Orthodontics

This case report presents the multidisciplinary treatment of severe orofacial malformation in a female Caucasian patient aged 24 years and 10 months. Clinical examination showed mandibular deficiency, severe skeletal Class II and skeletal open bite with backward chin posture. The patient displayed noticeable facial asymmetry, a narrow upper jaw with unilateral crossbite, shifted midlines, incompetent lips up to 7 mm and hypertonic musculus mentalis when trying to put lips together. The Orthodontic phase of the treatment aimed at a) correction of the transversal discrepancy through Surgically Assisted Rapid Maxillary Expansion (SARME) using bonded acrylic Hyrax appliance, b) midline correction and c) creation of sufficient space for the alignment of all teeth and for insertion of implants to teeth 14 and 27. Surgical correction in the upper jaw was performed by Le Fort I corticotomy, Bilateral Sagittal Split Osteotomy (BSSO) in the lower jaw and chin genioplasty. The total time taken to accomplishing the treatment goals and to meet patient's expectations was three years and five months. The patient was very satisfied with her new appearance due to corrected open bite, new position of the teeth and mandibular deficiency reduction, resulting in better face appearance, and her self-confidence increased tremendously. Follow-up checks have taken place over a period of six years since completion of treatment in order to maintain the stability of the results and it is anticipated that long-term cooperation with the patient will continue.

related loss of muscle tone in the tissues supplied by the glossopharyngeal nerve,, anatomical obstruction of the nasal passages, large tonsils, large tongue, a retrognathic Mandible, obesity, alcohol, sedative medication, allergies. The orthodontic approach is intended to provide patients with immediate relief from OSA, as well as changes to the airway that may address an underlying cause. It can be treated using surgery, continuous positive airway pressure and oral appliances therapy. This article review some of the basic aspects of this sleep-related disorder, its diagnosis and treatment modalities.

In orthodontics, torquing, particularly in the maxillary incisors is required to overcome play between wire and bracket, for
an ideal interincisal angle, adequate incisor contact, and sagittal adjustment of the dentition in order to achieve an ideal
occlusion. Various torquing auxiliaries and twisting of rectangular wire have been tried. Most of these approaches require
increased chair side time in wire bending and patient discomfort with unguaranteed effects. To control incisor torque,
trend of bidimensional technique is increasing in labial/lingual orthodontics. The purpose of this article is to provide an
overview of the bidimensional technique.
Keywords: Torque; Ideal Occlusion; Bidimensional Technique.

Cette publication est une mise au point sur les valeurs d'ancrage en orthodontie et leurs influences sur les choix thérapeutiques. Un échantillon de 80 sujets a été analysé. La tomodensitométrie tridimensionnelle permet, grâce aux logiciels C2000-Cépha et Cépha3DT, de calculer certains paramètres d'anatomie dentaire tels que les volumes radiculaires. Ces derniers peuvent servir de base pour définir la notion d'ancrage en orthodontie. Les valeurs guides sont calculées et comparées à celles proposées dans la littérature. Les nouveaux coefficients d'ancrage proposés remettent en cause certaines attitudes thérapeutiques en orthodontie.

Varus misalignment of the hip-knee-ankle angle causes greater loads on the medial compartment of the knee and increases the risk of developing knee osteoarthritis. High tibial osteotomy is a surgical method where the load-bearing axis is shifted laterally. The purpose of this study is to define a subject-specific three-dimensional multibody model of the knee to investigate the effect of osteotomy on cartilages and menisci during the stance phase of gait. It is assumed that osteotomy transfers load-bearing to the lateral parts of the knee. Magnetic resonance images of a patient with varus alignment were used to generate the geometries of the bones, cartilages, and menisci. Then, an experimental approach was used to determine the parameters for the stiffness matrices and compliant contact models of the tibio-meniscofemoral articulations with the use of finite element solutions. As indicated by the research findings, the contact force at the medial cartilage decreased as the load-bearing axis was transferred to the lateral parts. This subject-specific noninvasive analysis of contact force can be considered as a preoperative assessment tool for the surgeon. to predict the effects of high tibial osteotomy and the shifting of the load-bearing axis to the soft tissues of the knee.

Aim: To assess the effect of length and insertion angle on stability of mini screw in synthetic bone replica used for retraction of anterior teeth. Materials and Methods: A total of 120 titanium miniscrews (SK Surgicals) were equally divided into two groups based on their insertion in synthetic replica of bone (ORTHOBONES, 3B scientific, Germany) i.e. maxillary (Group I) or mandibular (Group II) bone. Both the groups were further divided into 8 subgroups based on length and angulation i.e. Ia60 (8mm, 60o), Ia90 (8mm, 90o), Ib60(11mm, 60o), Ib90(11mm, 90o), IIa60(6mm 60o), IIa90(6mm 90o), IIb60(8mm 60o) and IIb90(8mm 90o). Two customized angulation guiding jigs, at 60o and 90o angle were fabricated. Miniscrew was driven into the bone using the screwdriver. A Universal testing machine was used to conduct Shear Compressive Strength test on all the Miniscrews. Data was collected and ANOVA and Post Hoc Test were applied to get the results. Result: For maxillary bone analogue (Group I), 1...

Lateral cephalometric radiography is commonly used as a standard tool in orthodontic assessment and treatment planning. The aim of this study was to evaluate the available scientific literature and existing evidence for the validation of using lateral cephalometric imaging for orthodontic treatment planning. The secondary objective was to determine the accuracy and reliability of this technique. We did not attempt to evaluate the value of this radiographic technique for other purposes. A literature search was performed using specific keywords on electronic databases: Ovid MEDLINE, Scopus and Web of Science. Two reviewers selected relevant articles, corresponding to predetermined inclusion criteria. The electronic search was followed by a hand search of the reference lists of relevant papers. Two reviewers assessed the level of evidence of relevant publications as high, moderate or low. Based on this, the evidence grade for diagnostic efficacy was rated as strong, moderately strong, limited or insufficient. The initial search revealed 784 articles listed in MEDLINE (Ovid), 1,034 in Scopus and 264 articles in the Web of Science. Only 17 articles met the inclusion criteria and were selected for qualitative synthesis. Results showed seven studies on the role of cephalometry in orthodontic treatment planning, eight concerning cephalometric measurements and landmark identification and two on cephalometric analysis. It is surprising that, notwithstanding the 968 articles published in peer-reviewed journals, scientific evidence on the usefulness of this radiographic technique in orthodontics is still lacking, with contradictory results. More rigorous research on a larger study population should be performed to achieve full evidence on this topic.

Objective: To determine the best technique for measuring mesial-distal tooth widths on digital models. Methods: The individual mesial-distal tooth widths were measured (first molar to first molar, maxillary and mandibular) on 32 stone casts and corresponding digital models (emodels, GeoDigm, Chanhassen, Minn). The digital models were measured using five different techniques: occlusal aspect, occlusal aspect zooming in on each individual tooth, facial aspect rotating as needed, facial aspect from three standard positions (R buccal, facial, and L buccal), and qualitatively rotating the model in any position deemed necessary. Measurements were repeated three times at least 1 week apart. The operator time needed to complete each set of measurements was recorded. Results: Four of five digital measurement techniques (except for the facial aspect from three standard positions) showed a slight positive bias (overestimation in measured width) compared with stone cast measurements. Measuring from the occlusal aspect resulted in the greatest Pearson correlation (98.509%), the least Altman-Bland standard deviation of differences value (1.881 mm), and the second fastest measuring time (2 minutes 3 seconds). Qualitatively rotating the model had similar Pearson correlation and Altman-Bland values to the Occlusal technique but took the longest time to measure (7 minutes 1 second). Conclusions: The Occlusal measurement technique for digital models was the best combination of accuracy, repeatability, and speed of measurement. (Angle Orthod. 2010;80:254-261.)

A national study of care and outcomes in children born with a unilateral cleft lip and palate (UCLP) was performed over a 15-month period. Two cohorts of children ('5-year-olds' and '12-year-olds') were examined. There were 57 active cleft teams in the U.K. with 105 consultant orthodontists involved in the care of these children. Only 36 teams could provide basic data such as patients names. Of the patients, 47-51 per cent had neonatal appliances. The dental arch relationships were measured with the Goslon Index and a Five-Year-Old Index, 37-39 per cent of both age groups were either 'poor' or 'very poor'. Seventy per cent of the 12-year-old patients had a Skeletal III relation and 42 per cent of bone grafts were seriously deficient or failed. Dental treatment for active caries was needed by 40 per cent of 5-year-olds and 20 per cent of 12-year-olds. In addition, the training of recently appointed consultant orthodontists involved in the care of these children was scrutinized. As a whole, the results were disappointing with standards of care not significantly raised in the last decade. Recommendations have been made to the Department of Health and the implications for the orthodontic profession are explored. Overall, it seems that fewer orthodontists will need to be involved in a centralized care model for these children.

To observe pattern of ALP activity in Gingival Crevicular Fluid (GCF) during canine retraction stage of fixed orthodontic treatment. Ten patients age between 15 to 27 years old with moderate upper labial segment crowding were recruited from postgraduate orthodontic clinic. The tested canines were distalized using nickel titanium push coil spring. The level of ALP at week 0 acted as the baseline. Samples were taken at day 0, at week 1, 4, 8 and 12. The activities of ALP were measured using spectrophotometer (405 nm). Paired sample t-test was used to assess the differences at weekly interval and between test and control groups over the study period. The ALP level was decreased in both the mesial and distal of the test teeth for the first month and stabilizes months after. Significant difference were detected from week 4 upward when compared to the baseline (p<0.05). The bony turnover specifically the bone formation can be monitored through the expression of ALP in the gingival crevicular fluid during orthodontic treatment.

S tatistical analysis of data is crucial in cephalometric investigations. There are certainly excellent examples of good statistical practice in the field, but some articles published worldwide have carried out inappropriate analyses. Objective: The purpose of this study was to show that when the double records of each patient are traced on the same occasion, a control chart for differences between readings needs to be drawn, and limits of agreement and coefficients of repeatability must be calculated. Material and methods: Data from a well-known paper in Orthodontics were used for showing common statistical practices in cephalometric investigations and for proposing a new technique of analysis. Results: A scatter plot of the two radiograph readings and the two model readings with the respective regression lines are shown. Also, a control chart for the mean of the differences between radiograph readings was obtained and a coefficient of repeatability was calculated. Conclusions: A standard error assuming that mean differences are zero, which is referred to in Orthodontics and Facial Orthopedics as the Dahlberg error, can be calculated only for estimating precision if accuracy is already proven. When double readings are collected, limits of agreement and coefficients of repeatability must be calculated. A graph with differences of readings should be presented and outliers discussed. Statistical methods for assessing agreement between double readings of clinical measurements 2011;19(5):488-92 J Appl Oral Sci. 490 Statistical methods for assessing agreement between double readings of clinical measurements 2011;19(5):488-92 J Appl Oral Sci. 492

Introduction
Studies in the dental literature do not yet provide conclusive evidence for the functional and psychosocial benefits of orthodontic treatment. In this cross-sectional study, we aimed to assess the oral health-related quality of life of young Brazilian adults, aged 18 to 30 years, who had completed orthodontic treatment compared with untreated subjects waiting for treatment.

Methods
The subjects were recruited at a state-funded university clinic. The sample comprised 100 patients in the retention phase of orthodontic treatment for more than 6 months (treated group) and 100 persons who were seeking orthodontic treatment and were still on a waiting list (nontreated group). Data were collected by using the oral health impact profile, the index of orthodontic treatment need (malocclusion severity and esthetic impairment), the Brazilian economic classification criteria (socioeconomic status), and the index of decayed, missing, and filled teeth (oral health status). Statistical analyses were performed by using chi-square and Fisher exact tests and negative binomial regression.

Results
The mean oral health impact profile scores were 3.1 (SD ± 2.99) and 15.1 (SD ± 8.02) in the treated and nontreated groups, respectively. The most frequent impacts in the treated and nontreated groups were “painful aching” and “been self-conscious,” respectively. Comparisons between the groups were controlled for malocclusion severity, clinician-assessed esthetic impairment, age, sex, socioeconomic status, and oral health status. Nontreated young adults had mean oral health impact profile scores 5.3 times higher than did the treated subjects.

Conclusions
Young Brazilian adults who received orthodontic treatment had significantly better oral health-related quality of life scores in the retention phase, after treatment completion, than did nontreated subjects.

A new &quot;light&quot; maxillo-mandibular fixation system for treatment of mandibular fractures, based on use of special pins, is proposed. Fifteen patients with non-displaced mandibular fractures (angle, body and symphysis), have been treated at the Department of Maxillofacial Surgery, S. Paolo University Hospital, Milan. The system is based on pins formed by a no. 1 metal wire and a bead. The free end of the pin is threaded around a tooth and then wound three or four times around the bead to fix it in place and, at the same time, separate it from the gingiva. One pin is usually positioned on each quadrant. Once the pins are in place they are tied to each other using a loop no. 0 to complete the maxillo-mandibular fixation. Particular attention was paid to maintain a correct individual occlusion. The time of maxillo-mandibular block was 10-15 days. Results were good with complete healing of all fractures, restoration of individual occlusion, minimal periodontal lesions and a good ...

Malocclusion can also be caused by abnormal functions, for instance, mouth breathing, tongue thrust, swallowing, and unilateral chewing and also by abnormal postures of oral circumferential muscles like forward tongue thrust, tongue biting, and low tongue at rest. Orthodontists agree that the tongue's habitually abnormal movement can cause a variety of malocclusions. The aim of the present literature is to enlighten the anatomy & development of tongue, along with its functions and orthodontic implications (role i n malocclusion).

Introduction: The study was undertaken to compare two indirect bonding methods, one method used a light cured adhesive system and clear vacuum formed transfer trays and a second method used a chemical cure adhesive system and putty transfer trays Materials and Methods: 191 bondings provided a data base of bond failures for two indirect bonding methods. The initial bond failure rates were compared using Fisher's Exact Test. The long term bond failure rates were compared using actuarial life tables and a Mantel-Haenzel comparison. Results: In initial bond failure the light cured method had a 9% failure rate compared to the chemical cured methods 0.7% failure rate. Long term the light cured method had a 0% failure rate while the chemical cured method had a 9% failure rate. Conclusion: The initial bond was less likely to fail with the chemically cured method but long term the light cured method was had fewer bond failures. Introduction When bonding fixed orthodontic appliances to teeth orthodontists have the choice of bonding indirectly or directly. Indirect bonding involves positioning the brackets on models of the teeth and then transferring the brackets to the patient's mouth to be bonded. This allows for determining the position of the bracket in the lab away from oral sources of contamination. It also allows for the evaluation of bracket position without the use of a mirror and from view points that would be difficult or impossible if positioning brackets directly in the mouth [1]. Once the bracket position is satisfactory a transfer tray is fabricated and the brackets can then be transferred to the patient's mouth with all of the brackets maintaining the chosen position. Conversely direct bonding involves positioning the brackets in the mouth and then bonding the bracket in place. This allows more time for the adhesive system used to bond the bracket to become contaminated [2]. Also, due to confined environment on the mouth often times in is difficult to fully visualize the bracket position. A large factor in initial and long term bond failure is contamination of the bonding site by saliva, blood, and or water. This contamination can occur after etching or after the placement of the primer/bonding agent. In the light cured indirect bonding method being studied brackets are placed in the mouth in groups of 5-12 and then bonded in place individually. The light cured method recommends a total of 10 seconds of curing per tooth in two separate 5 second intervals. The chemically cured indirect bonding method being studied places the brackets in the mouth in groups of 5-12 which are bonded simultaneously to the teeth. The chemical cure requires a 4 minute set time. The difference in timing and manner of curing allow for separate paths of contamination with no clear advantage to either method. Bond failures can represent a significant increase in treatment time. In 2007, a study by Haeger et al. [3] found an average increase of 1.21 months of treatment time per bond failure. Typical treatment times range from 16-24 months with each bond failure representing a 5-8% potential increase in treatment time. Longer treatment time increases the risk of root resorption and carious white spot lesions. Root resorption decreases the amount of tooth structure supported by bone and compromises the long term health of the tooth. White spot lesions are precursors to dental cavities and also present an aesthetic blemish on the tooth that is permanent. By determining if certain indirect bonding methods provide for decreased bond failure

Concordance involves a process of agreement or shared decision-making between patients and healthcare providers. Concordance was introduced to replace the term compliance, which has connotations of a paternalistic doctor-patient relationship. Patients and parents need sufficient information and discussion before they decide whether to proceed with orthodontic treatment which can last up to 2 years. Recent studies in orthodontics have noted that enhancing the relationship between the orthodontist and patient through effective communication and encouraging patient participation in choosing the best treatment alternative is essential for successful orthodontic treatment. The Objective of this study was to evaluate the preference for orthodontic brackets in patients visiting the Department Of Orthodontics at Educare Institute Of Dental Sciences and its influence in the attributed value of orthodontic treatment, considering their' socioeconomic status, age and gender. METHODE: Four different fixed orthodontic appliances and one clear aligner were displayed to the patients who visited our department. 1. Metal Braces, 2 Ceramic Brackets, 3 Self Ligating Brackets, 4 Lingual Brackets and 5 Clear Aligner were displayed to the patients. A questionnaire with 10 questions were prepared and given to the patients. A sample of 50 adults of age group between 16 to 28 were asked to rate each bracket kit for (1) its attractiveness on a visual analog scale (2) Treatment duration and (3) the willingness to pay (WTP) for a cosmetic appliance when compared to clear tray aligner. Comparisons between the appliances' attractiveness were performed using the Friedman's test and Dann's post-hoc test. Correlation between appliances' attributed value, socioeconomic status, age, gender, and esthetic perception was assessed using Spearman's correlation analysis. Initially, majority tend to prefer clear aligners over conventional brackets because of the superior comfort and esthetics, less visits, less food restrictions, and good periodontal health. The benefits of aligner therapy are numerous and in most cases, the benefits outweigh the cost. After explaining about its price, their preference was changed to conventional bracket system. Majority of patients preferred cost over comfort and cost over esthetics. Despite widespread acceptance, cost does matter.

This study aims to estimate orthodontic treatment need among 15-24 year-old individuals in Montevideo, Uruguay, and the association of occlusal traits with demographic, clinical and socioeconomic factors, considering a life course approach. A cross-sectional study using data from the First National Oral Health Survey in Uruguay was conducted. A two-stage cluster procedure was used to select a sample of 278 individuals in Montevideo. Household interviews and oral examinations were performed by six dentists. Dental Aesthetic (DAI) and Decayed Missing and Filled Teeth Indices (DMFT) were used to assess orthodontic treatment need and dental caries, respectively. Early life and current socioeconomic factors were obtained from the interview. Ordinal logistic regression was used to model the DAI index. Prevalence of definite malocclusion was 20.6%, followed by severe (8.2%) and very severe (7.6%). In the adjusted analysis, individuals with untreated dental caries (OR = 1.11; 95%CI: 1.03-1....

The aim of this prospective study was to compare a fixed lingual orthodontic appliance with a commonly used aligner system, focusing on oral impacts and speech disturbances, during the first 3 months of orthodontic treatment. Two groups of adults were evaluated: 21 treated with Invisalign® and 26 with In-Ovation L® lingual brackets. Health-related quality of life questionnaires were used to assess the oral impacts, and speech samples were collected for speech evaluation by professionals. The levels of pain and painkiller intake were similar, increasing on the first day, and decreasing at 3 months. Subtle injuries on the lip and cheeks were initially reported in the aligner group. Lingual patients experienced more discomfort in swallowing and opening the mouth, tongue injuries and food residues, even at 3 months. The consonants “s” and “z” were mainly affected in both groups immediately after appliance insertion, but more often in the aligner group. These speech disturbances recovere...

Objective To describe the establishment of an outreach centre for the training of all members of the orthodontic team. The development of the orthodontic team The remit of orthodontic nurses and orthodontic therapists is described and how their training may be delivered and integrated within a primary care training centre. Outreach training The reasons for the development of outreach training are discussed and how these are particularly relevant for the development of orthodontic training in the UK. The University of Warwick orthodontic outreach centre This has been established in Leamington Spa in comprehensively equipped premises providing seven surgeries, a lecture theatre, clinical skills laboratory, and technical support. It currently provides an MSc course in orthodontics for general dental practitioners (GDPs) and training for qualifi ed dental nurses leading to the award of an Orthodontic Nurse's Certifi cate. It has also recently been approved by the General Dental Council (GDC) for the delivery of a course leading to the Diploma in Orthodontic Therapy commencing in July 2008.

The aim of this prospective study was to compare a fixed lingual orthodontic appliance with a commonly used aligner system, focusing on oral impacts and speech disturbances, during the first 3 months of orthodontic treatment. Two groups of adults were evaluated: 21 treated with Invisalign ® and 26 with In-Ovation L ® lingual brackets. Health-related quality of life questionnaires were used to assess the oral impacts, and speech samples were collected for speech evaluation by professionals. The levels of pain and painkiller intake were similar, increasing on the first day, and decreasing at 3 months. Subtle injuries on the lip and cheeks were initially reported in the aligner group. Lingual patients experienced more discomfort in swallowing and opening the mouth, tongue injuries and food residues, even at 3 months. The consonants &quot;s&quot; and &quot;z&quot; were mainly affected in both groups immediately after appliance insertion, but more often in the aligner group. These speech...

In orthodontics, assessment of any case  is started with taking history and examining the jaws,
soft tissues and dentition in different planes. The present study was conducted to modify a clinical
method used to evaluate the sagittal jaw relationship and correlate it with other methods.
One hundred and five individuals were selected to participate in this study. Clinical examination
and  true  lateral  cephalometric  radiograph  were taken to  analyze  different methods for  assessing
sagittal  jaw  relationship  using  AutoCAD  program  2017.  Data  collected  were  analyzed  using
independent  sample  t-test,  one-way  ANOVA  followed  by  post  hoc  Tukey's  test  and  Pearson's
correlation coefficient test.
There  was  agreement  between  the  two  fingers  method  with  other  methods.  The  difference
between  modified  method  (Subspinale  and  Sublabiale  to  the  Zero-Meridian  line)  was  correlated
significantly with other methods in class II sample.
A new clinical method is developed to assess the sagittal jaw relation using Zero-Meridian line.

The life cycle of sucking, swallowing and breathing has causes and consequences, the purpose of this document is to provide and disseminate it. It is written to respond to step mothers and some health professionals. El ciclo vital de succión, deglución y respiración tiene causas y consecuencias, el proposito de éste documento es el de dar a conocerlo y difundirlo. Esta escrito para dar respuestas a las madres y de paso a algunos profesionales de la salud.

Introduction: Palatal rugae is a collection of mucosal folds in front of the palatal and is unique to each individual. Rugae have been studied for various purposes. This research investigates the pattern of palatal rugae with different skeletal relationships in the sagittal dimension in a group of the Iranian population.
Materials & Methods: A cross-sectional study was examined on 135 pre-orthodontic dental casts. The patients were grouped as Class I, Class II, and Class III according to the Nasion -A to Nasion -B angle (ANB) 45 patients in each group. Palatal rugae were recorded based on length, orientation, and pattern in each group, then compared. Data were analyzed by Chi-square, ANOVA, and Tukey post hoc test. In this study p<0.05 was considered significant.
Results: The mean number of total rugae was significantly different among groups (p value=0.02). Cl III malocclusion had less number of rugae in comparison to other groups (p value=0.03). The number of straight pattern was significantly different between groups, (p value=0.04) and Cl I malocclusion had  more straight pattern than other groups .
Conclusion:This study showed some differences in the palatal rugae pattern between different classes of malocclusion according to Angle’s classificatin. In addition, orientation of some rugae were also found to be significantly different between malocclusion  groups.

Post-orthodontic relapse of lower incisors is a common phenomenon. Sometimes a bonded retainer is fitted to prevent this relapse. In this article, we suggest a handy clinical technique of fitting a lower bonded retainer, which is convenient and easy to carry out.

Introduction: The aim of this study was to assess oral health-related quality of life (OHQOL) in adolescents who sought orthodontic treatment. A comparison between these adolescents and their age-matched peers who were not seeking orthodontic treatment provided an assessment of the role of OHQOL in treatment seeking. Methods: The sample consisted of 225 subjects, 12 to 15 years of age; 101 had sought orthodontic treatment at a university clinic (orthodontic group), and 124, from a nearby public school, had never undergone or sought orthodontic treatment (comparison group). OHQOL was assessed with the Brazilian version of the short form of the oral health impact profile, and malocclusion severity was assessed with the index of orthodontic treatment need. Results: Simple and multiple logistic regression analysis showed that those who sought orthodontic treatment reported worse OHQOL than did the subjects in the comparison group (P \0.001). They also had more severe malocclusions as shown by the index of orthodontic treatment need (P 5 0.003) and greater esthetic impairment, both when analyzed professionally (P 5 0.008) and by selfperception (P \0.0001). No sex differences were observed in quality of life impacts (P 5 0.22). However, when the orthodontic group was separately evaluated, the girls reported significantly worse impacts (P 5 0.05). After controlling for confounding (dental caries status, esthetic impairment, and malocclusion severity), those who sought orthodontic treatment were 3.1 times more likely to have worse OHQOL than those in the comparison group. Conclusions: Adolescents who sought orthodontic treatment had more severe malocclusions and esthetic impairments, and had worse OHQOL than those who did not seek orthodontic treatment, even though severely compromised esthetics was a better predictor of worse OHQOL than seeking orthodontic treatment. (Am J Orthod Dentofacial Orthop 2010;138:152-9)

o r t h o d o n t i c w a v e s 6 8 ( 2 0 0 9 ) 1 1 6 -1 2 2 Maxillary midline spacing Relapse Low level laser therapy a b s t r a c t Background and objectives: Maintenance of a corrected median diastema after orthodontic treatment often requires permanent retention. This study was performed to evaluate low level laser therapy (LLLT) effect on bone density after diastema closure and to determine whether increased density will prevent diastema relapse.

Background: Bioactive glass (BAG) is used as an antibacterial agent. This study aimed to assess the effect of addition of BAG to glass ionomer cement (GIC) on accumulation of Streptococcus mutans (S. mutans) and Lactobacilli around orthodontic bands. Material and Method: This clinical trial was conducted on 10 patients requiring orthodontic treatment with lingual arch and molar bands. In five patients, Fuji II SC GIC was used for cementation of the right and Fuji II SC containing 30wt% BAG was used for cementation of the left molar band. In the remaining five patients, Fuji II LC was used for cementation of the left and Fuji II SC containing 30wt% BAG was used for cementation of the right molar band. Formation of S. mutans and Lactobacillus colonies in the culture medium was assessed and number of colonies was counted using a colony counter. The data were analyzed by using paired t-test. Results: The mean number of total bacteria, aerobic Lactobacilli, anaerobic Lactobacilli and S. mutans was significantly different between the two cements with and without BAG such that the mean count of total bacteria, aerobic Lactobacilli, anaerobic Lactobacilli and S. mutans in Fuji II LC plus BAG was less than that in plain Fuji II SC cement. Conclusion: Addition of BAG to GIC decreases the accumulation of S. mutans and anaerobic and aerobic Lactobacilli around orthodontic bands. Key Message: The used cement can be effective in reducing the damaging effect of orthodontics' bands.

iii Acknowledgment I would like to thank Dr. Eser Tüfekçi, who supported the idea of this research project and assisted me in writing the thesis. I appreciate all of her hard work and the timely manner in which she returned my thesis drafts. It has been a privilege working with her.

We may not have the flying cars or hoverboards of Robert Zemeckis’ depiction of 2015 – the 1989 film Back to the Future Part II – but this year is set to be a landmark year for dental professionals in the UK as London hosts the International Orthodontic Congress for a third time, the only city in the world yet to do so. This article gives an overview of how this international meeting came to be and what we can expect from
the 8th International Orthodontic Congress later this year.

Background: The aim of this study was to determine the perception of smile esthetics among orthodontists and laypeople with respect to the presence of diastemas in the upper lateral incisor in the mesial, distal, and both surfaces using an oblique smile analysis. Methods: Two standardized oblique photos of pleasant smiles from two white women were selected. Images were digitally altered to create diastemas in the lateral incisor, in 0.5-mm increments, in the mesial, distal, or both surfaces. Final images were randomly assembled in a photo album, which was given to 120 judgesd60 orthodontists and 60 laypersons. Each rater was asked to evaluate the attractiveness of the images on a visual analog scale. The data collected were submitted to statistical analysis by the means of one-way ANOVA with the Tukey post hoc test and the unpaired Student's t test. Results: The most attractive smile was the one without spacing, and the presence of diastemas was considered unattractive by both groups of raters, following a pattern: the greater and the more mesially located, the more unattractive was the smile. Conclusions: The results of this study suggest that diastemas in the upper lateral incisor area were considered unattractive, following a pattern: the greater and the more mesially located, the more unattractive was the smile.

Two case reports illustrate the effective treatment of Class II division 2 malocclusion with modifications to the Twin Block appliance. This approach may reduce the total treatment time and reduce the need for extra-oral anchorage. In each of the cases presented treatment has been carried out on a non-extraction basis with full correction of the malocclusion. 272 F. M. V. Dyer et al.

Frontal facial symmetry is the major component of facial esthetics. However,
comparative study on perceptions with regard to treatment decisions of various groups involved on this issue has been lacking. This study aims to compare perception and treatment decisions of orthodontists, orthodontic students, oral surgery students, orthodontic patients and laypeople on frontal symmetrical facial esthetics.

One hundred and twelve dental professionals (40 orthodontists, 40 orthodontic students, 32 oral surgery students), 40 orthodontic patients and 40 laypeople were recruited. A frontal facial photograph of a Thai female subject was modified to achieve the highest degree of symmetry. The freeware WinMorph 3.01 was then used to distort the lower one-third of face to produce a series of images, of which the chin points were moved away from the facial midline leftwards and rightwards at intervals of 0 mm, 2 mm, 4 mm, 6 mm, 8 mm, and 10 mm. The assessors were asked to score each image for symmetry, using a modified 6-point Likert’s Scale (0-not deviated, 1- least deviated, 2-less deviated, 3-average, 4-more deviated, and 5-most deviated), and evaluate the treatment necessity of each images

‘Less deviated’ was found to be the most reliable point of differentiation among assessor groups and was used as the point of reference. The orthodontists were the most sensitive in detecting deviation, followed by orthodontic students, laypeople, orthodontic patients, and oral surgery students. The mean distances in differentiating right-deviated pictures were 4.05, 4.40, 5.42, 5.78, 6.00 and in left-deviated pictures they were 3.60, 4.15, 5.00, 5.19, and 5.93 respectively. Using the Analysis of Variance, it was revealed that there was no significant difference of treatment decisions among the groups of assessors. The mean distance indicating need for treatment was 7.39 mm and 6.92 mm for right and left deviated pictures, respectively.

There were some differences in degree of sensitivity which related to professional factors that affect the ‘acceptable range of deviation’ among groups of assessors. However, it did not seem to affect treatment decisions which were similar in all groups of assessors.

The aim of this study was to retest the hypotheses of by conducting a similar randomized controlled trial in an orthodontic clinic in the Netherlands. It was hypothesized that a reminder would reduce the failed attendance rate and that the form of the reminder would be irrelevant. Methods: All patients with appointments in the orthodontic clinic at the Academic Centre of Dentistry Amsterdam during a 3-week period were divided into 4 groups. Three groups received a reminder 1 day before the appointment, either by telephone, mail, or short message service (SMS, a service used to send and receive short text messages to and from cell phones). A control group did not receive a reminder. In a follow-up study, random subsamples in each group were interviewed by telephone. Subjects were asked how they felt about receiving a reminder and which reminder they preferred. Results: The hypothesis that a reminder would reduce the failed attendance rate was not confirmed. Also, no differences were found between the 4 conditions, indicating that the form of the reminder is irrelevant. However, most of the interviewed participants felt positive or very positive about receiving a reminder. There was a significant preference for a reminder by mail (56.3%), followed by a telephone reminder (26.0%) and a reminder by SMS (17.7%). No less than 20% of the interviewed participants felt negative or very negative about the reminders and considered them to be a waste of time and money. Conclusions: The hypothesis that reminders are useful in the prevention of failed appointments was not confirmed. This study underlines the importance of replication studies. It demonstrates that every research result, whether it is generated by evidence-based or tradition-based research, should be interpreted with care and should be replicated in other studies before the results can be generalized. (Am J Orthod Dentofacial Orthop 2005;127:355-7)

Aim of the study was to get more insight into the opinion of European surgeons and orthodontists on the use of distraction osteogenesis (DO) for patients with different diagnoses and treatment protocols. A web based survey was set up, showing records of four patients with different conditions: hemifacial microsomia (case 1), bilateral mandibular deficiency (case 2), cleft lip and palate (case 3) and Crouzon syndrome (case 4). Respondents from 181 Eurocleft centres were asked to fill out a questionnaire for each patient. Most of the respondents considered case 1 (80%), case 3 (81%) and case 4 (86%) suitable for DO, while only 31% were considering case 2 for DO. There was lack of consensus among the respondents about many aspects of DO. Out of six different treatment parameters, an acceptable degree of agreement was only seen in two: a latency period of 3e7 days and a distraction rate of 1 mm per day. Furthermore, there was noticeable disagreement on the ideal age for treatment, surgical technique, distraction device, and retention period. Our results showed that there is a wide variety in treatment approaches for craniofacial anomalies in Europe. There is disagreement on essential steps in the distraction procedures. Ó 2009 European Association for Cranio-Maxillo-Facial Surgery

Capítulo As Bases Fisiológicas da Resposta Óssea à Estimulação Funcional Na escala filogenética, o osso surgiu para proteger. Os organismos em desenvol-vimento começaram a tomar um grau de complexidade que exigiu da natureza um mecanismo de enrijecimento dos envólucros cartilaginosos que já não ofereciam proteção suficiente. A solução foi a mineralização e, com isso, o surgimento do primeiro tecido rígido. 1 No entanto, a evolução prossegue e esse tecido rígido assume também a função de sustentação e ancoragem, passando a compor com os tecidos com que se relaciona um sistema mecânico complexo. Esse siste-ma torna-se extremamente dependente das cargas à que é submetido, e o processo de modelagem das estruturas rígidas passa a ser responsivo às estimulações funcionais que recebe. O binômio forma e função es-tabelecido por Julius Wolff é a expressão máxima dessa inter-relação. Não existe for-ma adequada se não houver a estimulação funcional correta. 2 Mas se o crescimento ósseo é tão dependente da execução da função com geração de cargas, como são geradas essas cargas sobre o tecido ósseo? Podemos afirmar que o tônus muscular tanto no repouso quanto no movimento é o principal gerador, tendo como coadjuvante as pressões e tensões exercidas no tecido ósseo por outras estruturas (p. ex., o cérebro em crescimento, os seios paranasais inflados pelo ar, etc.). 3,4 Precisamos compreender que, ao fazermos uma intervenção ortopédica funcional, estamos, entre outros mecanis-mos, usando caminhos de estimulação neural que levarão a alterações no tônus muscular, que por sua vez gerará a estimu-lação mecânica necessária para a indução do crescimento e desenvolvimento ósseos desejados. 5 Quais são estes caminhos? Onde se processam estes estímulos neurais? No nosso organismo existem proprioceptores (especializações das terminações das fibras nervosas sensitivas) em todo o corpo e estes proprioceptores informam ao SNC (sistema

In this 2nd part, the current treatment of white spot lesions by erosion/infiltration is presented, beginning with a reminder of the principle of superficial infiltration, which enables most early carious lesions, fluorosis and post-traumatic lesions to be treated. However, this technique has met with frequent failures in cases of MIH or deep lesions of traumatic origin or those associated with fluorosis. For this reason a new deep infiltration technique is proposed: thanks to its global treatment concept, this enables all white spots to be treated. The place of whitening in these treatment options is discussed, with explanations of the main reasons for its failures.