Jeffrey L. Berger

The influence of the SPEED bracket's self-ligating design on force levels in tooth movement: A comparative in vitro study

In the SPEED bracket system the arch wire is retained in the arch wire slot by means of a built-in, escape-proof, flexible spring clip. Unlike the traditional edgewise bracket, it requires no ligature tie, thus ostensibly reducing the frictional force generated by the more-established elastomeric or steel-tie ligature systems. An in vitro study was designed to compare the level of force required to move four distinct arch wires a similar distance, on six occasions, through four ligated bracket systems and the self-ligated SPEED bracket. The results consistently demonstrated a significant decrease in the force level required for the SPEED bracket with all four arch wires when compared with elastomeric and steel-tie ligation in both metal and plastic bracket systems.

Stability of orthopedic and surgically assisted rapid palatal expansion over time

At the present time no reports are available on the stability between orthopedic and surgically assisted rapid palatal expansion. This study was designed to examine and compare the dental and skeletal changes over time for both orthopedic maxillary expansion and surgically assisted palatal expansion. The study was divided into two groups. Group one was orthopedically expanded and consisted of 14 males and 10 females. The ages ranged from 6 years to 12 years with a mean of 8.5 years. Group two received surgically assisted rapid palatal expansion and consisted of 12 males and 16 females with ages ranging from 13 years to 35 years and a mean age of 19.25 years. All 52 subjects were white, from the same geographic area, and were treated by the same two operators. Dental models and posterior anterior cephalograms were obtained immediately before and after expansion, at removal of the expansion device, and 1 year after removal of the appliance. A repeated measures analysis of variance test was applied to assess changes over time between groups. The surgical and nonsurgical techniques displayed similar trends over time although the surgical group contained a greater quantity of expansion. Both the orthopedic and the surgical groups showed stable results.

Treatment effects of the mandibular anterior repositioning appliance in patients with Class II skeletal malocclusions.

OBJECTIVE To examine the changes produced by the mandibular anterior repositioning appliance (MARA) appliance and compare the treatment effects to an untreated Class II control group. MATERIALS AND METHODS Thirty consecutively treated patients were matched with an untreated control group. Lateral cephalograms were taken at T1, 5 months pre-MARA (CVMS 2.7); T2, immediately after MARA removal and prior to placement of full fixed edgewise appliances (CVMS 4.2); and T3, at least 2 years after MARA removal and completion of edgewise treatment (CVMS 5.4). The mean age of the MARA patients was 11.9 years for boys and 10.8 years for girls. Repeated-measures analysis of variance (ANOVA) was used to assess if the samples were morphologically comparable at the outset and to test if there were significant differences between the groups for the various increments of change. Given a significant ANOVA, the source of the difference was explored via Tukey-Kramer tests. RESULTS Restriction of maxillary growth and no significant mandibular growth were observed with the MARA appliance. The Class II correction was obtained mainly by slight maxillary molar distalization and intrusion, in addition to mesial migration of the lower molars and flaring of the lower incisors. No vertical effect was observed with this appliance. CONCLUSION The MARA appliance was effective in the treatment of Class II malocclusions. Restriction of maxillary growth and dentoalveolar changes in the maxillary and mandibular arches were responsible for the correction of the Class II malocclusion. Significant mandibular growth did not contribute to this correction.

Photographic analysis of facial changes associated with maxillary expansion.

Previous studies on the effects of surgical and rapid palatal expansion have been largely based on general skeletal and dental findings ascertained from radiographs and casts. The aim of this study was to measure and compare the soft tissue changes of the face during the expansion process and to determine the stability of any changes 1 year later. The sample consisted of 44 patients with unilateral or bilateral posterior crossbites. Twenty-four of the patients required a surgically assisted expansion procedure, and a second group of 20 patients were treated with orthopedic expansion. Ten measurements were made from standardized frontal facial photographic slides at 5 intervals of treatment: initial, bond appliance, stop expansion, debond appliance, and 1 year retention. Differences over time between the surgical and nonsurgical groups were analyzed by a 2 way multivariate analysis of variance (MANOVA) and post hoc t tests. Differences between initial and 1 year retention were found in the nasal widths (P <.001) of both surgical and nonsurgical groups. Other significant changes and trends were discussed.

The SPEED appliance: A 14-year update on this unique self-ligating orthodontic mechanism

Since its inception in 1975, the SPEED appliance has undergone many significant design improvements. This article is intended to describe the various integral components of the SPEED appliance and review the function of each.