Combined orthodontic-orthognathic surgical treatment of a Class II, Division 1 malocclusion

This case report shows the need to extract four first premolars in addition to orthognathic surgery, even though the initial treatment plan involved a nonextraction strategy. The extractions were necessary to reduce maxillary dental protrusion and proclination and also to recover from the mandibular incisor proclination that occurred as a consequence of leveling the mandibular arch. (Am J Orthod Dentofac Orthop 1997;111:640-5.)     

The Effect of Brushing on Surface Roughness of Denture Lining Materials

PURPOSE: The purpose of this study was to test the effect of brushing on surface roughness of two resilient liners (Luci Sof and Sofreliner) compared with an acrylic resin (QC 20). MATERIALS AND METHODS: Twenty specimens of each material were prepared (25 mm x 14 mm x 3 mm). Ten specimens served as controls and were stored in distilled water and not brushed. The remaining ten specimens were subjected to mechanical brushing, using an MSEt plus machine to simulate brushing at a rate of 5.0 strokes per second (30,000 cycles). Surface roughness measurements were recorded before and after brushing. Random samples were analyzed using scanning electron microscope. Data collected were analyzed by a two-way analysis of variance using material and treatment as variables, followed by Tukey's test (alpha= 0.05). RESULTS: Initial surface roughness of materials indicated that QC 20 was the smoothest (0.13 microm), and Luci Sof the roughest (0.68 mum). Sofreliner had an intermediate value (0.31 microm). All materials were significantly different. Mechanical brushing significantly increased surface roughness in all the materials. Although there was no statistical difference between QC 20 and Luci Sof after mechanical brushing (0.88 and 1.00 microm, respectively), both differed significantly from Sofreliner (7.74 microm). CONCLUSION: The two resilient liners and the acrylic resin became rougher, to a greater or lesser extent, when subjected to mechanical brushing.     

The Effect of Fatigue Damage on the Force Required to Remove a Restoration in a Cement-Retained Implant System

PURPOSE: To evaluate the luting agents and retentive forces before and after mechanical stressing. MATERIALS AND METHODS: Sample size N was 12 for each group, and 12 Cera-One closed-end gold cylinders were cemented with three types of luting cements (ImProv, UltraTemp, and TempBond). The force required to remove the gold cylinders from the abutments was determined with an MTS testing machine. After cleaning and recementing the cylinders, the samples were placed in the housings of an Alabama-type three-body wear machine and load of 110 N was applied to the gold cylinders at a frequency of 80 cycles/min for 50,000 cycles. Then each cylinder was pulled from its abutment and the force at which the failure occurred was recorded. The procedure was repeated with 300,000 cycles. RESULTS: Statistical analysis arising from two-way ANOVA found that the forces required to remove the abutments were significantly different. The most retentive cement was ImProv. Before cyclic loading, on average, ImProv produced a retentive value 85% higher than that yielded by TempBond, and 25% higher than that of UltraTemp. The three cements were significantly different at each of the three cycle levels. CONCLUSIONS: These results might suggest TempBond luting agent as the material of choice for provisional cementation because it allows easier removal of the prosthesis and maintains enough retention to prevent loosening of the restoration. The clinical implication is that the effect of cyclic load on the strength of the cements is different, an important factor in selection of a cement. ImProv had the highest retentive value before and after the two cycles, and TempBond had the lowest. UltraTemp had the highest percentage of retentive value lost. TempBond had no significant loss under loading even though initially it was the weakest.     

Nonsyndromic craniosynostosis: diagnosis and contemporary surgical management

Contemporary surgical management of nonsyndromic craniosynostosis requires the combined expertise of a pediatric craniofacial surgeon and pediatric neurosurgeon. The goals of surgical intervention are the release of the affected suture, which allows for unrestricted development of the visceral components (eg, brain, eyes) and three-dimensional reconstruction of the skeletal components, which establishes a more normal anatomic position and contour. Surgeon who care for infants with these cranial and orbital malformations must maintain a thorough understanding of the three-dimensional anatomy, characteristic dysmorphology associated with the different types of synostosis, and the complex interplay that exists between surgical intervention and ongoing skeletal growth.     

Improving the oral health status of all Americans: roles and responsibilities of academic dental institutions: the report of the ADEA President's Commission

Academic dental institutions are the fundamental underpinning of the nation's oral health. Education, research, and patient care are the cornerstones of academic dentistry that form the foundation upon which the dental profession rises to provide care to the public. The oral health status of Americans has improved dramatically over the past twenty-five to thirty years. In his 2000 report on oral health, the Surgeon General acknowledges the success of the dental profession in improving the oral health status of Americans over the past twenty-five years, but he also juxtaposes this success to profound and consequential disparities in the oral health of Americans. In 2002, the American Dental Education Association brought together an ADEA President's Commission of national experts to explore the roles and responsibilities of academic dental institutions in improving the oral health status of all Americans. They have issued this report and made a variety of policy recommendations, including a Statement of Position, to the 2003 ADEA House of Delegates. The commission's work will help guide ADEA in such areas as: identifying barriers to oral health care, providing guiding principles for academic dental institutions, anticipating workforce needs, and improving access through a diverse workforce and the types of oral health providers, including full utilization of allied dental professionals and collaborations with colleagues from medicine.     

Dimensional Accuracy of 7 Die Materials

PURPOSE: The purpose of this study was to compare the linear dimensional accuracy and the handling characteristics of 7 die materials. MATERIALS AND METHODS: A master die analogous to a complete veneer crown preparation was machined from medical grade stainless steel, and 3 measurements (1: vertical; 2 and 3: horizontal) were made from 3 scribed reference lines. Individual polyvinylsiloxane impressions were made (n = 10) for each of the specimens. The fabricated dies were measured (50x) to the nearest 0.0001 mm. Data were subject to ANOVA/Duncan tests at significance level 0.05 and pairwise comparisons. RESULTS: Type IV resin-impregnated dental stone and copper-plated dies most closely approximated the dimensions of the master die, and were not significantly different from each other in any of the pairwise comparisons. Conventional Types IV and V dental stone dies exhibited setting expansion within the range appropriate for gypsum. Epoxy resin die materials demonstrated shrinkage comparable to the expansion of the Types IV and V dies. Polyurethane dies displayed a combination of linear expansion and shrinkage. Bis-acryl composite resin dies had excessive shrinkage. CONCLUSIONS: Type IV resin-impregnated dental stone and copper-plated dies were more dimensionally accurate than the other die materials tested.     

Study design IV. Cohort studies

Previously in this series I have given an overview of the main types of study design and the techniques used to minimise biased results. In this article I describe more fully cohort studies, their uses, advantages and limitations.     

Evaluation of Stresses and Forces in Selected I-Bars Using the Finite Element Method

Purpose Three-dimensional models of half-round, tapered and full-round, untapered I-bar clasps of varying configurations and material properties were constructed. The purpose of this study was to examine the stresses and reaction forces produced within each model upon deflection to 0.01 in (0.254 mm), 0.02 in (0.508 mm), and 0.03 in (0.762 mm) at 1 mm from the tip using the finite element method. Materials and Methods Three-dimensional computer models of half-round and full-round clasps were constructed using solid eight-node brick elements. The half-round, tapered I-bar clasp model was 2.4 and 1.4 mm in diameter at the base and tip, respectively. The full-round, tapered I-bar clasp model was 1 mm in diameter. Three design groups were created for each clasp form. Group A had 25% of the total length in the straight anchor end of the I-bar clasp, B had 35%, and C had 50%. All models were 31 mm in length and had a radius of curvature of 5 mm. Different material properties were incorporated into the models. Each model was deflected at a point 1 mm from the tip to 0.01 in (0.254 mm), 0.02 in (0.508 mm), and 0.03 in (0.762 mm). Results The stresses and forces produced as a result of the deflection applied to each clasp were viewed and displayed graphically. The maximum von Mises stresses in megapascals and the reaction force in newtons (N) were recorded. Stresses varied in each clasp in the range of 0 to 154.3 MPa for the half-round, tapered I-bar clasp models, and 0 to 100.9 MPa for the full-round I-bar clasp models at 0.01-in deflection. Reaction force measured near the tip of the clasp models was between 1.60 N and 6.31 N for the half-round, and between 0.22 N to 2.13 N for the full-round I-bar clasp models. For all clasps studied, as the deflection increased, the location of stress within each group remained the same regardless of the material properties; however, the stress and force values increased linearly. Conclusions The location of maximum stress varied with the length of the anchor portion of the clasps studied. Maximum stresses were located on the flat side of the half-round, tapered I-bar clasp model.