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The incidence of eating disorders (ED) is increasing, not only in Westernized societies, but developing countries as well. Individuals having EDs may develop significant functional impairments across organ systems with serious life-threatening consequences, leading to the highest rates of mortality and morbidity among mental disorders. [ABSTRACT FROM AUTHOR]

White spot lesions (WSLs) are an all too common negative outcome of orthodontic treatment: a disheartening truth in an esthetically driven profession. WSLs are areas of enamel demineralization 100–150-µm deep, with an intact porous surface layer, which can progress until a complete inward collapse of the surface occurs. Their un-esthetic opaque appearance is potentially reversible, but irreversible once cavitated. Clinically detectable WSLs can occur as early as 1 month after fixed appliance placement. It is estimated that 50% of patients develop WSLs in at least one tooth by the end of orthodontic treatment. Although orthodontists have recognized this issue, the problem still persists. An immediate application of fluoride to a white spot lesion will cause a rapid surface remineralization, leaving deeper layers demineralized, so prevention of lesion progression is necessary for an ideal esthetic outcome. Aside from excellent oral hygiene, fluoride varnish, MI Paste, and smooth surface sealants are currently the primary methods of WSL prevention. There is an existing body of research related to the use of topical fluoride and calcium–phosphate pastes to prevent demineralization during orthodontic treatment, including at-home topical treatments. However, the self-reported compliance rate is approximately 50%. Professional fluoride varnish is thought to have the advantages of reducing demineralization without being technique sensitive. Other methods of WSL prevention are available, such as placement of sealants on facial surfaces of teeth, but preliminary research has shown conflicting results on their effectiveness. Regression of WSLs after treatment is attributed to gradual surface abrasion of tooth structure. Research has shown no improvement in WSLs when comparing non-invasive treatment methods such as MI Paste to routine oral hygiene practice. Success has been shown in treating arrested WSLs with a resin infiltration technique, but this is most useful on a small scale. [ABSTRACT FROM AUTHOR]

Objective: To explore the impact of fixed labial orthodontic appliances on speech sound production. Materials and Methods: Speech evaluations were performed on 23 patients with fixed labial appliances. Evaluations were performed immediately prior to appliance insertion, immediately following insertion, and 1 and 2 months post insertion. Baseline dental/skeletal variables were correlated with the ability to accommodate the presence of the appliances. Results: Appliance effects were variable: 44% of the subjects were unaffected, 39% were temporarily affected but adapted within 2 months, and 17% of patients showed persistent sound errors at 2 months. Resolution of acquired sound errors was noted by 8 months post-appliance removal. Maladaptation to appliances was correlated to severity of malocclusion as determined by the Grainger's Treatment Priority Index. Sibilant sounds, most notably /s/, were affected most often. Conclusions: (1) Insertion of fixed labial appliances has an effect on speech sound production. (2) Sibilant and stopped sounds are affected, with /s/ being affected most often. (3) Accommodation to fixed appliances depends on the severity of malocclusion. [ABSTRACT FROM AUTHOR]

Introduction: Esthetic considerations play an increasingly important role in patient care, and clinicians need a methodology that includes imaging techniques to capture the dynamic nature of the smile. Photographs of the posed smile are routinely used to guide diagnosis and treatment, but there is no standardized and validated method for recording the dynamic smile. The purposes of this study were to (1) determine whether a posed smile is reproducible, (2) compare visual and verbal cues in eliciting a smile, and (3) compare the diagnostic value of videography and photography in evaluating a patient's smile. Methods: The smiles of 22 subjects were simultaneously photographed and videotaped on 2 separate occasions. For objective comparisons, measurements of the smile were obtained from 8 × 10 color still photographs and selected digitized video images. A panel consisting of a layperson, an oral surgeon, an orthodontist, and a prosthodontist subjectively assessed the reproducibility of the smile, posed vs spontaneous smiles, and the diagnostic value of video vs still images. Results: Objective measurements showed that the posed smile can be reliably reproduced, whether captured by videography or still photography. However, subjectively, the panel members detected differences between the posed smiles taken on different days 80% of the time. The clinician panel members expressed a strong preference for videography over photography and for the spontaneous over the posed smiles. Conclusions: This study emphasizes the need to continue to investigate and standardize the methods of eliciting and recording a smile of diagnostic quality. [ABSTRACT FROM AUTHOR]

Introduction: Previously, we reported fluctuation of the levels of the inflammatory mediators interleukin-1β (ΙL-1β) and β-glucuronidase (βG) in gingival crevicular fluid (GCF) from the maxillary first molars in adolescents undergoing rapid palatal expansion. In this study, we compared the responses of IL-1β and βG in the GCF of the maxillary first molars, first premolars, and central incisors during palatal expansion at the same patients. Methods: Nine patients requiring palatal expansion were selected at the postdoctoral orthodontic clinic at Columbia University College of Dental Medicine. Each patient received periodontal prophylaxis and instructions in proper home care including rinsing with chlorhexidine. Four weeks after periodontal prophylaxis, a modified hyrax appliance was placed. The jackscrew was activated twice daily until the appropriate expansion was achieved. GCF samples were collected before and after periodontal prophylaxis and during passive wearing of the appliance, active orthodontic treatment, and retention. Fluid samples were collected with filter paper strips and analyzed by ELISA and time-dependent fluorometry for IL-1β and βG, respectively. The values recorded after periodontal prophylaxis were used as the baseline. Paired t tests were used to compare mediator levels at baseline with the levels obtained at each subsequent observation. Results: The results validate that IL-1β and βG are present in the GCF of adolescents, and, although their level decreases after a strict regimen of plaque control, it increases during orthodontic or orthopedic movement. Moreover, this study demonstrates that both heavy and light forces evoke increased levels of IL-1β and βG, stronger forces cause higher levels of inflammatory mediators, and both IL-1β and βG respond to direct and indirect application of mechanical force to teeth. Conclusions: This investigation corroborates previous findings that an inflammatory process occurs during application of mechanical force to teeth. Although this inflammation is considered relatively aseptic, additional inflammation, such as that induced by plaque accumulation, must be avoided during orthodontic or orthopedic treatment. [Copyright &y& Elsevier]