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American Journal of Orthodontics and Dentofacial Orthopedics

Sometimes we are interested in comparing pairs of observations within the same subjects. Then we should bear in mind that those observations are not independent and should be treated accordingly.

Virtual surgical planning (VSP) and 3-dimensional (3D) printing of surgical splints are quickly becoming the standard of care in preparation for orthognathic surgery. Studies conducted over the past few years have shown that patients planned with virtual model surgery result in comparable or better outcomes compared with traditional 2-dimensional (2D) treatment planning using cephalometric analysis, model surgery, and manual fabrication of surgical splints. This study aimed to compare VSP and 3D printing of surgical splints with standard surgical planning and manual splint fabrication not based on their clinical merit but based on their monetary costs.

Farhadian N, Mashoof RU, Khanizadeh S, Ghaderi E, Farhadian M, Miresmaeili A. Streptococcus mutans counts in patients wearing removable retainers with silver nanoparticles vs those wearing conventional retainers: A randomized clinical trial. Am J Orthod Dentofacial Orthop 2016;149:155–60.

James William Barnett died on Saturday, September 17, 2016. He was 93. Jay was born on September 30, 1922, in Groom, Texas, to Beulah and Ivan Barnett. He graduated from Phillips High School and Texas Tech University; he received a dental degree from University of Missouri at Kansas City and a graduate degree from the University of Texas School of Orthodontics in Houston. He served in the US Navy as the chief dental officer aboard the USS Doyen. He began his orthodontic practice in 1959 in Amarillo, Texas, and worked into his 80s, eventually selling his practice to Dr Steve Astuto.

Orthodontic education is often questioned when it is obtained from unfamiliar institutions. The intent of this book is to answer the questions related to this uncertainty; moreover, it gives the reader the insight to judge more objectively the various international programs listed. It is a tremendous resource with valuable information about the academic, research, and clinical elements of postgraduate orthodontic programs worldwide. It is not a textbook describing clinical procedures or techniques; however, it refers to international, regional, and national guidelines pertaining to the recognition and accreditation criteria of health authorities, professional organizations, and scientific societies involved in orthodontic education or specialty recognition.

The European Journal of Orthodontics

<span class="paragraphSection"><div class="boxTitle">Summary</div><div class="boxTitle">Objectives:</div>To analyse and compare the effects during Herbst treatment combined with a lingual (completely customized) or labial (straight-wire) multibracket appliance (MBA), with special regard to lower incisor gingival recessions.<div class="boxTitle">Subjects and methods:</div>Eighteen Class II:1 patients [overjet ≥ 5mm, Class II molar relationship ≥ 0.5 cusp widths (CW) bilaterally or 1.0 CW unilaterally, median age 16.0 years] treated with a Herbst appliance in combination with a lingual MBA (group LINGUAL) were retrospectively matched (molar relationship and skeletal maturity) to 18 Class II:1 patients treated with a Herbst appliance combined with a labial MBA (group LABIAL). Study models and intraoral photographs from before and after treatment were uated regarding occlusal variables and gingival recessions. Lateral cephalograms from before, during (before and after Herbst), and after treatment were analysed to assess lower incisor changes.<div class="boxTitle">Results:</div> Both groups showed similar reductions of overjet (5.4/5.6mm), overbite, (2.9/2.7mm) and sagittal molar relationship (0.9/0.8 CW). During the Herbst phase, the changes in lower incisor inclination and incisal edge position were significantly smaller in the LINGUAL than in the LABIAL group (iiL/ML: +7.0/+12.7degrees, <span style="font-style:italic;">P</span> = 0.002; ii-MLp <sub>pg</sub> : +2.5/+3.9mm, <span style="font-style:italic;">P</span> = 0.004). For the total treatment period, no significant differences were found (iiL/ML: +5.3/+8.6degrees; ii-MLp <sub>pg</sub> : +2.1/+2.4mm). No clinically relevant gingival recessions were seen. <div class="boxTitle">Conclusion:</div>Both treatment approaches successfully corrected the malocclusion. The group LINGUAL exhibited significantly less proclination during the Herbst phase only. Neither treatment approach induced deleterious gingival recessions.</span>

<span class="paragraphSection">Twin studies: research in genes, teeth and faces Authors: TownsendGrant , PinkertonSandra , RogersJames , BockmannMichelle and HughesToby Publisher: University of Adelaide Press Price: $55.00 ISBN: 978-1-925261-14-1 (paperback), 978-1-925261-15-8 (ebook) </span>

<span class="paragraphSection"><div class="boxTitle">Summary</div><div class="boxTitle">Background:</div>Recently, the use of skeletal anchors in conjunction with fixed functional appliances (FFAs) has been advocated to enhance skeletal changes and reduce proclination of the lower incisors.<div class="boxTitle">Objective:</div>To compare the skeletal and dento-alveolar effects of the use of FFAs with and without skeletal anchorage (miniscrews or miniplates).<div class="boxTitle">Search methods:</div>Unrestricted electronic search of six databases and additional manual searches were performed up to July 2015.<div class="boxTitle">Eligibility criteria:</div>Randomized and prospective non-randomized controlled trials directly comparing the use of FFA with and without skeletal anchorage, and involving growing patients with Class II malocclusion.<div class="boxTitle">Data collection and analysis:</div>Skeletal and dento-alveolar outcomes data were extracted in pre-defined sheets to collect study characteristics by two authors independently. After uating risk of bias, the standardized mean differences (SMDs) and 95% confidence intervals (CIs) were calculated with random-effects models. Subgrouping was pre-planned on the basis of the skeletal anchorage type used. Additional subgroup analysis was performed on the basis of the type of FFA used and the study design.<div class="boxTitle">Results:</div>Seven studies were uated, and only five of which were included in the meta-analysis. The analysis included data from 157 Class II subjects (77 treated with FFA and skeletal anchorage, and 80 with FFA alone). Random-effects meta-analysis demonstrated no significant differences in the mandibular length and SNB angle changes [SMD = 1.98 (95% CI −0.11 to 4.07) and 1.20 (95% CI −0.37 to 2.77) respectively]. Significant differences were found between the inclination changes of lower and upper incisors [SMD = −1.43 (95% CI −2.59 to −0.27) and SMD = −1.04 (95% CI −1.57 to −0.51) respectively]. Subgroup differences were highly significant in most of the outcomes.<div class="boxTitle">Conclusions:</div>The studies reviewed provide insufficient evidence to form a conclusion regarding the effects of the use of skeletal anchorage with FFA. The available weak evidence suggests that the use of skeletal anchorage with FFA has no superior skeletal effects but is able to reduce proclination of the lower incisors.</span>

<span class="paragraphSection"><div class="boxTitle">Summary</div><div class="boxTitle">Background:</div>The reliable assessment of craniofacial morphological changes during growth requires invariant regions for image registration. As these regions have not yet been identified in three dimensions, intra-osseous implants are required as fiducial markers for the reliable assessment of three-dimensional (3D) mandibular growth changes. The objective of this study was to develop an animal model for the assessment of the 3D morphological changes of the mandible during growth, using implants as fiducial markers.<div class="boxTitle">Materials and methods:</div>Titanium implants were placed in the body of the mandible of six New Zealand White rabbits. Cone beam computed tomography (CBCT) scans were taken 1-week following implant placement and after an additional 8-weeks of growth. Segmentations of CBCT images were exported into custom-made scripts, implant centroids were identified, implant stability during growth calculated, and the segmented mandibles were registered on the implant centroids.<div class="boxTitle">Results:</div>The buccal cortical bone of the body of the mandible was stable during growth and suitable for fiducial marker placement. Bilateral implants resulted in more accurate rigid registration of the growing rabbit mandible than only unilateral implants. 3D mandibular growth changes were visualised by means of semi-transparencies.<div class="boxTitle">Conclusions:</div>This animal model appears to be feasible for the assessment of the 3D morphological changes occurring during mandibular growth. To the best of our knowledge this is the first time that the implant superimposition method has been combined with 3D imaging to accurately reveal mandibular growth changes.</span>

<span class="paragraphSection"><div class="boxTitle">Summary</div><div class="boxTitle">Background/Objectives:</div>Although the electromyographic (EMG) activity of the perioral muscles, including the orbicularis oris and mentalis muscles, has been described in individuals with lip incompetence during lip sealing, blood flow through these muscles remains to be elucidated. The purpose of this study was to examine the blood flow associated with EMG activity in the perioral muscles using laser speckle imaging in individuals with lip incompetence.<div class="boxTitle">Subjects/Methods:</div> Blood flow and EMG activity of the superior and inferior orbicularis oris and mentalis muscles were measured with the lips in contact (C condition) and apart (O condition) in lip incompetence (experimental) and control subjects ( <span style="font-style:italic;">n</span> = 15 in each group; mean age: 29.5 years). The change ratios of blood flow and EMG activity in the C condition versus O condition (C/O ratios) were calculated and plotted in a scattergram. The Mann–Whitney <span style="font-style:italic;">U</span> -test, Wilcoxon signed-rank test, discriminant analysis using the Mahalanobis generalized distance, and Spearman correlation were used for statistical analysis. <div class="boxTitle">Results:</div>In the experimental group, blood flow and EMG activity in all muscles were significantly greater in the C condition than in the O condition. The plots of C/O ratios in the experimental group showed a distinct and wide distribution and were significantly different than those in the control group. In both groups, a significant positive correlation was observed between blood flow and EMG activity in the mentalis muscle.<div class="boxTitle">Conclusions/Implications:</div>The present findings suggest that observing blood flow in the mentalis muscle is an effective and easily performed method of uating lip incompetence.</span>

<span class="paragraphSection"><div class="boxTitle">Summary</div><div class="boxTitle">Objectives:</div>The purpose of this study was to compare the clinical effectiveness in reducing large overjet between a prefabricated functional appliance (PFA) and a slightly modified Andresen activator (AA).<div class="boxTitle">Setting and sample population:</div>Public Dental Service, Gothenburg, Sweden.<div class="boxTitle">Participants, study design, and methods:</div>A multicentre, prospective randomized clinical trial was conducted with patients from 12 general dental practices. One hundred and five patients with an Angle Class II, division 1 malocclusion and an overjet of ≥6mm were eligible for the study. Eight patients were excluded due to various reasons and the sample consisted thus of 97 subjects (44 girls, 53 boys) with a mean age of 10.3 years. The study was designed as intention to treat and the patients were randomly allocated by lottery to treatment with either a PFA or an AA. The PFA and AA group consisted of 57 subjects (28 girls, 29 boys) and 40 subjects (16 girls, 24 boys), respectively. Overjet, overbite, lip seal, and sagittal molar relationship were recorded before, at the end of treatment and 1-year post-treatment. Blinding was not performed. The endpoint of treatment was set to overjet ≤3mm and after this a 6 months retention period followed.<div class="boxTitle">Results:</div>No significant difference was found in overjet, overbite, sagittal relation, and lip seal between the two groups for the total observation period. The treatment of 40 (70 per cent) patients with PFA and 21 (53 per cent) with AA were considered unsuccessful mainly due to poor compliance.<div class="boxTitle">Limitations:</div>No cephalometric records were taken as only patient-centred clinical outcome were used as an indicator for treatment success. The criteria of reduction of overjet to as low as 3mm could have affected the success rate.<div class="boxTitle">Conclusion:</div>No difference in effectiveness could be shown between PFAs and AAs in correcting overjet, overbite, sagittal molar relation, and lip seal. The success rate in treatment with both appliances is, however, low.<div class="boxTitle">Registration:</div> This trial was registered in “FoU i Sverige” ( http://www.fou.nu/is/sverige ), registration number: 97131. <div class="boxTitle">Protocol:</div>The protocol was not published before trial commencement.</span>

<span class="paragraphSection"><div class="boxTitle">Summary</div><div class="boxTitle">Objectives:</div>To determine the total torque play of various rectangular titanium molybdenum alloy (TMA)/stainless steel (SS) wires in various 0.018″ upper incisor lingual brackets and slot size measurements.<div class="boxTitle">Methods:</div> TMA (0.0175″ × 0.0175″, 0.0170″ × 0.025″, 0.0182″ × 0.0182″, 0.0182″ × 0.025″) and SS wires (0.016″ × 0.022″, 0.016″ × 0.024″, 0.018″ × 0.025″) were twisted in standard (Hiro, Incognito™, Joy®, Kurz 7th generation, STb™: fixation with elastic modules) and self-ligating brackets (Evolution SLT®, In-Ovation® L MTM: closed ligation mechanism) from −20 degrees to +20 degrees with a custom-made machine. The total torque play was calculated by extrapolating the linear portion of the twist/moment curves to the <span style="font-style:italic;">x</span> -axis and adding the absolute negative and positive angle values at the intercepts. The bracket slot height was measured before and after the experiments with a series of pin gauges with round profile. <div class="boxTitle">Results:</div>Brackets in ascending order for total torque play with the most slot-filling wire TMA 0.0182″ × 0.025″: Evolution SLT® (0 degree ± 0 degree), Incognito™ (2.2 degrees ±1.1 degrees), Hiro (5.1 degrees ±3.0 degrees), In-Ovation® L MTM (6.3 degrees ±2.2 degrees), STb™ (6.6 degrees ±1.8 degrees), Kurz 7th generation (7.1 degrees ±0.8 degrees), and Joy® (12.0 degrees ±0.8 degrees). Wires in ascending order for total torque play with the most precise slot Incognito™: TMA 0.0182″ × 0.025″ (2.2 degrees ±1.1 degrees), TMA 0.0182″ × 0.0182″ (2.4 degrees ±0.9 degrees), SS 0.018″ × 0.025″ (5.5 degrees ±1.0 degrees), TMA 0.0170″ × 0.025″ (9.4 degrees ±1.8 degrees), TMA 0.0175″ × 0.0175″ (13.0 degrees ±1.5 degrees), SS 0.016″ × 0.024″ (16.1 degrees ±1.4 degrees), SS 0.016″ × 0.022″ (17.8 degrees ±1.0 degrees); differences between some of the experimental groups were not statistically significant. Bracket slot dimensions in ascending order: Evolution SLT® (less than 0.452mm), Incognito™ (0.460mm ±0.002mm), In-Ovation® L MTM (0.469mm ±0.001mm), Hiro (0.469mm ±0.010mm), STb™ (0.471mm ±0.002mm), Kurz 7th generation (0.473mm ±0.002mm), and Joy® (greater than 0.498mm).<div class="boxTitle">Limitations:</div>The applied method must be questioned when used with brackets with incomplete slot walls (Evolution SLT®). Slot measurement with pin gauges may not register bracket wing deformation.<div class="boxTitle">Conclusions:</div>All brackets showed a differing slot size from the nominal 0.018″ (0.457mm). Incognito™ presented the most precise and Joy® the widest slot. The main wires for the retraction phase SS 0.016″ × 0.022″/SS 0.016″ × 0.024″ showed poor torque control. Among the finishing TMA wires, TMA 0.0175″ × 0.0175″ exhibited the highest and TMA 0.0182″ × 0.0182″/TMA 0.0182″ × 0.025″ the smallest torque play.<div class="boxTitle">Significance:</div>The manufacturers could profit from this investigation towards optimization of the dimensional precision of their products. The orthodontist must be aware of the torque play of the wire–bracket combinations to be able to plan and individualize the appliance by third order customization.</span>

<span class="paragraphSection"><div class="boxTitle">Summary</div><div class="boxTitle">Objectives:</div>To determine genetic and environmental impact on mandibular morphology using lateral cephalometric analysis of twins with completed mandibular growth and deoxyribonucleic acid (DNA) based zygosity determination.<div class="boxTitle">Materials and methods:</div>The 39 cephalometric variables of 141 same gender adult pair of twins were analysed. Zygosity was determined using 15 specific DNA markers and cervical vertebral maturation method was used to assess completion of the mandibular growth. A genetic analysis was performed using maximum likelihood genetic structural equation modelling (GSEM).<div class="boxTitle">Results:</div>The genetic heritability estimates of angular variables describing horizontal mandibular position in relationship to cranial base and maxilla were considerably higher than in those describing vertical position. The mandibular skeletal cephalometric variables also showed high heritability estimates with angular measurements being considerably higher than linear ones. Results of this study indicate that the angular measurements representing mandibular skeletal morphology (mandibular form) have greater genetic determination than the linear measurements (mandibular size).<div class="boxTitle">Conclusions:</div>The shape and sagittal position of the mandible is under stronger genetic control, than is its size and vertical relationship to cranial base.</span>

<span class="paragraphSection"><div class="boxTitle">Summary</div><div class="boxTitle">Objective:</div>To investigate the long-term outcome of treatment of missing maxillary incisor teeth by transplantation of premolars, with special reference to aesthetics and patient satisfaction.<div class="boxTitle">Subjects and Methods:</div>Twenty subjects who had undergone transplantation of premolars to the maxillary incisor area were recalled for follow-up varying between 12 and 22 years post-surgery. Twelve subjects presented for examination, including radiography and three subjects participated only by answering questions. Three reference groups—general practitioners, orthodontists, and lay people—uated the aesthetic results from photographs. Patient satisfaction was uated by interviews and OHIP-14.<div class="boxTitle">Results:</div>The mean age at transplantation was 12.3 years: 1 subject had been 20 years old and 11 were in the range of 9–14 years. Twelve to 22 years after autotransplantation, 5 subjects could not be reached: of the 15 who could be contacted, the survival rate was 15 out of 15. In the 12 subjects who presented for clinical examination, 11 out of the 12 transplants were assessed as successful. Nine transplants were restored with crowns and five had been recontoured with composite build-ups. In one patient, no restorative treatment had been undertaken. The subjects were satisfied with the aesthetic result.<div class="boxTitle">Conclusion:</div>Autotransplantation of premolars is an appropriate method for treatment of missing maxillary anterior teeth. Subjects with a transplanted tooth to the maxillary anterior region perceive their oral health as good long term.</span>

Journal of the World Federation of Orthodontists

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