John J. Cunat

A dental-facial attractiveness scale

Since the decision to seek orthodontic treatment is frequently the result of concerns about appearance, assessment of need for treatment should include an impartial evaluation of dental-facial appearance. While some of the standardized techniques for assessing malocclusion have included a consideration of esthetic impairment, they tend to confound this with functional impairment. The purpose of this study was to develop a valid and reliable index that provides relatively objective judgments of dental-facial attractiveness. The subjects in this study were eighth- and ninth-grade children seeking orthodontic treatment and their siblings, and eighth- and ninth-grade children not seeking treatment and their siblings. Photographs of the children were rated for dental-facial attractiveness by lay and dental judges. Children were also assessed for severity of malocclusion by means of the Treatment Priority index. Children seeking treatment were perceived as significantly less attractive than children not seeking treatment. Dental judges rated children seeking treatment as more attractive than did nondental judges. Intraclass reliability coefficients were moderate to high.

Variables Discriminating Individuals who Seek Orthodontic Treatment

Characteristics differentiating two groups of adolescents were identified: those planning orthodontic treatment and a comparison group not planning treatment. Two separate analyses, for psychosocial and dental-related variables, were completed. Additional analyses were applied using salient variables for each group. Eighty-two percent of the subjects were correctly categorized using the resulting discriminant function.

Physical and mechanical properties of elastomers in orthodontic positioners

Elastomers for conventional Kesling-type tooth positioners are relatively inelastic and are primarily indicated as finishing devices. However, new materials, first described in the Japanese literature, with claims of a greater range of tooth movement warrant a comparison with conventional materials. Physical and mechanical property testing of positioner elastomers has not been reported in the orthodontic literature. This investigation compared properties of a high temperature vulcanizing (HTV) Japanese silicone (Orthocon) to three traditional polyurethane and vinyl-based polymers and five experimental silicone elastomers. Fourier transform infrared spectroscopy established the definitive chemical composition of the urethane and vinyl materials obtained from a commercial positioner laboratory. Tear strength, tensile strength, tensile stress at selected elongations, and ultimate elongation of all materials were evaluated at 37 degrees C in an aqueous environment. Hardness and water sorption values also were determined and an in vitro force measurement apparatus was fabricated to determine force levels exerted by positioner materials at low displacements. Orthocon was statistically different (Duncans multiple range test, p less than 0.05) from the traditional commercial urethane and vinyl materials. Orthocon had lower tear strength than the traditional materials. It also demonstrated lower stress values below 100% elongation. The parameters of tensile stress at 50% elongation and ultimate elongation were statistically identical for Orthocon and one experimental silicone material.

Relationships between variation of mandibular morphology and variation of nasopharyngeal airway size in monozygotic twins.

Abstract No Abstract Available. Based on a thesis submitted to the Faculty of the Graduate School of State University of New York at Buffalo in partial fulfillment of the requirements for the degre...

A dental-facial attractiveness scale: Part II. Consistency of perception☆

A previous report describes the reliability and validity of a scale designed to assess perceptions of dental-facial attractiveness, independent of occlusal function. The purpose of the present study was to assess the consistency of judgments of dental-facial attractiveness (DFA) for sex and race differences in photographed children. Using a five-pont DFA scale, twelve college freshmen (three black females, three black males, three white females, three white males) rated ninety-six photographs of the mouths and jaws of 13- to 14-year-old children (twenty-four black females, twenty-four black males, twenty-four white females, twenty-four white males). No significant mean differences were found between the black and white photographed or between the female and male children photographed. However, means were significantly different for DFA judgments by race and sex of the raters. Black raters judged all photographs to be more attractive than did white raters, and female raters judged all photographs to be more attractive than did male raters. Correlational data are presented describing consistency of perception within rater groups and photographed groups of children.

Reliability and validity of clinical assessments of malocclusion

The purpose of this research was to determine the reliability and validity of selected clinical judgments of malocclusion, including general evaluations of occlusal status and more specific aspects of dentofacial malrelations. Study casts of twenty-one adolescents planning orthodontic treatment and twenty-nine not planning treatment were examined and rated. The examiners were five dentists in an orthodontic specialty-training program. They completed ratings on six dimensions: (1) need for treatment, (2) degree of malocclusion, (3) potential for tissue loss, (4) negative effect on occlusal stability, (5) negative effect on dental-facial attractiveness, and (6) negative effect on masticatory function. Six weeks later the same five rates scored the fifty casts, using the standardized Treatment Priority Index (TPI). Three weeks later, or 9 weeks after the initial ratings, the casts were again rated on the two general dimensions: need for treatment and degree of malocclusion. Correlations among all the measures were examined. Inter-rater reliability was highest for the ratings of impact on dental-facial attractiveness (r = 0.88). The two general assessments also yielded relatively high rater reliabilities, and the second rating yielded stability coefficients of 0.84 for both of these ratings. Correlations with total TPI scores were 0.70 for the dental-facial attractiveness measure and 0.65 and 0.64, respectively, for assessments of need for treatment and degree of malocclusion. The data indicate that clinical evaluations of the severity of malocclusions are comparable to objective measures in terms of inter-rater reliability. Clinical evaluations are also relatively stable over time. Correlations with the TPI scores also provide evidence of the concurrent validity of clinical judgments.

The impact of interproximal band thickness on treatment and retention

I t is common knowledge that mechanical orthodontic therapy has, over the years, taken a variety of forms. The two major appliance systems, fixed and removable, have each had strong defenses, sometimes real, sometimes imaginary, on both biologic and technical grounds. Moreover, within each school of thought, a good deal of controversy exists with regard to diagnostic philosophy and treatment objectives. The purpose of this article will be to examine one area of disagreement among those who advocate the use of fixed appliances, namely, the effect of the physical size of interproximal band material upon diagnosis, treatment planning, and retention. Some proponents of orthodontic systems which utilize only a few bands have suggested that leaving the teeth comparatively free of appliances allows natural forces to assist in guiding teeth into their proper positions. On the other hand, those who choose to band essentially all of the erupted teeth favor the notion that this more elaborate type of appliance system allows the practitioner to precisely control the relationships of the teeth in all three planes of space, both individually and collectively. If these were the only considerations, appliance selection could be relatively straightforward, in that one would only have to decide how much liberality he would allow the dentition in any given situation. Of a far more serious nature are the allegat,ions that diagnosis is very much affected by the dictates of the appliance. For example, Wilson,l in commenting on the interproximal thickness of bands and cement common to all multibanded appliances, has made the following charge : “In some instances, this is more space than is required to treat the case if such an appliance were not used. Additional arch increase under