal relationships were negligible. FLMGM was effective in treating growing Class II/1 patients and produced favorable dentofacial effects, with the matched untreated sample showing minimal changes. Lower incisor retroclination was a benefit of FLMGM treatment.ABSTRACT
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DOI: 10.2319/051613-378.1
To identify the regenerating junctional epithelium (JE) during orthodontic tooth movement in rats. Closed-coil springs were used to create a 20 g mesial force to the maxillary first molars. On days 1, 3, 7, 10, and 14 after force application, histologic changes in JE were examined by immunohistochemistry using proliferating cell nuclear antigen (PCNA), odontogenic ameloblast-associated protein (ODAM), and cytokeratin 14 (CK14). On day 1, JE was destroyed and lost attachment to the tooth surface. Cell division activity was rarely observed in JE, and ODAM localization was weakly detected in damaged JE. By day 3, regenerating JE had not fully recovered. High cell proliferation activity and CK14 expression started to appear in most basal cells of JE. ODAM expression was reduced and appeared in a small area. By day 7, JE had almost recovered. Cell proliferation activity was still observed in several basal cells of JE, and ODAM expression was detected among JE cells. CK14 was hardly observed in JE except in the basal cells. By days 10 and 14, regenerated JE appeared. ODAM, PCNA, and CK14 expression was similar to that of the control. Damaged JE might recover rapidly during orthodontic tooth movement because basal cells of the remaining JE, which show higher proliferation activity, are involved in JE regeneration. Reduced ODAM expression during proliferation of JE cells may increase again after JE regeneration is complete. Therefore, ODAM may be associated with the normal function of JE.ABSTRACT
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DOI: 10.2319/060213-416.1
To evaluate how different bracket-slot design characteristics affect the forces released by superelastic nickel-titanium (NiTi) alignment wires at different amounts of wire deflection. A three-bracket bending and a classic-three point bending testing apparatus were used to investigate the load-deflection properties of one superelastic 0.014-inch NiTi alignment wire in different experimental conditions. The selected NiTi archwire was tested in association with three bracket systems: (1) conventional twin brackets with a 0.018-inch slot, (2) a self-ligating bracket with a 0.018-inch slot, and (3) a self-ligating bracket with a 0.022-inch slot. Wire specimens were deflected at 2 mm and 4 mm. Use of a 0.018-inch slot bracket system, in comparison with use of a 0.022-inch system, increases the force exerted by the superelastic NiTi wires at a 2-mm deflection. Use of a self-ligating bracket system increases the force released by NiTi wires in comparison with the conventional ligated bracket system. NiTi wires deflected to a different maximum deflection (2 mm and 4 mm) release different forces at the same unloading data point (1.5 mm). Bracket design, type of experimental test, and amount of wire deflection significantly affected the amount of forces released by superelastic NiTi wires (P < .05). This phenomenon offers clinicians the possibility to manipulate the wire's load during alignment.ABSTRACT
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DOI: 10.2319/042113-309.1
To determine if the shape of the oropharyngeal airway is related to the vertical morphology of the skeletofacial complex, including the hyoid bone. Cone beam computed tomography scans from 50 pretreatment adult orthodontic records were used to obtain skeletal and airway measurements. Linear regression statistics were used to compare soft tissue variables to hard tissue predictor variables. Transverse airway widening was significantly increased when the distance between the hyoid and vertebrae was reduced; when the three-dimensional (3D) facial axis angle decreased (became more vertical); when the 3D mandibular plane angle increased; when the width of the hyoid increased, or when the calculated length of the geniohyoid decreased. A laterally elliptical airway—found when the face is more vertical and when the hyoid is closer to the cervical vertebrae—is hypothetically more resistant to collapse. Patients with a retrognathic, skeletal deep bite and a rounded oropharynx should be identified and corrected early to prevent potential airway problems.ABSTRACT
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Review Article
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DOI: 10.2319/083013-636.1
To use a systematic review to determine which materials and technique/protocol present the highest success rate in bonding brackets to porcelain surfaces. Different databases were searched without limitations up to July 2013. Additionally, the bibliographies of the finally selected articles were hand searched to identify any relevant publications that were not identified earlier. In vitro and in vivo articles were included. No in vivo articles were found that fulfilled the inclusion criteria. A total of 45 in vitro articles met all inclusion criteria. They were published between 2000 to July 2013. The best protocol described in this review is the etching of 9.6% hydrofluoric acid for 1 minute, rinsed for 30 seconds, and then air-dried. The etching of hydrofluoric acid should be followed by an application of silane. Considering the harmful effects of etching with hydrofluoric acid, another appropriate suggestion is mechanical roughening with sandblasting followed by an application of silane.ABSTRACT
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Case Report
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DOI: 10.2319/070813-498.1
To present a patient treated with submerging autotransplantation (SA) of an immature premolar and subsequent orthodontic space closure (OSC) and to report a 10-year follow-up result. A 10-year-old boy had multiple missing premolars with an asymmetric pattern (maxillary right first and second premolars, teeth 14 and 15; maxillary left second premolar, tooth 25; and mandibular right second premolar, tooth 45). After considering several treatment options, tooth 35 with immature root development underwent SA into the missing site of tooth 15 at a depth 5 mm below the occlusal plane and was stabilized with sutures to create a symmetric missing condition of the premolars in the four quadrants. Three months after autotransplantation, spontaneous eruption of the transplanted tooth was observed. Nine months after autotransplantation, presence of the lamina dura of the transplanted tooth was confirmed with a periapical radiograph. Active orthodontic treatment was initiated to reduce lip protrusion by closing the missing spaces of teeth 14, 25, 35, and 45 and to correct dental midline deviation. After 33 months of active orthodontic treatment, Class I canine and molar relationships were obtained. During the 10-year follow-up, the pulp vitality of the transplanted tooth was maintained without any pathologic findings, including root resorption or pulp canal obliteration. In a patient with lip protrusion and multiple congenitally missing premolars with an asymmetric pattern, SA of one premolar from the normal quadrant into the quadrant missing two premolars with subsequent OSC of the missing sites of the other premolars can be an effective treatment modality.ABSTRACT
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Guest Editorial
Erratum
Vol. 84, No. 1, January 2014, page 190. “Reviewers for The ANGLE ORTHODONTIST For 2013” Angle Orthod. 2014;84:188–192. With apologies we noted that the name of Dr. Yaghma Masood was incorrectly listed as Mohd Masood in the listing of reviewers in 2013.
Letters From Our Readers
I would like to congratulate the authors of this article. It raises interesting issues regarding the relationship between malocclusion and quality of life, and how these affect orthodontic treatment. The assessment of OHRQoL has an important role to play in clinical practice. However, the patients' age, gender and economic class may affect the patients' responses to the questionnaire. In the paper, it was stated that most of the patients were from a high socioeconomic status. Were low socioeconomic status patients purposely excluded from the study? I think including patients from all socioeconomic statuses wouldTo: Editor, The Angle Orthodontist
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, and
We thank Dr. Zhou for the positive comments about our manuscript and agree that socioeconomic factors play an important role in the relationship between malocclusion and quality of life. As we aimed to recruit enough cases with severe and very severe malocclusion for comparison purposes, we opted to use a convenience sample of hospital volunteers. This sampling strategy allowed us to recruit a group that was homogenous in terms of socioeconomic background but not representative of the child population in the country. These points were all addressed at the end of the discussion inTo: Editor, The Angle Orthodontist
and
We read this paper with great interest. Thank you for examining the performance of removable thermoplastic appliances (RTA) evaluating different hygiene protocols. In the in vivo part of the study, the patients were each assigned the same three stage protocol: only brushing for 4 weeks, followed by brushing and chlorhexidine immersion (CHX) for 10 weeks, followed by a vibrating bath solution (VBC) for 10 weeks. Since patients' oral hygiene has been shown to change over the course of treatment with most getting worse over time and some better with more instruction, perhaps this would affectTo: Editor, The Angle Orthodontist
Dr,
Dr, and
Professor
Thank you for your enlightening remarks and questions regarding our article. Regarding patient hygiene effect on the experiment protocol: The study was undertaken for 24 weeks during which time 3 aligner hygiene protocols were examined. If indeed oral hygiene had deteriorated over this time span, aligners from week 0–4 would have accumulated less biofilm than those from week 14–24. Consequently, the VBC (examined from week 14 to 24) should have shown less cleaning efficacy than the regular aligner maintenance (examined during weeks 0–4). However, the opposite was found. This suggests that oral hygiene did notTo: Editor, The Angle Orthodontist
I would like to express my congratulations to the authors for publication of this article reporting the effects of long-term hypofunctional occlusion and its recovery on the morphology and PDL structure of rat molar roots. Various approaches have been used previously to create hypofunctional occlusal conditions in animals: extraction1 or occlusal reduction2 of the antagonist teeth, bite opening with composite resin on the occlusal surface of molars,3 or placing a metal cap on the incisors.4 The latter was used in this study because it is reversibleTo: Editor, The Angle Orthodontist
DDS., PhD
Thank you very much Dr. Zhao for your interest in our study. I would like to respond to the comments on this study. The distance between the first molars was analyzed in our study in the hypofunctional group (HG) at 16 weeks of age and the value was 1.8 ± 0.6 mm (n = 6). Also, a powdered diet (Rodent Diet CE-2; Japan CLEA Inc, Tokyo, Japan) was industrially selected by using mesh so that the diameter of granules was less than 100 µm. Moreover, Figure 8 in our article, which was a 3D reconstructed view, showedTo: Editor, The Angle Orthodontist
Academic Opportunities
This listing of academic opportunities is provided as a free service to the profession and the community. Rank: Post Graduate Director/Faculty rank commensurate with training & experience Require: DDS/DMD or equivalent; ABO certification; experience in academic and clinical supervision and teaching. MS Dent or PhD preferred. Nova Southeastern University College of Dental Medicine/Orthodontics 3200 South University Drive Fort Lauderdale, FL 3328-2018 Apply: www.nsujobs.com, job #992943 Addtl info contact: Dr. Abraham B. Lifshitz, email: al674@nova.edu Rank: Orthodontic Instructor and Pre-Doctoral Researcher Indiana University School of Dentistry Department of Orthodontics and Oral Facial Genetics 1121 W. MichiganFLORIDA
INDIANA
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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