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At least 469 records · Page 26Linked to original sources
PubMed2006

Transverse implications of maxillary premolar extraction in Class III presurgical orthodontic treatment.

INTRODUCTION: Maxillary premolars are often extracted to resolve incisor proclination in presurgical orthodontic treatment for severe skeletal Class III patients. The aim of this article was to compare arch-width changes and orthodontic tooth movements between maxillary premolar extraction and nonextraction modalities, and to provide an additional indication for presurgical maxillary premolar extraction according to the transverse dental arch characteristics of Class III surgical-orthodontic patients. METHODS: Pretreatment and posttreatment dental casts of 55 adult Class III patients (24 nonextraction, 31 extraction) who underwent surgical-orthodontic treatment were collected. The changes in maxillary and mandibular dental arch widths were measured from the canines to the second molars. Orthodontic tooth movement was evaluated with an angulation-and-inclination measuring gauge. RESULTS: Statistical analyses showed that intermaxillary arch congruity was attributed mainly to maxillary arch-width changes. The arch-width changes could be interpreted as the result of inclination changes in both posterior dentitions. For the arch-width change, analysis of covariance (ANCOVA) showed a significant extraction effect: the premolar extraction group's ability to accommodate arch-width change was significantly greater than that of the nonextraction group. CONCLUSIONS: The indications for maxillary premolar extraction in Class III presurgical orthodontic treatment might depend in part on the characteristics of the maxillary arch width and posterior teeth inclinations.

Adult↗
PubMed1993

Reflections on my involvement in orthodontic research.

Some years ago, Professor Takihashi, who was then the greatest living professor of orthodontics in Japan, called on us in Ann Arbor just before his retirement. I asked Dr. Takihashi who would replace him? and he replied, "There's a young man who will do better than I because he will be able to take Japanese orthodontics to the world and bring the world's orthodontics to Japan." That young man was Fujio Miura. Fujio Miura has, in the years since Takihashi spoke to me, written one of the most amazing records in the history of our specialty. His research is as far ranging as anyone's. For example, in biology he has written well on the ethnology of Japanese craniofacial morphology and that of the aborigines in Japan. He has written on developmental biology and on the tissue reaction of tooth movements. In metallurgy he has contrived alloys that have revolutionized our appliances, for he was a pioneer in the use of nickel-titanium wires. Fujio Miura invented direct bonding. Professor Miura has fulfilled Professor Takihashi's predictions well for he has become the most famous orthodontic professor in Japan's history. It is interesting to see that his students occupy most of the chairs of orthodontics in Japan and many elsewhere. Miura is an accomplished artist who has exhibited his work. This personable scholar probably attends more meetings of the American Association of Orthodontists Society than most American members, and he is equally at home in the European society, and many other orthodontic groups in the world.

Dental Alloys↗
PubMed1992

Evaluation of an anamnestic questionnaire as an instrument for investigating potential relationships between orthodontic therapy and temporomandibular disorders.

A group of 100 patients who received orthodontic treatment, between the ages of 16 to 31 years, were asked to complete the TMJ Scale (an anamnestic temporomandibular disorder [TMD] questionnaire) and undertake a simple clinical TMD examination, the Helkimo clinical dysfunction index. The purpose of this study was to compare the TMJ Scale and the Helkimo clinical dysfunction index to validate the use of the TMJ Scale as a potential method with which to examine whether there is any relationship between TMD and orthodontic therapy. Comparisons between TMJ Scale scores from the orthodontically treated group were made with previously reported TMJ Scale data. In addition, comparisons were made between various treatment and malocclusion groups identified within the orthodontically treated sample. On the basis of the TMJ Scale global scale scores for the orthodontically treated group and two normative nontemporomandibular disorder groups described by Levitt, Lundeen, and McKinney, no differences were observed. Similarly, TMJ Scale comparisons between various treatment and malocclusion subgroups showed no statistically significant differences. The results of this study support the use of the TMJ Scale as a valid instrument with which to determine whether there is any relationship between orthodontic therapy and TMD.

Adolescent↗
PubMed1996

Perceived orthodontist behaviors that predict patient satisfaction, orthodontist-patient relationship, and patient adherence in orthodontic treatment.

Orthodontist-patient relationships have significant effects on the success of orthodontic treatment. The purpose of this study was to evaluate the effects of patient-perceived orthodontist behaviors on (a) patient perceived orthodontist-patient relationship, (b) patient satisfaction, and (c) orthodontist-evaluated patient adherence or compliance in orthodontic treatment. The sample consisted of 199 orthodontic patients, 94 boys and 105 girls, ages 8 to 17 years, who were recruited at the beginning of orthodontic treatment by a member of the research team who was not involved in treating the patients. The patients were asked to complete standardized questionnaires in a room away from the orthodontic clinic, 8 to 12 months into treatment. At the same time, the orthodontic resident treating each patient completed a standard instrument that evaluated patient compliance. Orthodontist behavior items such as politeness, friendliness, communicativeness, and empathy were evaluated by the patients. Stepwise multiple regression analyses (p < 0.05) showed that eight behaviors predicted perception of the orthodontist-patient relationship (final model R2 = 0.7930 and 0.7333) as well as patient satisfaction (final model R2 = 0.7952) and two behaviors predicted patient compliance (final model R2 = 0.0986). Of the 24 orthodontist behaviors, 22 were significantly correlated (p < 0.0001) with favorable orthodontist-patient relationship and patient satisfaction. Of the 24 behaviors, 10 were significantly correlated (five at p < 0.01 and five at p < 0.05) with patient compliance. Patient-perceived orthodontist behaviors are related to and predict (1) patient perceived orthodontist-patient relationship, (2) patient satisfaction, and (3) orthodontist-evaluated patient adherence or compliance.

Adolescent↗
PubMed1997

In vitro evaluation of matrix-bound fluoride-releasing orthodontic bonding adhesives.

Sustained fluoride-releasing composite resins have the potential to prevent decalcification of enamel that may occur during the course of orthodontic treatment. The purpose of this study was to evaluate the potential of matrix-bound fluoride-releasing adhesives (MBF) for orthodontic use by comparing the shear bond strengths (in MPa) and remnant adhesive on debonding (ARI scores) of these resins with commercially available orthodontic adhesives. Two types of resins were evaluated in separate groups: The light-cured resins (group I) consisted of two light-cured MBF, designated resins LA and LB, and five nonfluoride releasing resins, designated LC, LD, LE, LF, and LG. The self-cured resins (group II) consisted of one MBF, designated resin SA, and six nonfluoride releasing resins, designated resins SB, SC, SD, SE, SF, and SG. These resins were used to attach upper right central incisor metal (foil mesh based) orthodontic brackets to 210 freshly extracted bovine incisors in groups of 15 each. Student-Newman-Keuls multiple comparison tests were performed at p < 0.05 to determine significant differences among the resin types. Resin LA was significantly higher in bond strength (mean = 27.4 MPa) compared with LD and LG (mean = 18.9, 10.7 MPa, respectively). Further, LA demonstrated a higher mean bond strength compared with LB, LC, LE, and LF (mean = 21.9, 24.1, 24.3, and 20.8 MPa, respectively). Resin LB had significantly lower ARI scores (mean = 0.33) compared with LF and LG (mean = 1.20 and 1.80). LA, LB, LC, LD, and LE (mean = 0.47, 0.33, 0.60, 0.73, and 0.73, respectively) were not significantly different in their ARI scores. Resin SB demonstrated significantly lower bond strength (mean = 17.2 MPa) compared with SC, SD, SE, SF, and SG (mean = 23.9, 23.7, 23.4, 23.8, and 22.9 MPa, respectively). Resin SA (mean = 19.0 MPa) was not significantly different in bond strength from SB, SC, SD, SE, SF, and SG. Resin SA demonstrated significantly lower ARI scores (mean = 0.73) compared with SD and SE (mean = 2.13 and 1.87). Resin SA had lower mean ARI scores compared with SB, SC, SF, and SG (mean = 1.00, 1.27, 1.13 and 0.87, respectively). Sustained fluoride-releasing (matrix-bound) orthodontic adhesive systems demonstrated bond strength and ARI scores that compared favorably with commercially available orthodontic adhesives.

Adhesiveness↗
PubMed1998

Comparative study of electric and manual toothbrushes in patients with fixed orthodontic appliances.

The objective of this three treatment, three period, single blind, cross-over trial was to evaluate the efficacy of three toothbrushes in a cohort of children undergoing fixed appliance orthodontic therapy. The brushes used were: (1) Dental Logic HP550 with regular brush head HP5924 (Philips, U.K.); (2) Braun Oral B Plaque Remover (D7) with dedicated orthodontic brush head OD5-1 (Braun AG, Germany); and (3) a manual dedicated orthodontic toothbrush (P35, Oral B Laboratories, Calif.). Sixty orthodontic patients, aged 10 to 16 years and wearing upper and lower fixed appliances, were screened and recruited with parental consent. After an oral soft tissue examination at baseline, the percentage of plaque-covered tooth surfaces and gingival bleeding sites were recorded using visible plaque and gingival bleeding indexes. Each subject was randomly allocated to one of three groups (n = 20) with brushing sequences 1-2-3, 2-1-3, 3-2-1. The first brush was given 2 weeks after baseline (visit 1). The time interval for using each brush was 4 weeks at the end of which visible plaque and gingival bleeding indexes were recorded and a further prophylaxis given. Statistical analysis was undertaken with analysis of variance. Data were analyzed on a site-specific basis; buccal smooth and interproximal surfaces, lingual smooth and interproximal surfaces. At baseline the mean visible plaque index for all subjects were; buccal smooth, 52.5% (+/- 22.5%); buccal interproximal, 70.5% (+/- 18.5%); lingual smooth, 68.5% (+/- 21%); lingual interproximal, 76% (+/- 16%). At visit 1, the plaque scores at all surfaces had reduced significantly compared to baseline, but there had been no active treatment. This was attributed to a Hawthorne effect. Subsequently, there were no significant effects on visible plaque (or gingival bleeding) indexes with any toothbrush at any tooth surfaces. This suggests that the new HP550 is equally effective as specifically designed orthodontic toothbrushes in removing plaque from patients with fixed orthodontic appliances.

Adolescent↗
PubMed1998

Psychological influences on the timing of orthodontic treatment.

Debates about the "ideal" timing of orthodontic treatment have focused on issues of biologic development and readiness. In this article we examine psychologic issues that should be considered in the decision to initiate orthodontics in the younger child or to wait until adolescence or later. Psychologic development during the preadolescent and adolescent stages may influence the child's motive for, understanding of, and adherence to treatment regimens. Results of a study of some personality characteristics, motives, and aesthetic values of young phase I patients are presented. Questionnaires were completed by 75 children (mean age 10.85 years, 52.1% female, 84% white) and their parents. Children's perceived reasons for treatment were consistent with their parents' reports (chi 2 = 76.08, p < .001); most were referred for crowded teeth (56%) and overbite (17.3%). Although body image and self-concept scores were within the normal range, both children and their parents expected the most improvement in self-image and oral function, with greater expectations by parents on self-image (p < .0001), oral function (p < .0001), and social life (p < .03) than children themselves. Although white and minority children were similar in their self-ratings and expectations from orthodontics, the former were more critical in their aesthetic judgments. They rated faces with crowded teeth (p < .02), overbite (p < .02), and diastema (p < .01) more negatively than did ethnic minorities. These results suggest that younger children are good candidates for Phase I orthodontics, have high self-esteem and body-image, and expect orthodontics to improve their lives. White children who have been referred for Phase I orthodontics appear to have a narrower range of aesthetic acceptability than minority children.

Adolescent↗
PubMed1999

Potential application of the dental aesthetic index to prioritize the orthodontic service needs in a publicly funded dental program.

Resources for publicly funded dental programs may never be sufficient to accommodate unlimited orthodontic service demands. There is therefore an obligation to ensure that they are preferentially provided to those patients most likely to derive the greatest benefits. To address this strategic concern, the pretreatment records of 38 patients were prioritized on a visual-analog scale relative to their differential orthodontic service needs by 16 independent orthodontic specialists. Unfortunately, inconsistencies in these assessments were unacceptable for a publicly funded program. When these same records were prioritized relative to their scores derived from the Dental Aesthetic Index, their assessments proved more consistent, especially when based on a modified Dental Aesthetic Index. The relevance of such Dental Aesthetic Index scores proved controversial, because the need for orthodontic services is dependent on other factors in addition to esthetics. The lack of established clinical guidelines to delineate the most appropriate service and timing for specific occlusal discrepancies further hampers the prioritization of orthodontic service needs. Dental Aesthetic Index case-scores may therefore be considered as just 1 of many criteria to prioritize orthodontic service needs, although the potential impact of the others has yet to be quantified.

Canada↗
PubMed1999

Osteoclast activation and recruitment after application of orthodontic force.

In this study, whole body radioactive cobalt 60 (Co60) irradiation was used in an orthodontic tooth movement model to investigate osteoclast activation and recruitment in adult rats. Seventy-five rats were divided into three groups and were irradiated with Co60 ranging from 10 to 26 Gray. An orthodontic appliance was fitted to each rat 12 days after initiation of irradiation. Identical appliances were fitted on an additional 25 unirradiated rats. Groups of rats were sacrificed 1 week before and on the day of appliance placement as well as 1, 2, 3, 4, or 5 weeks after appliance placement. Histologic sections from decalcified maxillary processes were prepared and osteoclasts were counted. Results showed that regardless of irradiation dosage, osteoclast number did not decrease during the first 3 weeks of orthodontic treatment; animals receiving lower (ie, 10 Gray) total irradiation actually showed a transient increase in the osteoclast number. In addition, regardless of dose in the irradiated rats, the total time osteoclasts were present in the periodontal membrane after orthodontic activation was reduced from 4 to 3 weeks. These findings lead us to hypothesize that osteoclasts involved in appliance-induced remodeling are initially from precursors in the periodontal membrane. During prolonged periods of orthodontic force application, replacement osteoclasts originate from bone marrow precursors. Although an orthodontic bone resorption cycle lasts 4 weeks, the life span of individual osteoclasts is limited to 9 to 10 days. The clinical significance of this finding remains to be elucidated.

Animals↗
PubMed1997

Guidelines for managing the orthodontic-restorative patient.

Occasionally, patients require restorative treatment during or after orthodontic therapy. Patients with worn or abraded teeth, peg-shaped lateral incisors, fractured teeth, multiple edentulous spaces, or other restorative needs may require tooth positioning that is slightly different from a nonrestored, nonabraded, completely dentulous adolescent. Generally, orthodontists are not accustomed to dealing with patients who require restorative intervention. Should the objectives of orthodontic treatment differ for the restorative patient compared with the nonrestorative patient? How should the teeth be positioned during orthodontic therapy to facilitate specific restorations? Should teeth be restored before, during, or perhaps after orthodontics? The answers to these and other important questions are vital to the successful treatment of some orthodontic patients. This article will provide a series of eight guidelines to help the interdisciplinary team manage treatment for the orthodontic-restorative patient.

Dental Restoration, Permanent↗
PubMed1997

Orthodontic adhesives and bond strength testing.

A bracket bond failure is a frustrating occurrence in orthodontic practice. Because the location of the bond failure may indicate the probable cause, it is important to understand the significance of "bond strength" in a clinical application. Bonding in orthodontics can be studied using controlled clinical models or in vitro using simulated clinical models or more fundamental, isolated substrate models, in which bonding of an adhesive to tooth structure or a bracket is studied independently. With numerous adhesives and orthodontic band and bracket materials available as well as other orthodontic substrates besides enamel, such as esthetic ceramic restorations, in vitro models play an important role in characterizing the bonding potential of new systems. This article reviews bonding of orthodontic brackets and bands using various orthodontic adhesives to dental substrates from the perspective of bond strength and its measurement.

Acid Etching, Dental↗
PubMed2002

A longitudinal evaluation of pulpal pain during orthodontic tooth movement.

OBJECTIVES: To examine the longitudinal changes in pulpal sensitivity to electrical stimulation and the relationship to pulpal sensitivity as measured by electrical stimulation and subjective reports of tooth pain after archwire insertion. DESIGN: Non-randomized, prospective trial, with matched controls. SETTING AND SAMPLE POPULATION: Regional Clinical Dental Research Center at the University of Washington School of Dentistry. Eighteen adult subjects of age 13-37 years. Nine experimental subjects planned for orthodontic treatment. Nine control subjects matched for gender and age who did not have orthodontic treatment. EXPERIMENTAL VARIABLE: Fixed orthodontic appliances and initial archwire placement in experimental subjects compared with 'no treatment' control subjects. OUTCOME MEASURE: Subjective assessments of orthodontic tooth pain were made using visual analogue scales. Electrically evoked detection and pain thresholds were determined using a computer-controlled tooth stimulator. Data were gathered at five time points: after bracket placement (baseline), 1 h after placement of initial archwires, 1 day after archwire placement, 1 week after archwire placement, and 1 month after archwire placement. Comparable time intervals were used for the 'no treatment' control subjects. RESULTS: Subjective ratings of treatment-evoked tooth pain in the experimental group were the greatest at the post-archwire day 1 observation and progressively decreased for the remaining observations. Control subjects reported little pain at any of these observation times. The detection and pain threshold changes from baseline showed no statistical differences over time or between groups. While not statistically significant, a trend was noted where reports of greater orthodontic tooth pain were associated with increased sensitivity to electrical stimulation (i.e. lower detection and pain thresholds). CONCLUSION: Orthodontic patients experience significant pain and discomfort 1 day after initial archwire placement (i.e. activation). Future research should investigate whether self-reports of treatment-evoked tooth pain intensity are associated with pulpal sensitivity.

Adolescent↗
PubMed1995

Dentists' perceptions of orthodontic services.

In this investigation the orthodontic referral patterns of the dentists working within two FHSA areas in the north of England were surveyed. A sub-sample of 149 of the dentists was selected and they were sent a postal questionnaire directed at their perceptions of the service provided and factors influencing their choice of orthodontist. One hundred and twenty one questionnaires (90%) were returned. It was found that 26.4 of the dentists did not refer an orthodontic patient and 51% referred to only one type of treatment provider. The most important factors governing their choice of orthodontic treatment provider were the length of treatment waiting list (62%) and the standard of treatment provided (66.9). In addition, the dentists' perceptions of the roles of the orthodontic services were not in concordance with those of the orthodontic treatment providers. They also expressed a degree of dissatistfaction with the orthodontic services.

Attitude of Health Personnel↗
PubMed2003

The planning, contracting and monitoring of orthodontic services, and the use of the IOTN index: a survey of consultants in dental public health in the United Kingdom.

OBJECTIVES: To establish which factors are used in planning, contracting and monitoring orthodontic services in the United Kingdom. In addition, the study investigated the value of the Index of Orthodontic Treatment Need (IOTN) as an instrument for planning orthodontic provision. METHODS: A structured questionnaire was sent to all consultants in dental public health in the United Kingdom. RESULTS: Over 80% of the respondents used the Index of Orthodontic Treatment Need (IOTN) as an instrument for planning, contracting and monitoring orthodontic services. Seventy per cent of these consultants regarded the IOTN index as a useful or very useful instrument. The main strength reported was that the IOTN index allows prioritisation (25.0%). The main weakness reported was that the index does not assess complexity (70.5%). CONCLUSIONS: Consultants in dental public health perceived the IOTN as a useful tool for planning orthodontic provision despite some shortcomings.

Consultants↗
PubMed1975

Fluoride application procedures in orthodontic practice, current concepts.

A survey is given of present knowledge of different methods of fluoride administration with emphasis on practical measures of proved value for orthodontic patients. The review covers different F administration procedures by dental personnel and self-application and includes the use of prophylaxis pastes, topical solutions, gels, mouth rinses, dentifrices, tablets, cements, coatings, varnishes, etc. Some recommendations are given as to optimal programs in orthodontic practice based upon evaluations of clinical effectiveness, safety and ease of application. Some caries reduction has been obtained from professional application of F prophylaxis pastes, but F pastes cannot replace topical F application. Treatment with F gels or solutions preceded by thorough cleaning and drying of the teeth is advocated before the placement of appliances and at recementations. Because F solutions are tedious to apply, and not more effective than F gels, the latter are preferable. APF gel application is suited in conjunction with impression taking. Daily self-application of SnF2 gels undoubtedly is effective in reducing caries in orthodontic patients. However, daily NaF or APF mouth rinses may have the dual effect of caries inhibition and stimulating hygiene interest and are more thoroughly tested. In addition to the other forms of F administration, a F dentifrice should be used regularly. Daily F application is appropriate also for orthodontic patients in fluoridated areas. In vitro studies with F cements indicate a great F uptake by the enamel, but controlled, long-term clinical studies are lacking. Also the final judgment of a number of new coating techniques and F varnishes must await further clinical testing, although a beneficial effect of F sealing in orthodontic patients is substantiated. In conclusion, APF gel application before insertion of appliances and at regular recementations plus daily rinsing with dilute NaF or APF solutions throughout the periods of treatment and retention plus the regular use of a F dentifrice is recommended as a routine procedure for all orthodontic patients.

Child↗
PubMed1983

An evaluation of functional occlusal interferences in orthodontically treated and untreated subjects.

Centric occlusion-generated functional bite registrations failed to show a difference in the number, location or severity of nonworking (balancing) or protrusive functional occlusion contacts between 49 post-orthodontically treated subjects and 27 non-orthodontically treated subjects with ideal static occlusion. Nonworking (balancing) side functional occlusion contacts were present in 85% of the non-orthodontic subjects and 97% of the post-orthodontic subjects. At least within the parameters of this investigation, the lateral and protrusive occlusions of post-orthodontic subjects and comparable non-orthodontic subjects were equivalent. It is important to note that this is a study of incidence. It does not address the meaning or importance of such contacts.

Dental Occlusion, Centric↗
PubMed1996

RVG-S, VIXA, and Ektaspeed film in detection of proximal enamel defects under orthodontic bands.

An in vitro investigation was carried out to compare CCD-based intraoral radiographic systems with E-speed film for the detection of proximal enamel defects beneath orthodontic bands, with and without added niobium filtration to attenuate the x-ray beam. Twenty caries-free extracted teeth were randomly divided into five groups. Fifteen of 30 contacting proximal surfaces remained lesion free; the other 15 received a small, medium large mechanically induced enamel defect. Images were made with and without the addition of 30 microns niobium filtration, and with and without orthodontic bands. Six dentists were viewers. Receiver operating characteristic (ROC) curves were developed for each modality under each test situation. The area under the curve (Az) was used as an index of diagnostic accuracy, and the critical ratio was used for statistical comparisons. In the absence of orthodontic bands, the Az values for E-speed film and for nonenhanced RVG-S were greater than for all other modalities tested, indicating that they have the greatest diagnostic accuracy. With orthodontic bands, the RVG-S with steep gradient enhancement (X-function) had a higher Az value than all other modalities. Addition of niobium had no significant effect on defect detection. CCD-based devices hold no diagnostic advantage over conventional film for detecting changes in the density of enamel not covered by orthodontic bands. Contrast enhancement of digital images (RVG-S X-function) holds promise for the detection of such changes beneath orthodontic bands.

Bicuspid↗
PubMed1998

Occlusal traits and perception of orthodontic need in eighth grade students.

In 1994, 1155 eight-grade students in Alachua County, Fla., were asked about self-perception of and level of concern for their occlusal status. Clinical assessments of orthodontic parameters were also recorded. Twenty-five percent of the students had a history of orthodontic treatment. Of the remaining students who had no history of orthodontic treatment, 74% reported satisfaction with the way their teeth looked, 64% expressed no perceived need for braces, and 57% were judged clinically to have optional or no orthodontic needs. Sex, soft tissue profile, overjet, anterior crowding, and molar classification were significantly associated with the perception of need for braces while race and overbite were not. Clinical judgment of orthodontic need differed significantly among levels of satisfaction with teeth. Eighth graders with no history of orthodontic treatment were generally satisfied with the appearance of their teeth and perceived less need for braces than clinicians.

Adolescent↗