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AIMS: To use data from a large health maintenance organization to specifically investigate dental utilization rates among patients with and without temporomandibular disorders (TMD). METHODS: Subjects were enrolled in Kaiser Permanente Northwest between 1998 and 2003. Two age- and gender-matched controls were selected for each subject who had a TMD diagnosis during the study period. Dental treatment was categorized using Current Dental Terminology (CDT) codes. Overall dental utilization rates were calculated, as well as rates based on age, gender, categories of treatment, and periods before and after TMD diagnoses. These rates were analyzed with t tests. RESULTS: TMD subjects utilized significantly more dental services than comparison subjects overall and for several dental categories. The difference was between 10% to 20%, or about 1 additional dental procedure per year. A positive linear relationship existed between dental utilization rates and age, with a significant increase in utilization for each ascending age cohort. Females had higher dental utilization rates than males in TMD and non-TMD groups and in all categories of dentistry. After a TMD diagnosis, major differences in utilization were not found when compared to patterns of treatment prior to the diagnosis. CONCLUSION: TMD subjects utilized 10% to 20% more dental services than non-TMD subjects. Gender and age were important factors with increased utilization in females and older patients. TMD diagnoses did not affect dental utilization patterns, indicating that most TMD patients continue to seek routine dental care. [ABSTRACT FROM AUTHOR]

Introduction: This pilot two-arm, parallel group, randomized clinical trial aimed to compare the efficacy of tooth movement and patient comfort during orthodontic leveling and alignment with the BRIUS™ lingual system (BR) versus labial full fixed appliances (LFFAs). Methods: Patients in the permanent dentition with mild to moderate crowding were recruited at the University at Buffalo and randomly assigned into the BR group (seven patients) or LFFAs group (six patients). The patients' dental arches were scanned before bonding (T1) and after 18 weeks (T2). Digital dental model superimpositions were performed to three-dimensionally evaluate tooth movement. Changes between T1 and T2 were measured in the x, y, and z planes. Little's Irregularity Index (LII) was also assessed at T1 and T2. An electronic questionnaire was completed daily for 7 days after T1 to evaluate the patients' comfort levels. Results: After 18 weeks, similar displacements were observed for all teeth in both groups except for the lower left second premolar (LL5) in the x-axis which showed greater displacement in the BR group ( p = 0.016). Groups showed similar changes in LII. Discomfort during the first week after bonding was greater on the tongue in the BR group and on the lips and cheeks in the LFFAs group. Tongue discomfort caused by the BR lasted for around 3 days. Conclusion: The BR and LFFAs showed similar teeth displacements and therefore were equally effective at leveling and aligning teeth. LFFAs caused cheek- and lip-borne discomfort while the BR caused tongue-borne discomfort during the first week after bonding. Larger studies with longer follow-ups are needed to obtain more definitive results.

Background: The purpose of this study was to compare color alterations (ΔE) of white-spot lesions (WSLs) bleached before versus after resin infiltration (RI)., Methods: Using the facial surfaces of bovine maxillary incisors, WSLs were created and the teeth were allocated into 2 groups (n = 45/group): bleach then RI (B-RI group) and RI then bleach (RI-B group). To determine ΔE, Commission Internationale de l'Eclairage L∗ a∗ b∗ (L∗ represents lightness, ranging from black to white [0-100]; a∗ represents green to red chromaticity [-150-+100]; and b∗ represents blue to yellow chromaticity [-100-+150]) measurements were obtained at baseline, after WSL formation, and after RI and bleaching. Representative specimens were evaluated by means of scanning electron microscopy. Statistical analyses included the Mann-Whitney U and Wilcoxon signed rank tests (P ≤ .0016) and repeated measures analysis of variance (P ≤ .05)., Results: No differences in ΔE were found comparing B-RI with RI-B groups or when the B-RI group was compared with bleached enamel. A statistically significant difference was found when the RI-B group was compared with bleached enamel (ΔE, 0.81; P < .001), but the difference was deemed not clinically significant. Scanning electron microscopy revealed that bleaching after RI increased surface roughness of the resin., Conclusions: There were no clinically significant differences in ΔE of WSLs when bleach was applied before or after RI; however, applying bleaching agent after RI roughened the surface of the resin material., Practical Implications: Results indicate that ΔE were not clinically significantly different between WSLs bleached before versus after RI, although it is best to sequence bleaching before RI therapy, as bleaching after RI roughened the restoration's surface., (Copyright © 2022 American Dental Association. Published by Elsevier Inc. All rights reserved.)

Objective: To assess weight gain of infants with cleft lip and/or palate (CL ± P) treated with nasoalveolar molding (NAM)., Design: Retrospective, case-control chart review., Setting: Doernbecher Children's Hospital, Oregon Health & Science University, Portland, Oregon., Patients, Participants: Infants with nonsyndromic CL ± P and noncleft controls., Interventions: Prior to primary lip surgery, NAM was either included (+NAM) or not included (-NAM) in the cleft treatment protocol., Main Outcome Measure(s): Weight gain and percentage weight gain relative to initial weight were compared among +NAM, -NAM, and control groups from birth to 7 months and from birth to 36 months., Results: Comparing +NAM and -NAM groups, no significant difference in weight or percentage weight gain was found in either time window. Compared to controls, from birth to 7 months, both CL ± P groups weighed less ( P < .001), while percentage weight gain was greater for the +NAM ( P < .001) and did not differ for -NAM. From birth to 36 months relative to controls, weight for +NAM showed no significant difference and -NAM weighed less ( P < .01), while percentage weight gain was greater for both CL ± P groups ( P < .001)., Conclusions: Comparisons of CL ± P infants treated with and without NAM showed that with the NAM appliance, despite its added complexity, there was no adverse impact on weight gain. Comparisons to noncleft, control infants suggests that NAM treatment may have a beneficial impact on weight gain.

Objective: A third focused workshop explored how to transfer novel findings into clinical orthodontic practice., Setting and Sample Population: Participants met at the Scottsdale Plaza Resort, 12-16 September 2018 for the Consortium for Orthodontic Advances in Science and Technology 2018 Innovators' Workshop. Thirty speakers and four lunch-hour focus group leaders shared and exchanged information with approximately 45 registered attendees., Material and Methods: This Innovators' Workshop was organized according to five themed sessions which covered: (a) The relevance of genetics, biology and environment to therapeutic outcomes; (b) Application of bioinformatics in craniofacial research; (c) Regeneration with and for orthodontic treatment; (d) Technology in precision orthodontics; and (e) Muscle, joint, and airway: Growth, function and pain., Results: The papers that comprise this supplemental issue exemplify the important outcomes of the 2018 COAST Workshop. In addition, matters identified as important needs include improved understanding of neural, skeletal and muscle tissue crosstalk in early craniofacial growth; standardized methods for three-dimensional radiographic and surface landmark and reference plane identification, measurements and serial superimpositioning techniques for use in the clinic; sharing and making available existing data sets (eg, cone beam computed tomography images, genotype-phenotype data); evidence of the usefulness and effectiveness of new devices; guidelines of what to measure to characterize the airway; more information about the influences of the soft tissues on craniofacial morphology; and information about effective digital work flows applied to clinical and educational settings., Conclusions: Progress in bridging the biology-technology gap has identified new needs for improvements in orthodontics and craniofacial care., (© 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Objectives: To assess the effectiveness and efficiency of ultraviolet (UV) illumination compared to conventional white light in the detection of fluorescent-tagged adhesive remnants during orthodontic debonding., Materials and Methods: Orthodontic brackets were bonded to extracted human premolars using one of two bonding resins having fluorescent properties (Pad Lock, Reliance Orthodontics, Itasca, Ill; Opal Bond MV, Opal Orthodontics, South Jordan, Utah; n = 40 each). The brackets were then debonded and, in each adhesive group, half the teeth had the remaining adhesive resin removed under illumination using the operatory light and the other half using a UV (395 nm) light emitting diode (LED) flashlight (n = 20/group). Time for teeth cleanup was recorded. Follow-up images were obtained under a dissecting microscope using UV illumination, and the surface area of adhesive remnants was calculated. Effectiveness of adhesive removal was also assessed using scanning electron microscopy imaging. Analysis of variance and Kruskal-Wallis tests were used to analyze time and adhesive remnants, respectively., Results: Assessment using the dissecting microscope found groups using UV light during adhesive removal had statistically significantly lower amounts of adhesive remnants than groups using white light ( P ≤ .01). Time for adhesive removal was significantly lower with Opal Bond MV adhesive using UV light when compared with the white light ( P ≤ .01). Assessment by scanning electron microscopy showed that thin remnants of adhesive (<2 μm) remained undetected by UV illumination., Conclusions: UV light is more effective and tends to be more efficient than white light in the detection of fluorescent adhesive during orthodontic debonding. Although there are limitations, the use of UV LED lighting is a practical tool that aids in adhesive detection.

Purpose: To investigate cone beam computed tomography (CBCT) accuracy in measuring facial bone height and detecting dehiscence and fenestration defects around teeth., Materials and Methods: Patients who were treatment planned for periodontal flap or dental implant surgeries were enrolled (n = 25). CBCT imaging (Carestream CS 9300) was obtained at 0.09-mm voxels (n = 10 patients, 23 teeth) and at 0.18-mm voxels (n = 15 patients, 33 teeth). Facial bone height measurements, from cusp tip to crest of bone height along the long axis of the tooth, and presence or absence of dehiscence or fenestration defects were recorded from CBCT images in triplicates independently by two examiners. The corresponding clinical measurements were made at the time of surgery. Comparisons of CBCT and clinical measurements were made using paired t tests for teeth: anterior and posterior, maxillary and mandibular, with or without restorations, or root canal therapy. Level of agreement between investigators was assessed by concordance correlation coefficients (CCC), Pearson's correlation coefficient (PCC), and Cohen's Kappa., Results: Comparing mean CBCT and clinical measurements, statistically significant differences were noted for 0.09-mm and 0.18-mm voxel sizes, for anterior and posterior teeth, for maxillary and mandibular teeth, for teeth with or without restorations, and for teeth without root canal therapy (P < .05). Clinical and CBCT measurements were similar for teeth with crowns and with root canal therapy (P > .05). CBCT measurements underestimated mean facial bone height from 0.33 ± 0.78 to 0.88 ± 1.14 mm (mean ± SD) and absolute facial bone height values from 0.56 ± 0.35 to 1.08 ± 0.92 mm. Intraexaminer and interexaminer reliability for measuring facial bone height ranged from poor to substantial (PCC = 0.78 to 0.97 and CCC = 0.63 to 0.96, respectively). Interexaminer reliability for detection of dehiscence and fenestration defects ranged from poor to moderate (Cohen's Kappa = -0.09 to 0.66)., Conclusion: CBCT imaging underestimated facial bone height and overestimated the presence of dehiscence and fenestration defects.

Objective: To evaluate the effect of different curing modes available in a dental light-curing unit on degree of conversion (DC) of a composite photoactivated under a metal orthodontic bracket., Materials and Methods: The average irradiance and total energy delivered by three curing modes (standard, high, and extra power) of a multiwave LED unit (Valo Cordless, Ultradent Products, South Jordan, Utah) were measured using the longest time available for each mode (20, 4, and 3 seconds, respectively). Brackets (n = 3/group) were bonded to molar epoxy resin replicas using each curing mode. Mesiodistal sections, 0.5 mm thick, were assessed using an infrared spectrometer microscope. Spectra of composite beneath the brackets were sequentially collected using the mapping tool in near-infrared (NIR)-transmittance mode. Composite conversion was mapped between the mesial and distal edges of the bracket base using 400-μm steps for a total of 10 measurements per specimen. Data from irradiance and total energy were analyzed by one-way ANOVA, while data of DC were analyzed with two-way repeated measures ANOVA (α = 0.05)., Results: The highest DC values were observed for standard power (mean 56%, P < .05), while no difference was observed between high (50%) and extra power (49%) modes. Regarding the site of measurement, higher DC was observed close to the bracket edges (52%, P < .05)., Conclusions: The use of high irradiance for a short time slightly reduced the DC. The small magnitude of reduction suggests that use of a high irradiance protocol is a clinically valid approach when bonding metal brackets.

Objective: A second focused workshop explored how to transfer novel findings into clinical orthodontic practice., Setting and Sample Population: Participants met in West Palm Beach (Florida, USA), on 9-11 September 2016 for the Consortium for Orthodontic Advances in Science and Technology 2016 Innovators' Workshop (COAST). Approximately 65 registered attendees considered and discussed information from 27 to 34 speakers, 8 to 15 poster presenters and four lunch-hour focus group leaders., Material and Methods: The innovators' workshops were organized according to five themed sessions. The aims of the discussion sessions were to identify the following: i) the strength and impact of the evidenced-based discoveries, ii) required steps to enable further development and iii) required steps to translate these new discoveries into orthodontic practice., Results: The role of gene-environment interactions that underlie complex craniofacial traits was the focus of several sessions. It was agreed that diverse approaches are called for, such as (i) large-scale collaborative efforts for future genetic studies of complex traits; (ii) deep genome sequencing to address the issues of isolated mutations; (iii) quantifying epigenetic-environmental variables in diverse areas myofascial pain, alveolar remodelling and mandibular growth. Common needs identified from the themed sessions were multiscale/multispecies modelling and experimentation using controlled and quantified mechanics and translation of the findings in bone biology between species. Panel discussions led to the consensus that a consortium approach to establish standards for intra-oral scanning and 3D imaging should be initiated., Conclusions: Current and emerging technologies still require supported research to translate new findings from the laboratory to orthodontic practice., (© 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Objective: To bring together orthodontic stakeholders from academics, industry, and private practice for a series of thematically focused workshops to explore and develop the transfer of novel approaches into clinical orthodontic practice., Setting and Sample Population: Twenty-seven invited speakers, eight poster presenters, and participants of the Consortium for Orthodontic Advances in Science and Technology (COAST) 2014 Innovators' Workshop at the Eaglewood Resort and Spa, Itasca, Illinois, September 11-14, 2014., Material and Methods: Five themed sessions involving between 4-7 presentations followed by panel discussions were organized. The aims of the discussion sessions were to highlight important findings and consider the strength of evidence for these, indicate next steps and needed research or technological developments to move forward, and to weigh the expected benefits from these findings and steps to implement in clinical practice., Results: Among important areas for attention identified were need for multiscale and multispecies modeling and experimentation for interspecies translation of results; large-scale collaborative efforts within the profession to address the need for adequate sample sizes for future genetic studies of complex traits such as malocclusion; a consortium approach to improve new technologies such as intra-oral scanning and 3D imaging by establishing standards; and harnessing the growing body of knowledge about bone biology for application in orthodontics., Conclusions: With increased awareness of the potential of current and emerging technologies, translation of personalized and precision approaches in the field of orthodontics holds ever-increasing promise., (© 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Objectives: To investigate the accuracy and reliability of cone beam computed tomography (CBCT) measurements of buccal alveolar bone height (BBH) and thickness (BBT) using custom acquisition settings., Settings and Sample Population: School of Dentistry, Oregon Health & Science University. Twelve embalmed cadavers., Materials and Methods: Cadaver heads were imaged by CBCT (i-CAT® 17-19, Imaging Sciences International, Hatfield, PA) using a 'long scan' (LS) setting with 619 projection images, 360° revolution, 26.9 s duration, and 0.2 mm voxel size, and using a 'short scan' (SS) setting with 169 projection images, 180° rotation, 4.8 s duration, and 0.3 mm voxel size. BBH and BBT were measured with 65 teeth, indirectly from CBCT images and directly through dissection. Comparisons were assessed using paired t-tests (p≤0.05). Level of agreement was assessed by concordance correlation coefficients, Pearson's correlation coefficients, and Bland-Altman plots., Results: Mean differences in measurements compared to direct measurements were as follows, LS 0.17±0.12 (BBH) and 0.10±0.07 mm (BBT), and SS 0.41±0.32 (BBH) and 0.12±0.11 mm (BBT). No statistical differences were found with any of BBH or BBT measurements. Correlation coefficients and Bland-Altman plots showed agreement was high between direct and indirect measurement methods, although agreement was stronger for measurements of BBH than BBT., Conclusions: Compared to the LS, the similarity in results with the reduced scan times and hence reduced effective radiation dose, favors use of shorter scans, unless other purposes for higher resolution imaging can be defined., (© 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Objective: To measure and compare bracket transfer accuracy of five indirect bonding (IDB) techniques., Materials and Methods: Five IDB techniques were studied: double polyvinyl siloxane (double-PVS), double vacuum-form (double-VF), polyvinyl siloxane vacuum-form (PVS-VF), polyvinyl siloxane putty (PVS-putty), and single vacuum-form (single-VF). Brackets were bonded on 25 identical stone working models. IDB trays were fabricated over working models (n  =  5 per technique) to transfer brackets to another 25 identical stone patient models. The mesiodistal (M-D), occlusogingival (O-G), and faciolingual (F-L) positions of each bracket were measured on the working and patient models using digital photography (M-D, O-G) and calipers (F-L). Paired t-tests were used to compare bracket positions between working and patient models, and analysis of variance was used to compare bracket transfer accuracy among the five techniques., Results: Between the working and patient models, double-VF had the most teeth with significant differences (n  =  6) and PVS-VF the fewest (n  =  1; P < .05). With one exception, all significant differences were ≤0.26 mm and most (65%) were ≤0.13 mm. When the techniques were compared, bracket transfer accuracy was similar for double-PVS, PVS-putty, and PVS-VF, whereas double-VF and single-VF showed significantly less accuracy in the O-G direction., Conclusions: Although overall differences in bracket position were relatively small, silicone-based trays had consistently high accuracy in transferring brackets, whereas methods that exclusively used vacuum-formed trays were less consistent.

Background: The authors conducted a randomized, single-masked clinical trial involving patients who had completed orthodontic treatment to assess changes in the appearance of white-spot lesions (WSLs) that were treated with resin infiltration., Methods: The authors divided affected teeth into control and treatment groups. In the treatment group, they restored teeth with WSLs by using resin infiltration. They evaluated changes in WSLs photographically by using a visual analog scale (VAS) (0 = no change, 100 = complete disappearance) and area measurements (in square millimeters). The authors analyzed the data by using two-way analysis of variance., Results: The mean VAS ratings for treated teeth demonstrated marked improvement relative to that for control teeth immediately after treatment (67.7 versus 5.2, P < .001) and eight weeks later (65.9 versus 9.2, P < .001). The results for treated teeth showed a mean reduction in WSL area of 61.8 percent immediately after treatment and 60.9 percent eight weeks later, compared with a -3.3 percent change for control teeth immediately after treatment and a 1.0 percent reduction eight weeks later., Conclusions: Resin infiltration significantly improved the clinical appearance of WSLs, with stable results seen eight weeks after treatment., Practical Implications: Resin infiltration, a minimally invasive restorative treatment, was shown to be effective for WSLs that formed during orthodontic treatment.

Introduction: Cone-beam computed tomography (CBCT) imaging has broadened opportunities for examining morphologic aspects of the craniofacial complex, including alveolar bone, but limitations of the technology have yet to be defined. Through the use of comparisons with direct measurements, the purpose of this study was to investigate the accuracy and reliability of buccal alveolar bone height and thickness measurements derived from CBCT images., Methods: Twelve embalmed cadaver heads (5 female, 7 male; mean age: 77 years) were scanned with an i-CAT 17-19 unit (Imaging Sciences International, Hatfield, Pa) at 0.3 mm voxel size. Buccal alveolar bone height and thickness measurements of 65 teeth were made in standardized radiographic slices and compared with direct measurements made by dissection. All measurements were repeated 3 times by 2 independent raters and examined for intrarater and interrater reliability. Measurement means were compared with 2-tailed t tests. Agreement between direct and CBCT measurements was assessed by concordance correlation coefficients, Pearson correlation coefficients, and Bland-Altman plots., Results: Intrarater reliability was high as were interrater correlations for all measurements (≥0.97) except CBCT buccal bone thickness (0.90). CBCT measurements did not differ significantly from direct measurements, and there was no pattern of underestimation or overestimation. The mean absolute differences were 0.30 mm in buccal bone height and 0.13 mm in buccal bone thickness with 95% limits of agreement of -0.77 to 0.81 mm, and -0.32 to 0.38 mm, respectively. Agreement between the 2 methods was higher for the measurements of buccal bone height than buccal bone thickness, as demonstrated by concordance correlation coefficients of 0.98 and 0.86, respectively., Conclusions: For the protocol used in this study, CBCT can be used to quantitatively assess buccal bone height and buccal bone thickness with high precision and accuracy. Comparing the 2 sets of CBCT measurements, buccal bone height had greater reliability and agreement with direct measurements than did the buccal bone thickness measurements., (Copyright © 2011 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.)

Aim: To (1) evaluate the use of adenosine triphosphate (ATP)-driven bioluminescence for quantification of total plaque bacteria in orthodontic patients, (2) compare plaque bacteria amounts at the bracket-tooth interface with use of elastomeric-ligated and self-ligating brackets after 1 year of orthodontic treatment, and (3) analyze formation of white spot lesions by photographic evaluation and laser-light fluorescence (DIAGNOdent)., Methods: Thirteen subjects had fixed orthodontic appliances placed where lateral incisors were bonded with either elastomeric-ligated or self-ligating brackets. Plaque bacteria were collected from incisor surfaces after 1 year and quantified using plating methods and ATP-driven bioluminescence. White spot lesions were evaluated by photographic and DIAGNOdent determinations. A 2 x 2 x 2 mixed-design ANOVA was conducted to determine differences in plaque retention between elastomeric-ligated and self-ligating brackets., Results: ATP-driven bioluminescence values correlated to numbers of total plaque bacteria (r = 0.80). However, unlike findings published in the original pilot study, which described increased plaque retention with elastomeric-ligated brackets at 5 weeks postbonding, there were no significant differences in bacterial numbers or ATP-driven bioluminescence values surrounding the elastomeric-ligated vs self-ligating brackets after 1 year of orthodontic treatment. Based on photographic and DIAGNOdent determinations, white spot lesions were found relatively equally on teeth bonded with either bracket type. DIAGNOdent measurements were found to have moderate sensitivity (0.71) and good specificity (0.88) when compared to white spot lesions determined using photographic evaluation., Conclusion: ATP-driven bioluminescence can be used as an accurate assessment of total plaque bacteria in orthodontic patients. After 1 year of orthodontic treatment for patients in this pilot study, there appeared to be no differences in retention of plaque bacteria or white spot lesions comparing the bracket types. The use of DIAGNOdent has some limitations, but may prove to be useful to monitor white spot lesions longitudinally.

Objective: To compare porcelain surfaces at debonding after use of two surface preparation methods and to evaluate a method for restoring the surface., Materials and Methods: Lava Ceram feldspathic porcelain discs (n = 40) underwent one of two surface treatments prior to bonding orthodontic brackets. Half the discs had sandblasting, hydrofluoric acid, and silane (SB + HF + S), and the other half, phosphoric acid and silane (PA + S). Brackets were debonded using bracket removing pliers, and resin was removed with a 12-fluted carbide bur. The surface was refinished using a porcelain polishing kit, followed by diamond polishing paste. Measurements for surface roughness (Ra), gloss, and color were made before bonding (baseline), after debonding, and after each step of refinishing. Surfaces were also examined by scanning electron microscopy (SEM). Data was analyzed with 2-way ANOVA followed by Tukey HSD tests (alpha = 0.05)., Results: The SB + HF + S bonding method increased Ra (0.160 to 1.121 microm), decreased gloss (41.3 to 3.7) and altered color (DeltaE = 4.37; P < .001). The PA + S method increased Ra (0.173 to 0.341 microm; P < .001), but the increase in Ra was significantly less than that caused by the SB + HF + S bonding method (P < . 001). The PA + S method caused insignificant changes in gloss (41.7 to 38.0) and color (DeltaE = 0.50). The measurements and SEM observations showed that changes were fully restored to baseline with refinishing., Conclusions: The PA + S method caused significantly less damage to porcelain than the SB + HF + S method. The refinishing protocol fully restored the porcelain surfaces.

Objective: Objectives of this study were to (1) compare the mean shear-peel bond strength of orthodontic bands luted to porcelain molar denture teeth with glass ionomer cement (GIC), resin-modified glass ionomer cement (RMGIC), or compomer cement; (2) assess the amount of cement remaining on the teeth after debanding; and (3) compare the survival times of the cemented bands subject to mechanical fatigue., Materials and Methods: Sixty banded denture teeth (20 per cement group) were used to determine shear-peel bond strength, and 30 banded denture teeth (10 per cement group) were used to determine fatigue survival time. Shear-peel bond strength was determined with a universal testing machine, and groups were compared by one-way analysis of variance. The amount of cement remaining on the teeth after band removal was scored, and a chi-square test was used to compare groups. Fatigue testing was conducted in a ball mill, and a log-rank test was used to compare differences in survival times., Results: No differences were found in mean shear-peel bond strength among the three groups. The amount of cement remaining on the teeth varied between the compomer and GIC groups (P = .01), with more compomer cement remaining relative to GIC. The mean survival times of bands cemented with compomer or RMGIC were longer than for bands cemented with GIC (P < .001)., Conclusion: The findings show that on porcelain teeth the band cements have comparable mean shear-peel bond strengths, but that band retention with RMGIC and compomer cement are superior to GIC when subjected to simulated mechanical fatigue.

Wheat germ agglutinin conjugated to tetramethylrhodamine isothiocyanate-dextran (WGA-TRITC) was studied as a novel tracer of primary projection neurons of pharyngeal (PhN) and superior laryngeal (SLN) branches of the vagus nerve. The SLN and PhN were dissected from rat cervical tissues and the proximal end of the nerves were bathed in tracer for 60-90 min. The animals were sacrificed 42-72 h later. The tissue was fixed, sliced, mounted on slides and viewed under epifluorescence. The clarity of the fluorescent label in projection neurons was confounded in some regions of the brainstem by autofluorescence. A computer image analysis method was developed to quantify fluorescence intensity for definitive identification of labeled neurons. Brainstem neurons labeled by afferent projections of the SLN and PhN were localized to the nucleus tractus solitarius. Efferents were identified in the nucleus ambiguus. WGA-TRITC labeled cells were observed in the ipsilateral brainstem at intensities significantly different from the fluorescence observed in controls (P<0.01). The distribution and density of labeling is in agreement with results of previous investigations, suggesting that WGA-TRITC is a useful alternative for tracing SLN and PhN projections to brainstem nuclei.

This lateral cephalometric study investigated the dental and skeletal effects of the Jasper Jumper appliance used in the correction of Class II Division 1 malocclusions. A sample of 36 growing patients treated with the Jasper Jumper appliance was divided into two groups: (1) 24 patients with records obtained at the start and completion of orthodontic treatment, and (2) 12 patients with records available at the beginning and end of the Jumper phase of treatment. Treatment effects were determined by statistical comparisons of cephalometric changes in the patients relative to age-adjusted cephalometric standards, and from structural superimpositions. While the Jumpers were in place, maxillary incisors were retroclined and the molars were moved distally, tipped back, and intruded. The mandibular incisors were proclined and intruded, while the molars were translated mesially, tipped forward, and extruded. Skeletal measures showed reduced forward maxillary displacement and no significant alteration of horizontal mandibular growth. During orthodontic finishing, molar tipping and maxillary incisor retroclination were corrected, although the mandibular incisors remained proclined. In summary, this study found that the Jasper Jumper appliance corrected Class II discrepancies largely through maxillary and mandibular dentoalveolar effects and, to a limited extent, by restraint of forward maxillary growth.

Following orthodontic treatment, an increase in the number of occlusal contacts is usually desired during retention. In this study, Hawley and clear overlay orthodontic retainers were compared relative to changes in the number of occlusal contacts. Occlusal contacts were quantified in 30 orthodontic patients at debonding, at retainer delivery, and after 3 months of retention. The paired t-test was applied to evaluate longitudinal changes in the number of and intensity of contacts. Results show that with the Hawley retainer there was a significant increase in occlusal contacts on posterior teeth and no change on anterior teeth. With the clear overlay retainer there was no significant change in either posterior or anterior contacts during retention. The retentive capacities of the two retainers differ: the Hawley retainer allows relative vertical movement (settling) of the posterior teeth while the clear overlay retainer holds teeth in their debanding position.

Migration of mandibular periosteum and attached musculature was tracked along the inferior border of the ramus in growing and nongrowing guinea pigs (Cavia porcellus) over a 6-week period. Particulate metallic growth-tracing implants were placed through the bony mandible and adjacent musculature at two anteroposterior locations and two bony reference markers were placed anteriorly. Quantification from weekly radiographs of growing animals showed marked posterior migration of the periosteum, whereas in nongrowing animals there was negligible periosteum movement. Significantly greater migration occurred in posterior (6.37 +/- 0.76 mm) implants relative to the anterior implants (3.45 +/- 0.86 mm, p < 0.001). The neutral zone, where little periosteal migration occurs, was calculated to be approximately at the anteroposterior center of the molar tooth row. Analysis of the orientation of the medial pterygoid muscle relative to the mandible showed that muscle fibers on average become more horizontal. Thus, the study found differential anteroposterior migration of the mandibular periosteum in growing animals and correlative changes in orientation of the medial pterygoid muscle.

The objective of this study is to define the development of all components in the chick embryonic trigeminal primary sensory-motor complex, from their first appearance through the formation of central and peripheral axonal projections up to stage 34 (8 days of incubation). This was accomplished by two labeling procedures: application of the monoclonal antibody HNK-1, which binds to the precursors of all these components except the placode-derived neurons, and application of HRP to axons cut immediately distal to the trigeminal ganglion. Single immunopositive motor neuron precursors are present at stage 12. These accumulate in the transient medial motor column, whose neurons initiate axon outgrowth by stage 13-14, concomitant with the onset of translocation of their somata to form the definitive trigeminal lateral motor column (LMC). Initially these translocating somata accumulate on the medial margin of the LMC. Beginning on incubation day 5, axons growing from newly formed motor neurons pass beside the lateral margin of the LMC, and the nuclei of these cells subsequently follow this pathway. These events follow a rostral-to-caudal sequence, and this phase of motor nucleus formation is complete by day 8. The lateral translocation of some caudally located nuclei is arrested beginning on day 5. This cessation, which proceeds rostrally, demarcates neurons that form the dorsal motor nucleus of the trigeminal complex. Sensory neurite formation is initiated in ophthalmic placode-derived cells at stage 14.5, one stage later by maxillomandibular neurons, and from mesencephalic V cells at stage 15. Neural crest cells do not initiate axon formation until at least day 4 to 5. Following application of HRP distal to the condensing ganglion at stage 16, labeled ophthalmic nerve projections appear in contact with the wall of the hindbrain centrally and overlying the optic vesicle peripherally. Fibers forming the descending tract elongate rapidly, reaching the level of the VIIth nerve root (200 microns caudal to the trigeminal root) by stage 18 and the cervical cord by stage 22. Labeled terminal arborizations of descending trigeminal afferents are first visible at stage 22 and are evident along the entire descending and proximal ascending tracts by stage 27. Later-developing descending axons grow in close association with existing trigeminal fibers, though a few growth cones are consistently evident superficial to the other fibers. No projections different from those reported in adult birds are seen, nor are there any contralateral afferent projections.(ABSTRACT TRUNCATED AT 400 WORDS)

In the medulla of the axolotl (Ambystoma mexicanum), Mauthner cells (M-cells) occur as a pair of large identifiable neurons at the level of entry of the vestibular nerve (nVIII). Each receives synapses from the ipsilateral nVIII; the terminals can be identified as club endings and are restricted to a specific set of M-cell dendritic branches. We have examined these branches for morphologic changes following long-term deafferentation in the presence and absence of nerve regeneration. Deafferentation was brought about in a group of young larvae by unilaterally severing nVIII. The nerve was allowed to regenerate in half of the larvae. In those remaining, the nVIII ganglion was damaged to preclude or limit nerve regeneration. The contralateral side served as control. After 3 months survival, the larvae were killed and the medullae prepared for microscopy. To estimate the extent of nerve regeneration, axons in the experimental nVIII tract were counted and compared with the number in the control. The mean number of axons in the nVIII tract ipsilateral to intact ganglia indicated that 69% of the fibers had regenerated. In contrast, only 31% regenerated in larvae with damaged ganglia. Electron microscopic analysis of selected sections revealed that the mean number of nVIII terminals per section through M-cells ipsilateral to destroyed ganglia was significantly less than the mean number in analogous sections through either control cells or cells ipsilateral to intact ganglia. Control and experimental M-cells were reconstructed from serial sections. Deprived M-cells had significantly reduced dendritic branching patterns in the region that normally receives nVIII input. On the other hand, the extent of branching on cells receiving regenerated afferents from intact ganglia was like that of their contralateral controls. The distribution of dendritic branches on many reinnervated M-cells, however, was broader than that on control cells. Electron microscopic examination of the displaced dendritic branches (those extending into adjacent tracts) revealed that they received vestibular synapses. Thus, in some animals, regenerated vestibular fibers were not restricted to the nVIII tract. Deafferentation of the M-cells results in a reduction of dendritic branches in the region deprived of vestibular contacts.(ABSTRACT TRUNCATED AT 400 WORDS)