Frank M. Beck

A Radiographic Evaluation of the Availability of Bone for Placement of Miniscrews

Monocortical screws are increasingly being used to enhance orthodontic anchorage. The most frequently cited clinical complication is soft tissue irritation. It is thus clinically advantageous for these miniscrews to be placed in attached mucosa. The purpose of this study was to (1) determine radiographically the most coronal interradicular sites for placement of miniscrews in orthodontic patients and (2) determine if orthodontic alignment increases the number of sites with adequate interradicular bone for placement of these screws. Sixty panoramic radiographs (n = 30 pretreatment, n = 30 posttreatment) of orthodontic patients were obtained from an archival database after Institutional Review Board approval. Selection criteria included minimal radiographic distortion and complete eruption of permanent second molars. Interradicular sites were examined with a digital caliper for presence of three and four mm of bone. If three or four mm of bone existed, then a vertical measurement from the cementoenamel junction (CEJ) to first measurement was made. In addition, the magnification error inherent in panoramic radiographs was estimated. Ninety-five percent confidence intervals were calculated for the vertical distances from the CEJ to the horizontal bone location. Bone stock for placement of screws was found to exist primarily in the maxillary (mesial to first molars) and mandibular (mesial and distal to first molars) posterior regions. Typically, adequate bone was located more than halfway down the root length, which is likely to be covered by movable mucosa. Inability to place miniscrews in attached gingiva may necessitate design modifications to decrease soft tissue irritation.

Relation of stress and anxiety to oral lichen planus.

Stress and anxiety have frequently been mentioned as possible factors related to the development of oral lichen planus, although this association appears to have only an anecdotal origin. In this study, 48 patients with a clinical and histologic diagnosis of oral lichen planus completed questionnaires aimed at assessing their stressful life events (Social Readjustment Rating Scale) and their tendency for anxiety (the trait portion of the State-Trait Anxiety Inventory). Age- and sex-matched control groups included patients who underwent biopsies for irritation fibroma and routine clinic patients. No significant differences were seen among any of the groups with respect to scores on the questionnaires. These results suggest that patients who manifest oral lichen planus have no greater tendency toward anxiety and no more stressful life events than other individuals.

Effect of Cheese, With and Without Sucrose, on Dental Caries and Recovery of Streptococcus mutans in Rats

The objective of this study was to determine the effect of aged and young cheddar cheese with and without added sucrose on dental caries and the associated recovery of implanted Streptococcus mutans. Very little caries was observed in rats consuming cheese without sucrose. There was an increase in caries in rats fed cheeses with 20% sucrose, but this increase was not significant. There was significantly greater caries activity in rats fed standard diets containing 20% or 5% sucrose (SLS or MIT 305) than in rats fed cheeses containing 20% sucrose. Rats fed cheese or powdered diets containing sucrose had significantly higher frequency of recovery and higher levels of S. mutans infection than did rats fed cheese containing no sucrose. This study confirms the low cariogenic potential and possible cariostatic activity of cheddar cheese in rats. Since cheddar cheese with sucrose did not significantly interfere with S. mutans implantation, the cariostatic mechanism is apparently unrelated to a direct antimicrobial effect on S. mutans.

Validity of the Index of Complexity, Outcome, and Need (ICON) in determining orthodontic treatment need.

Occlusal indices are used to determine eligibility for orthodontic treatment in several publicly funded programs. The Index of Complexity, Outcome, and Need (ICON), based on the perception of 97 orthodontists from 9 countries, has been proposed as a multipurpose occlusal index. The aim of this study was to investigate the validity of the ICON as an index of orthodontic treatment need compared with the perception of need as determined by a panel of US orthodontists. One hundred seventy study casts, representing a full spectrum of malocclusion types and severity, were scored for orthodontic treatment need by an examiner calibrated in the ICON. The results were compared with the decisions of an expert panel of 15 orthodontic specialists from the central Ohio area. The simple kappa statistic (0.81) indicated very high agreement of the index with the decisions of the expert panel. The sensitivity (94%), specificity (85%), positive predictive value (92%), negative predictive value (90%), and overall accuracy of the ICON (91%) also confirmed good agreement with the orthodontic specialists. The panel found that 64% of the casts required orthodontic treatment; the ICON scores indicated that 65% of the cases needed treatment. There was agreement between the expert panel and the index in 155 of the 170 cases. These results support the use of the ICON as a validated index of orthodontic treatment need.

Bone remodeling in maxilla, mandible, and femur of young dogs.

Bone remodeling in the jaw is essential for metabolic needs, mechanical demands and for growth of the skeleton. Currently, there is no information on remodeling in the jaw of young dogs. Four ∼5‐month‐old male dogs were given a pair of calcein bone labels. After killing, bone sections were obtained from the maxilla, mandible, and femur. The jaw specimens were obtained from regions associated with erupting permanent teeth. Undecalcified specimens were prepared for examination by histomorphometric methods to evaluate mineral apposition rate (μm/d), mineralizing surface/bone surface (%), and bone formation rate (BFR, %/yr) in the bone supporting erupting teeth and in the femurs. Only intracortical secondary osteonal remodeling units were measured. There were significant (P < 0.05) differences in the BFR for the three sites examined, with the highest BFR (72%/yr) being in the femur. The mandible had a BFR twofold greater than the maxilla (51%/yr vs. 25.5%/yr). The rate of turnover in the jaw and femur of young dogs is distinct from a similar comparison between the jaw and appendicular skeleton of adult (∼1 yr old) dogs. Although BFR decreases with age in the femur, it remains elevated in the jaws. Anat Rec, 291:1–5, 2007.

Smile esthetics from patients' perspectives for faces of varying attractiveness.

INTRODUCTION Delivering an attractive smile is a key element in orthodontic patient satisfaction. Smile characteristics can be affected by the facial context. The purpose of this study was to investigate smile esthetics related to facial attractiveness and sex of the model. METHODS Attractive, average, and unattractive model faces (2 of each; 3 male, 3 female) determined by peer ratings were combined with 10 smile variables (buccal corridor, smile arc, maxillary gingival discrepancy, gingival display, incisal-edge discrepancy, cant, overbite, central-incisor gingival margin discrepancy, and maxillary midline to face, and maxillary midline to mandibular midline). Each smile characteristic was altered digitally and presented with slider technology to allow a continuous range of choices. Raters chose the ideal and the limits of acceptability. The variables were divided into 6 separate surveys and rated 96 times. Reliability was assessed by answering each question twice. RESULTS Individual smile variable reliability ranged from fair to excellent, except for the buccal corridor. Clinically significant values were defined as greater than 1.0 mm with statistical significance (P <0.05). Rater sex did not make a difference. Clinical significance was found for smile arc, gingival display, and maxillary midline to face. For females, accentuated smile arcs were preferred for the unattractive and attractive models compared with the average models. The opposite was found for male models. More gingival display was preferred for the attractive and unattractive male and female models compared with the average models. Attractive models were allowed less midline deviation. CONCLUSIONS Facial attractiveness and model sex impacted smile variables with a facial context, except for occlusal cant. These smile characteristics with a facial context should be considered when diagnosing and planning treatment for an orthodontic patient.

Anticariogenic Effects of Tea in Rats

Teas varying in fluoride and tannin concentration were evaluated in rats for anticariogenic activity. There was a direct correlation between fluoride in tea and the inhibition of sulcal caries in rats, whereas no relationship was observed between tannin and this type of lesion. Teas also had a significant effect on caries progression and imparted a black stain to the teeth.

Blood Pressure and Heart Rate Responses to Anticipated High-stress Dental Treatment

Twenty-four healthy adults participated in a study to determine the effects of anticipated high-stress dental treatment on blood pressure and heart rate. Blood pressure, heart rate, and state anxiety were assessed prior to four consecutive dental appointments. Appointments 1, 2, and 4 were of relatively low stress and appointment 3 was of relatively high stress. Blood pressure was unaffected while heart rate was highest prior to appointment 3 and lowest prior to appointment 1.

Periodontal attachment loss associated with proximal tooth restorations

This study documents that periodontal attachment loss is greater adjacent to restored tooth surfaces than adjacent to unrestored tooth surfaces. This finding emphasizes the importance of the prevention of caries and poor restorations.

A Study Comparing the Effectiveness of Ibuprofen (Motrin), Empirin with Codeine #3, and Synalgos-DC for the Relief of Postendodontic Pain

A study was done comparing the effectiveness of ibuprofen (Motrin), Empirin with Codeine #3, and Synalgos-DC for the relief of postendodontic treatment pain. Pain levels of 72 patients were evaluated at 0, 1, 2, and 3 h after ingestion of the randomly assigned test medications. The results showed that all three medications were equally effective in relieving postendodontic pain. There were no significant differences among the three medications concerning reported side effects.