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Biomedical subjects

S J Lindauer

Publications and source records attributed to S J Lindauer.

36 records · Page 2Linked to original sources

Responses of 3-dimensional arch wires to vertical v-bends: comparisons with existing 2-dimensional data in the lateral view.

The mechanics of V-bends in orthodontic arch wires have been described almost exclusively in terms of bending forces in two-dimensional (2-D) single plane terms. When a rectangular arch wire enters a third dimension, a more complex wire deformation pattern develops from both torsion and bending during the activation of the V-bends. The necessity for a rectangular three-dimensional (3-D) arch wire to undergo torsion during activation results in a greater resistance to deformation at those points in the wire where the torsion is greatest. This is especially apparent with 2 x 2 long span arch wires. This study used finite element analysis to model the force systems produced by activation of V-bends in 3-D arch wires. In both 2-D and 3-D data, greater moments are present as any V-bend is moved toward either adjacent bracket. In 3-D systems, however, a V-bend at the molar produces significantly less moment and associated equilibrium forces than the same V-bend located the same distance from the incisor. Moreover, the reversal of the direction of the moments at either bracket does not occur when the V-bend location is two thirds of the distance toward that tooth as reported with 2-D studies.

Computer Simulation↗

Ceramic bracket fracture resistance to second order arch wire activations.

The fracture resistance of ceramic brackets to orthodontic activations has been incorrectly estimated by previous investigations that have reported second order loads in terms of force magnitudes rather than moments. Because force magnitudes alone do not reflect the influence of distance from the site of force application on total load, it is impossible to apply previous results to actual clinical situations. The purpose of this study was to determine the average moments (in gram-millimeters) necessary to fracture various ceramic brackets subjected to second order tipping activations and compare them with actual clinical loads. Central and lateral incisor ceramic brackets from seven manufacturers were subjected to mesial-distal tipping arch wire activations at two speeds of load application with a testing apparatus designed for that purpose. Significant differences in fracturability among the brackets of various manufacturers and between central and lateral incisor brackets were found. There were no differences related to the speed of load application. Once the influence of bracket width was considered, the differences in fracture resistance between central and lateral incisor brackets were no longer apparent. Second order activations required to fracture the ceramic brackets in this study were all much greater than measured clinical orthodontic loads. It is unlikely that second order arch wire activations are a significant cause of ceramic bracket failure.

Ceramics↗

Chin, nose, and lips. Normal ratios in young men and women.

Existing soft tissue analyses reference profile characteristics to lines determined by surface landmarks. This study uses surface landmarks only to define an area, and soft tissue profiles are analyzed in terms of the surface area of each component part present within this area. The profiles of 66 young adults were measured, and the mean total profile area and all of the component parts except the nose were statistically larger in the men than in the women. The mean female nose was larger, but this difference was not significant. On the basis of percentage contributions, the mean female nose contributed significantly more to the total mean female profile than the mean male nose did to the mean male total profile. The contribution of the mean male chin to the total mean male soft tissue profile was significantly larger than the contribution of the mean female chin to the total mean female profile. When compared by percent contributions, both the upper and lower lips of the men and women contributed nearly equally to their respective profiles. The overall result was that the mean female profile was more convex and the mean male profile was relatively straighter.

Adolescent↗

Moments with the edgewise appliance: incisor torque control.

Traditional edgewise orthodontic mechanics are significantly limited in their ability to provide incisor torque control because of the limitations of bracket-to-bracket mechanics and the poorly defined reciprocal actions inherently produced. Attempts to address this issue clinically have been largely empirical. The science of mechanics dictates that all incisor torque control mechanisms must act through one of two basic principles: the moment of a couple or the moment of a force. The torquing arch is a modification of the traditional edgewise system and employs the moment of a couple to achieve incisor torque control and precise definition of reciprocal effects. The torquing arch force system includes a large moment to rotate incisors in a crown facial/root lingual direction, and concurrent equilibrium forces to extrude incisors and intrude molars. Alternatively, the base arch uses the moment of a force to also rotate incisors in a crown facial/root lingual direction. The base arch, however, includes a large moment to rotate molars in a crown distal/root mesial direction, and concurrent equilibrium forces to intrude incisors and extrude molars. Depending on how they are employed, torquing arches and base arches may also rotate molars in a faciolingual direction, enhance or diminish posterior anchorage, and increase or conserve arch perimeter. Contemporary quality orthodontic care requires an awareness and control of all of the forces created by orthodontic appliances.

Biomechanical Phenomena↗

Activating a 2 x 4 appliance.

When the long span of wire in a 2 x 4 orthodontic appliance enters a bracket in a nonparallel manner, it develops a couple and tendency for rotation called a moment. The moment of a couple creates inherent equal and opposite Newtonian equilibrium forces not readily sensed clinically. Moments at successive brackets, producing rotations in opposite directions, create equilibrium forces also in opposite directions which are subtractive from each other. When these equilibrium forces are equal and opposite, they cancel each other out. If the moments produce rotations in the same direction, the equilibrium forces are also in the same direction and are additive. The apparent simplicity of the 2 x 4 appliance conceals the fact that it is a powerful orthodontic tool that uses engineering mechanics in a way not possible with fully bracketed appliances. Clearly the application of engineering mechanics is a distinguishing characteristics of modern orthodontics.

Activator Appliances↗

Case report: four permanent second molar extractions.

A patient who had earlier undergone four second molar extractions and who demonstrated Class II buccal segments and major incisor crowding was treated with the relatively unusual extraction pattern of maxillary lateral incisors. The treatment resolved the crowding and created Class II buccal segments with maxillary canines substituted for extracted lateral incisors. Favorable tooth anatomy produced an acceptable esthetic result accomplished with a predictable outcome over a reasonable duration of treatment. The sequential panoramic radiographs show evidence of the third molars spontaneously progressing toward positions that may result in their successful substitution for the earlier extracted second molars. A relatively unorthodox treatment plan made possible resolution of a difficult existing clinical situation using relatively routine treatment procedures.

Adolescent↗

On tooth movement.

Current concepts of clinical orthodontic tooth movement are misleading. Traditionally, these have been described as dependent on force levels and being tipping/bodily in nature. The following is a reevaluation of the relationships between tooth movement and orthodontic mechanotherapy not usually considered when analyzing tooth movement clinically. It is our contention that confusion as to the biological response(s) to mechanical force is derived from in vivo orthodontic trials where conditions are undefined. This correlates with variable biological responses within the periodontium. Constantly changing moment to force ratios inherent to the dynamic load deflection rates of any system used to move a tooth cause changing tendencies for crown/root tipping. This implies that the accepted notion of static translatory tooth movement, although a useful didactic concept, is currently unattainable. In actuality, it has never been documented empirically using any conventional orthodontic appliance.

Biomechanical Phenomena↗

Effect of jaw opening on masticatory muscle EMG-force characteristics.

This study was designed to evaluate the way in which changes in vertical jaw opening affected the relative contributions of various masticatory muscles to bite force production. EMG activity was recorded simultaneously from the masseter, and anterior, middle, and posterior temporalis muscles, during controlled isometric biting at different force levels and vertical jaw openings. EMG-force characteristics were compared between muscles and bite openings. All but the posterior temporalis muscle displayed significant increases in muscle activity with increased bite force production; the masseter muscle demonstrated the largest activity increments. Statistically significant changes in muscle function due to jaw opening were demonstrated only for the masseter muscle, though similar trends were observed for the anterior and middle temporalis muscles. Minimum increases in muscle activity associated with increases in bite force occurred between 9 and 11 mm of opening, measured at the first molar, for all three muscle groups. The results of this study suggest that changes in masticatory muscle length resulting from vertical jaw opening cause alterations in muscle contractile properties, but the relative contributions of various masticatory muscles toward bite force production may also be affected by biomechanical factors and neural control adaptations.

Biomechanical Phenomena↗

Tantalum implants as markers for evaluating postoperative orthognathic surgical changes.

The stability of sagittal split osteotomy advancements is not always 100% predictable. Assessment of postsurgical changes has historically relied on clinical evaluation of dental changes and superimposition of serial cephalograms, both of which have been shown to have serious drawbacks. A technique that improves the analysis of postsurgical changes is described in this paper; tantalum pin implants are placed in the osteotomized segments of patients undergoing surgical advancements. Implants eliminate many of the problems (orthodontic, growth, and remodeling changes) related to superimposition of presurgical and postsurgical cephalograms. Using this technique, surgical changes can be precisely analyzed, and the contribution of each factor of postsurgical relapse can be determined. This information, concerning the magnitude and direction of postsurgical changes, aids in following an individual's progress and increases the accuracy of large group studies by eliminating sources of variability in radiographic and clinical interpretation.

Bone Remodeling↗

Development of supernumerary premolars in an orthodontic population.

Seven cases exhibiting supernumerary premolar development were detected during a 2-year period during the routine care of approximately 1,100 orthodontic patients. This 0.64% prevalence is more than twice as high as has been previously reported and represents an occurrence rate of 1 per 157 patients. This report describes the summary data for the cases detected and briefly reviews the available literature.

Adolescent↗

Increase in arch perimeter due to orthodontic expansion.

A mathematical model was developed to compare quantitatively the effects of various types of orthodontic expansion on mandibular arch perimeter. Mandibular arch form was modeled with spline interpolation to fit a smooth curve between assigned molar, canine, and incisor positions. Starting with average arch dimensions, intermolar width, intercanine width, and midline arch length were increased individually and in combination in millimeter increments up to 5 mm, and the consequent changes in arch perimeter were measured. Increasing midline arch length by incisor advancement was nearly four times as effective in increasing arch perimeter as was molar expansion; canine expansion had an intermediate effect. Arch perimeter increments increased slightly with successive amounts of expansion for the molar, canine, and incisor. Combinations of molar-canine and canine-incisor expansion yielded results comparable to the total effects achieved by expansion of those teeth individually. Combined molar-canine expansion created increases in arch perimeter that were only slightly less than those generated by incisor advancement alone.

Cephalometry↗

Quantitation of rotational movements associated with surgical mandibular advancement.

Surgical mandibular advancement can be used to correct an anteroposterior and/or vertical malocclusion. The procedure of choice is often the bilateral sagittal split osteotomy (BSSO). By varying the amount of presurgical overbite correction, the rotational movement of the distal segment of the osteotomy can be controlled. Consequently, the malocclusion and the resultant vertical and anteroposterior facial form changes are predictably planned to produce both the desired occlusion as well as the optimal esthetic facial result. Opening rotation of the distal segment elongates the lower face height by varying amounts depending on the nature of the rotation. The amount and type of rotation can be determined and quantified by the technique presented in this paper, which is based on a geometric theorem used to determine the kinematic center of rotation of an object. This technique can shorten treatment time and produce more predictable results. The specific applications are: 1) treatment planning for individual patients, 2) uniform analyses of treatments and grouping of treatment types, and 3) development of more accurate computerized treatment planning programs.

Algorithms↗

Electromyographic-force characteristics in the assessment of oral function.

The purpose of this investigation was to examine the utility of EMG-force characteristics as reliable and valid parameters by which to assess oral function. Masseter-muscle activity was recorded during controlled isometric biting exercises performed at various bite openings and force levels on two separate occasions. Measured muscle-activity levels, as well as the EMG-force characteristics of slope and y-intercept, were compared between bite openings and experimental trials. Sensitivity, assessed as the ability to detect statistically significant differences in muscle function due to changes in muscle length, was found to be acceptable for all measurements, except the y-intercept parameter, and during production of minimal forces. Reproducibility, evaluated as the correspondence between values recorded at different experimental sessions, was best for the EMG-force parameter of slope and during production of higher forces. The results from this study support the following conclusions: (1) Substantial variations in muscle function exist between individuals; (2) acceptable reliability and sensitivity of quantitative EMG values can be achieved, especially at higher muscle-activity levels, by rigidly controlling and quantifying functional activities during experimental trials; (3) the slope of an EMG-force curve is a reproducible, quantitative, and functionally sensitive measurement for assessment of muscle function; and (4) the EMG-force y-intercept is not a reliable quantity by which muscle-function characteristics may be studied.

Adult↗

Computers and cephalometrics.

Computers have been adapted to cephalometric data acquisition and analysis. Traditional cephalometric radiographs provide images that are entered into computers by converting them to digital data. Other non-ionizing radiation forms of energy, such as sound, light and magnetism, are now used to create images. Newer methods of data acquisition are emerging that convert objects directly to digital data for computer entry without going through intermediate analogue forms. The analysis of cephalometric data for diagnostic use is aided by computers, but the automated treatment planning application of computers is limited. This limitation is not a function of the computer, but a function of our inability to reliably predict absolute biologic changes in the face of biologic variability.

Cephalometry↗