James G. Burch

A two-month study of the effects of oral irrigation and automatic toothbrush use in an adult orthodontic population with fixed appliances

Forty-seven adult orthodontic patients with fixed orthodontic appliances were divided into three study groups: (1) oral irrigation with automatic toothbrush, (n = 16); (2) oral irrigation with manual toothbrushing, (n = 16); (3) control group with continued normal toothbrushing only, (n = 15). Gingival and plaque indices, bleeding after probing, and gingival sulcus depths were assessed at baseline, 1-month, and 2-month periods. Marked and significant gingival and plaque improvements from baseline were measured in all three study groups. After 1 to 2 months use of the automatic toothbrush and/or the oral irrigation device, there was a significant reduction in plaque when compared with the control group who used only the manual toothbrush (p = 0.026). Also, there was a significant reduction in gingival inflammation (p = 0.045) and evidence for reducing bleeding after probing (p = 0.037). No significant differences were found in probe depths among the three study groups, however, use of both devices reduced the pocket depth significantly from baseline by 0.5 mm (p < 0.0002). For this population of orthodontic patients, significant reductions in plaque, gingival inflammation, and a tendency for reduced bleeding after probing occurred in both groups with the power device. These improvements were most attributable to the effect of the oral irrigation device.

Incidence and size of pretreatment overlap and posttreatment gingival embrasure space between maxillary central incisors

Five hundred sets of orthodontic diagnostic records of patients (age 15 years +/- 3) (228 males, 272 females) whose six maxillary anterior teeth had erupted were studied. Incidence of overlapped and crowded maxillary central incisors and magnitude of that crowding were determined, also the incidence of postorthodontic open gingival embrasures (black triangles) and width of those triangular spaces between maxillary central incisors were determined. Of the 500 patients 185 (37%) had preorthodontic crowding of maxillary central incisors. Magnitude of crowding was 1.08 mm +/- 0.94, n = 185. One hundred twenty-nine of these patients were treated. Their postorthodontic records were studied. Of the 129 cases 54 (41.9%) had a black triangular gingival embrasure space between the two maxillary central incisors postorthodontically. Width of the triangular space was 0.43 mm +/- 0.32, n = 54. One third of a similar population of orthodontic patients can be expected to have crowded central incisors. Two-fifths of those can be expected to have a postorthodontic black triangle when treated similarly.

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 standardized system for evoking masseteric silent periods with decreased variance

Masseteric silent periods have been evoked in a group of normal subjects under a standardized system and under nonstandardized conditions. In the designed system, head position, electrode placement, bite force, tap force, direction of tap, and surface zone of tap force delivery were controlled. Analysis of data confirmed the hypothesis that standardization of the procedure for eliciting the silent period results in measurements of duration with decreased standard deviations and variances. In the present study, under the standardized system the SPD range of standard deviations was between 1.37 and 3.68 (mean 2.97) and the range of variances was between 1.89 and 13.54 (mean 8.85). The recorded low variability suggests a high degree of reproducibility of the system. High reproducibility and low variability of measurements are necessary if an accurate measure of silent period duration is to be achieved and used in the interpretation of diagnostic findings for craniomandibular disorders.