One of the most challenging, yet at the same time, rewarding and enjoyable characteristics of orthodontics lies in being able to treat patients with seemingly similar presentations in a variety of ways. Nevertheless, one of the most frustrating features of present day orthodontics is the confusion arising from the conflicting differences of opinion that exist between members of the specialty. Every orthodontist must work to hone their clinical skills by keeping an open mind and using it to evaluate each patient in a clear, rational manner. Such evaluation requires exacting analysis based upon scientific knowledge and a keen clinical sense.
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DOI: 10.2319/111517-787.1
The cervical vertebral maturation (CVM) method is used to determine the craniofacial skeletal maturational stage of an individual at a specific time point during the growth process. This diagnostic approach uses data derived from the second (C2), third (C3), and fourth (C4) cervical vertebrae, as visualized in a two-dimensional lateral cephalogram. Six maturational stages of those three cervical vertebrae can be determined, based on the morphology of their bodies. The first step is to evaluate the inferior border of these vertebral bodies, determining whether they are flat or concave (ie, presence of a visible notch). The second step in the analysis is to evaluate the shape of C3 and C4. These vertebral bodies change in shape in a typical sequence, progressing from trapezoidal to rectangular horizontal, to square, and to rectangular vertical. Typically, cervical stages (CSs) 1 and CS 2 are considered prepubertal, CS 3 and CS 4 circumpubertal, and CS 5 and CS 6 postpubertal. Criticism has been rendered as to the reproducibility of the CVM method. Diminished reliability may be observed at least in part due to the lack of a definitive description of the staging procedure in the literature. Based on the now nearly 20 years of experience in staging cervical vertebrae, this article was prepared as a “user's guide” that describes the CVM stages in detail in attempt to help the reader use this approach in everyday clinical practice.ABSTRACT
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DOI: 10.2319/052117-344.1
To evaluate and compare two treatment protocols to correct anterior dental crossbite in the mixed dentition. Thirty children, 8–10 years of age, participated. Individuals were divided into two groups. Group 1 consisted of 15 children treated with an upper removable appliance with finger springs; group 2, 15 children treated by bonding resin-reinforced glass ionomer cement bite pads on the lower first molars. The 30 participants were evaluated before treatment (T1) and 12 months after treatment began (T2). The variables evaluated included overjet, perimeter of the maxillary arch, intercanine distances in the maxilla and mandible, SNA, SNB, ANB, and U1.NA. Data analysis included descriptive statistics, paired t-test and Student's t-test. Effect sizes and confidence intervals were also calculated. Group 1 showed a significant increase in overjet (P < .001), intercanine distance in the maxilla (P = .006), intercanine distance in the mandible (P = .031), and U1.NA (P = .002). Group 2 showed a significant increase in overjet (P = .008), intercanine distance in the mandible (P = .005), and U1.NA (P < .001). For all the evaluated variables, no statistically significant differences were observed between the two groups. No significant differences were observed between the two protocols: use of a removable maxillary biteplate with finger springs and bonding of resin-reinforced glass ionomer cement bite pads on the lower first molars, for the correction of anterior crossbite in the mixed dentition.ABSTRACT
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DOI: 10.2319/080817-532.1
The present study aimed to compare the amount of incisal tooth wear in the maxillary central incisors of patients with skeletal Class III malocclusion and anterior crossbite receiving one-phase or two-phase treatment. The hypothesis was that tooth wear would differ according to treatment modalities. Maxillary dental casts obtained before (T1) and after (T2) orthodontic treatment were divided into three groups. Group I consisted of casts from 21 patients (7 males, 14 females; mean age 9.8 years) who received two-phase treatment (maxillary protraction followed by fixed appliance therapy). Group II comprised casts from 37 patients who underwent orthodontic camouflage treatment for crossbite, subdivided according to age. Group IIa consisted of casts from 15 adolescents (8 males, 7 females; mean age 13.5 years), and group IIb consisted of casts from 22 adults (13 males, 9 females; mean age 24.5 years). Maxillary dental casts obtained at T1 and T2 were scanned. For each pair of digital images, T2 was superimposed on T1 using the best-fit method. Tooth wear was quantified and compared among groups. Significantly less tooth wear was observed in group I compared to groups IIa and IIb, but no difference was found between groups IIa and IIb. Spearman correlation analysis revealed no significant correlation between tooth wear and age, treatment duration, or craniofacial morphology. Despite the long duration of early treatment, it caused less wear of the maxillary central incisors than did orthodontic camouflage treatment.ABSTRACT
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DOI: 10.2319/042717-282.1
This study investigated the long-term vertical skeletal changes induced by facemask therapy in patients with Class III malocclusion and different vertical skeletal patterns. A total of 54 patients (20 boys and 34 girls; mean age, 7.7 ± 2.0 years) with Class III malocclusion who were successfully treated with facemask therapy were included in this study. Vertical skeletal changes (overbite depth indicator, angle between the Sella-Nasion (SN) plane and Gonion-Gnathion (GoGn) line, angle between the Frankfort horizontal (FH) plane and mandibular plane, gonial angle, and angle between the SN plane and palatal plane) were measured on lateral cephalograms from before treatment (T0) to after facemask therapy (T1) and from T0 to after retention (T2). Multivariate linear regression analysis was used to study the associations of the patients' skeletal patterns with the short-term (T0–T1) and long-term (T0–T2) vertical skeletal changes as a result of facemask therapy. The mean treatment period of facemask therapy (T0–T1) was 1.4 ± 0.6 years, and the mean retention period (T1–T2) was 6.9 ± 2.6 years. Age at T0 was significantly correlated with vertical skeletal changes from T0 to T1. Differences in the treatment results between sexes were not significant. The angle between point A-point B line and mandibular plane to mandibular plane angle at T0 and the angle between the FH plane and mandibular plane at T0 were significant predictors for short-term and long-term changes. Changes in the Sella-Nasion-point A from T0 to T1 and from T1 to T2 significantly affected vertical changes in the short term and long term, respectively. Vertical skeletal changes as a result of facemask therapy are significantly associated with severity of the skeletal Class III malocclusion and mandibular plane angulation before treatment and the amount of forward maxillary growth during the treatment and retention periods.ABSTRACT
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DOI: 10.2319/072317-490.1
To evaluate soft tissue changes and their long-term stability in skeletal anterior open bite adults treated by maxillary posterior teeth intrusion using zygomatic miniplates and premolar extractions. Lateral cephalograms of 26 patients were taken at pretreatment (T1), posttreatment (T2), 1 year posttreatment (T3), and 4 years posttreatment (T4). At the end of treatment, the soft tissue facial height and profile convexity were reduced. The lips increased in length and thickness, with backward movement of the upper lip and forward movement of the lower lip. The total relapse rate ranged from 20.2% to 31.1%. At 4 years posttreatment, 68.9% to 79.8% of the soft tissue treatment effects were stable. The changes in the first year posttreatment accounted for approximately 70% of the total relapse. Soft tissue changes following maxillary posterior teeth intrusion with zygomatic miniplates and premolar extractions appear to be stable 4 years after treatment.ABSTRACT
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DOI: 10.2319/062017-407
To evaluate the effects of bone regeneration materials and orthodontic tooth movement (OTM) timing on tooth movement through alveolar bone defects treated with guided bone regeneration (GBR) utilizing xenografts (Bio-Oss) and alloplast (β-TCP). Twenty-four standard alveolar bone defects in six male beagle dogs were treated by GBR using either Bio-Oss or β-TCP (experimental), whereas the control defects were left empty. The defects were further grouped into early or late subgroups, depending on OTM timing after GBR (ie 1 month or 2 months, respectively). Rates of OTM were measured intraorally, while computed tomography scan images were used to assess bone density, alveolar bone height, second premolar displacement, and tipping tendency. Generally, the Bio-Oss early and Bio-Oss late subgroups recorded the lowest amount of tooth movement compared with other modes of GBRs assessed. Before OTM, the control group registered significantly lower bone height compared with the Bio-Oss and β-TCP groups (P < .01). The control group was inferior on bone density and bone height compared with Bio-Oss and β-TCP. The Bio-Oss group had favorable radiologic features (higher alveolar bone level and bone density with less premolar tipping) but showed slower OTM than the control group. The late OTM subgroup had favorable radiologic features and showed faster tooth movement than the early OTM in the β -TCP group.ABSTRACT
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DOI: 10.2319/051117-328.1
To analyze histologic findings of bone remodeling at the time of surgery and 90 days later at corticotomized and noncorticotomized sites. Eight adult patients with bilaterally inclined mandibular molars were included in this split-mouth study. Corticotomy was performed on the test side, and bone was harvested on both mandibular hemi-arches. Bone blocks were shipped to Forsyth Institute lab (Boston, Mass). After surgery, cantilevers were activated to upright inclined mandibular molars on both sides. Approximately 90 days after surgery, new mandibular bone blocks were harvested from test and control sites. Histologic analyses were performed on both groups (test and control sides) at two time points: baseline (T0) and 90 days after surgery (T90). Bone blocks were stained with hematoxylin and eosin, and Masson's trichrome. The protocols enabled screening of new bone formation and collagen in mineralized and nonmineralized connective tissue. Outcomes were compared using a clustered generalized estimating equations model The test group at T90 exhibited an increase of 16% of primary bone (P < .05), an increase of 6.6 in osteocytes quantity (P = .039), and an increase of 4.06 in reversal lines quantity (P = .924). Both groups exhibited a decrease in the inorganic proportion. The intentional bone injury performed in adult patients undergoing orthodontic treatment can be considered temporary and reversible. Evidence indicates that baseline bone characteristics are unaltered.ABSTRACT
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DOI: 10.2319/121116-889.1
To evaluate the changes in position of the maxillary dentition and the airway space after distalization using a modified C-palatal plate (MCPP) in adult patients through CBCT images and to analyze the relationship between the amount of distalization and the changes in the airway space. CBCT images of 33 adult Class II patients (22.2 ± 4.0 years old; 27 women and 6 men) treated by total maxillary arch distalization using the MCPP were evaluated before and after distalization. The patients were divided into nonextraction and extraction groups. The changes in the airway space as well as the changes in the positions of the maxillary dentition were evaluated. The distalization effects were calculated and assessed using paired t-tests. After distalization, the first molar showed significant distalization and intrusion (P < .001) with no significant rotation of the crown and no significant buccal displacement of its root in the transverse dimension. There were no significant changes in the airway volume or the minimum cross-sectional area of the oropharynx. The application of the MCPP resulted in significant total arch distalization without a significant effect on the transverse dimensions or changes in the oropharynx airway space. The MCPP can be considered a viable treatment option for patients with Class II malocclusion.ABSTRACT
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DOI: 10.2319/071917-482.1
To evaluate prevalence, distribution, and sexual dimorphism of dental anomalies (DA) among different skeletal malocclusions (SM) and growth patterns (GP) under the hypothesis that specific clinical patterns exist and may indicate common etiological roots. A total of 1047 orthodontic records of patients older than 8 years were evaluated. The SN-GoGn angle was used to classify GP (hypodivergent, normal, and hyperdivergent), and the ANB angle was used to verify SM (Angle Classes I, II, and III). These assessments were done from lateral cephalometric radiographs. DA were diagnosed using panoramic radiographs by one calibrated investigator. Odds ratios, chi-square, and Student's t-tests were used. Of the subjects, 56.7% were female, with mean age of 16.41 (±10.61) years. The prevalence of DA was 15.7%. Impaction and tooth agenesis were the most prevalent DA, with relative frequencies of 14.4% and 9.7%, respectively. DA were most prevalent in Class III SM (80.8%) and in hypodivergent GP (82.5%), although this was not statistically significant. Tooth agenesis (P < .01) and microdontia (P = .025) were significantly more common among hypodivergent GP and Class III SM, respectively. The results of this study support the idea that DA are preferentially associated with certain patterns of malocclusion.ABSTRACT
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DOI: 10.2319/062717-431.1
To evaluate the effects of rapid maxillary expansion (RME) on the vocal quality, maxillary central incisors, midpalatal suture, and nasal cavity in patients with maxillary crossbite. Coronal CT scans of 30 subjects (14 boys, 16 girls; mean age, 12.01 ± 0.75) were taken before RME (T0), and at the end of the expansion phase (T1). Voice samples of all patients were recorded with a high-quality condenser microphone (RODE NT2-A) on a desktop computer at T0 and T1. Statistical analyses were performed using a paired-sample t-test. The degree of association between the changes in the voice parameters and nasal width was assessed with Pearson's correlation. RME treatment produced a significant increase in the transverse dimensions of the midpalatal suture and nasal cavity between T0 and T1 (P < .05). The maximum F0 and jitter (%) results were shown to decrease statistically significantly from T0 to T1 (P < .001 and P = .042, respectively). Between T0 and T1, shimmer (%) and shimmer (dB) exhibited statistically significant increases (P = .037 and P = .019, respectively). After RME therapy, voice quality differences were found to be associated with increases in nasal width.ABSTRACT
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DOI: 10.2319/090717-602.1
The aim of this study was to examine the quality of information offered for patients seeking information on lingual orthodontic treatment. YouTube™ was searched for videos about lingual orthodontic treatment using the key word “lingual braces” from the Google Trends application. One hundred and four videos were selected to be analyzed from the first 120 results. The video content was evaluated using a 10-point score, which was used for classifying low- and high-content video groups. The video information and quality index (VIQI) was applied to determine the quality of the videos. The Mann-Whitney U-test, Chi-square test, and logistic regression analysis were used, and the Pearson correlation coefficient was calculated for statistical evaluations. We classified 32 videos as high-content and 72 as low-content. Most videos were uploaded by laypeople (58.7%, n = 61). Definition of lingual braces and psychological impact were the most commonly discussed topics (51.0%), followed by speech performance (47.1%), pain (44.2%), tongue soreness (37.5%), and biomechanics (14.4%). Compared to the low-content group, the high-content video group had a significantly higher mean number of views (19,867.41 vs 6720.08, P = .002) and more “likes” (135.88 vs 13.01, P < .001), “dislikes” (4.34 vs 0.81, P < .001), and “comments” (26.28 vs 5.31, P = .002). There was no difference in the total VIQI score between the groups (P = .009). The content of YouTube™ videos for lingual orthodontics was generally incomplete. Most videos mentioned psychological effects, but few videos discussed the biomechanics or procedure. Orthodontists should be aware of the information available on YouTube™.ABSTRACT
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DOI: 10.2319/051017-322.1
To evaluate the effects of personality traits and other variables on oral health–related quality of life (OHRQoL) of Chinese undergraduates aged 17 to 24 years with no history of orthodontic treatment. A total of 443 undergraduate students aged 17 to 24 years were selected and completed a two-section questionnaire: the Eysenck Personality Questionnaire Short Scale Chinese version and the Oral Health Impact Profile–14 Chinese version (OHIP-14). Malocclusion severity was assessed via clinical examination using the dental health component (DHC) and esthetic component of the Index of Orthodontic Treatment Need (IOTN). Severe dentofacial deformities that required orthognathic surgery were excluded. The total and all dichotomized OHIP-14 dimensions correlated closely with the neuroticism personality traits (P < .001). The total and some subscales of OHIP-14 were related with psychoticism. Women had higher OHIP-14 scores than men, especially in the normal occlusion group. Nevertheless, men with more severe malocclusions had higher scores that were similar to those of women. OHRQoL was significantly different between the major of dentistry and other majors. Personality affects comprehensive OHRQoL, and the most significant predictor is neuroticism. Female young adults have worse OHRQoL than male young adults, especially among those with mild malocclusion.ABSTRACT
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DOI: 10.2319/070917-455.1
To investigate the shear bond strength (SBS) of orthodontic metal brackets applied to different types of ceramic surfaces treated with different etching procedures and bonding agents. Monolithic CAD/CAM ceramic specimens (N = 120; n = 40 each group) of feldspathic ceramic Vita Mark II, resin nanoceramic Lava Ultimate, and hybrid ceramic Vita Enamic were fabricated (14 × 12 × 3 mm). Ceramic specimens were separated into four subgroups (n = 10) according to type of surface treatment and bonding onto the ceramic surface. Within each group, four subgroups were prepared by phosphoric acid, hydrofluoric acid, Transbond XT primer, and Clearfill Ceramic primer. Mandibular central incisor metal brackets were bonded with light-cure composite. The SBS data were analyzed using three-way analysis of variance (ANOVA) and Tukey HSD tests. The highest SBS was found in the Vita Enamic group, which is a hybrid ceramic, etched with hydrofluoric acid and applied Transbond XT Adhesive primer (7.28 ± 2.49 MPa). The lowest SBS was found in the Lava Ultimate group, which is a resin nano-ceramic etched with hydrofluoric acid and applied Clearfill ceramic primer (2.20 ± 1.21 MPa). CAD/CAM material types and bonding procedures affected bond strength (P < .05), but the etching procedure did not (P > .05). The use of Transbond XT as a primer bonding agent resulted in higher SBS.ABSTRACT
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DOI: 10.2319/060617-379.1
To test a proof-of-concept that the accuracy and reliability of alveolar bone height measurements from orthodontic grade (large field-of-view [FOV], large voxel-size) cone-beam computed tomography (CBCT) images may be improved by using pixel gray values. Twenty fresh cadaver pig heads underwent CBCT scans (17 × 23 cm FOV, 0.4-mm voxel size). Buccal alveolar bone heights of maxillary first molars were measured using the conventional vision-based (VB) and the proposed gray value–assisted (GVA) methods. The GVA methods entailed localization of landmarks through observation of gray value pattern changes across tissue boundaries followed by mathematical calculation of distances between landmark pixels. Interrater reliability and accuracy of CBCT measurements made by all methods were statistically analyzed by comparing with physical measurements (gold standards). The interrater reliability of CBCT measurements made by GVA methods was comparable to physical measurements but higher than those made by the VB method. The GVA (bend-down pattern) method yielded average measurements similar to physical measurements, while those obtained by the VB and the GVA (straight pattern) methods were significantly larger (repeated measures analysis of variance, P < .001). The GVA (bend-down pattern) method also produced significantly more measurements within one voxel size of physical measurements than did the VB and GVA (straight pattern) methods (Chi-square tests, P < .017). These data confirm a concept that local gray value change patterns may be used to improve the accuracy and reliability of alveolar bone height measurement from large FOV and large voxel-size CBCT images.ABSTRACT
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DOI: 10.2319/071217-468.1
The purpose of this systematic review was to synthesize the available literature concerning the reliability of three-dimensional superimposition methods when assessing changes in craniofacial hard tissues. Four electronic databases were searched. Two authors independently reviewed potentially relevant articles for eligibility. Clinical trials, cohort, case-control, and cross-sectional studies that evaluated the reliability of three-dimensional superimposition methods on the anterior cranial base were included. Six studies fulfilled the inclusion criteria. Four studies used the voxel-based registration method, one used the landmark-based method and one used the surface-based method. Regarding reliability, the voxel-based studies showed on average a difference of 0.5 mm or less between images. The optimized analysis using a six-point correction algorithm in the landmark-based method showed 1.24 mm magnitude of error between images. Although reliability appears to be adequate, the small sample size and high risk of bias among studies make available evidence still insufficient to draw strong conclusions.ABSTRACT
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Thank you for publishing this interesting study evaluating salivary leptin levels in normal weight and overweight female individuals and its correlation with orthodontic tooth movement (canine retraction). Evaluating salivary leptin levels is a new area of research in orthodontics. However, salivary leptin concentration is derived mostly from the salivary gland and only partly from gingival crevicular fluid (GCF).1,2 It is highly correlated to plasma leptin levels which may not be as closely related to orthodontic tooth movement. GCF leptin level, on the other hand, is more likely to be directly correlated to PDL-alveolar bone changes during
We thank the readers for the interest taken to read our research. The clarifications for the queries raised are as follows: The objective of our study was to evaluate the salivary leptin levels during orthodontic tooth movement in overweight and normal weight individuals. Leptin's influence on body fat mass is best studied by assessment of serum levels.1,2 GCF is considered to be a serum exudate3 and the quantity of leptin secreted in GCF is low when compared to salivary leptin. As salivary leptin concentration is reflective of serum leptin concentration,4 and also
This listing of academic opportunities is provided as a free service to the profession and the community. University of British Columbia Faculty of Dentistry Department of Oral Health Sciences Contact: Dr. Chris Wyatt – Head, Dept. of Oral Health Sciences e-mail: cwyatt@dentistry.ubc.ca Rank: Full time Assistant Professor Requirements: Postgraduate training in orthodontics. MSc or PhD. Preference given to individuals holding Fellowship in the Royal College of Dentists of Canada in Orthodontics. University of the Pacific Arthur A. Dugoni School of Dentistry Department of Orthodontics 155 Fifth Street San Francisco, CA 94103 Apply:BRITISH COLUMBIA, CANADA
BRITISH COLUMBIA
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His Letters, Accounts and Patents From the Archives of the Edward H. Angle Society of Orthodontists (EHASO) A 4-volume set compiled and edited by Sheldon Peck ISBN-13: 978-0-9779524-0-3 ISBN-10: 0-9779524-0-1 Library of Congress Control Number 2006910839 Published by The E. H. Angle Education and Research Foundation Boston, Mass. 2007, second printing 2010 About this monumental sourcebook on the beginnings of modern orthodontics. . . This is a 4-volume limited-edition hard-cover book set of over 3400 pages. Dr. Angle's correspondence and business accounts from 1899 to 1910, among his
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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