Faculty Bibliography

The perception of dental aesthetics has been shown to vary significantly among patients and dental professionals. Smile evaluations should not be completed without establishing an ideal spatial relationship between the teeth and their respective papilla in the aesthetic zone. To date, no studies have evaluated the influence of papilla length on the perception of aesthetics and whether dental professionals or patients can discern variations. The purpose of this study was to determine the perception of aesthetics through symmetric alteration of the papilla length. LEARNING OBJECTIVES: This article reviews the importance of ideal papilla location for optimal aesthetics and its evaluation by dental professionals and patients. Upon reading this article, the reader should: Have a greater understanding of papilla length on the perception of aesthetics. Improve his or her familiarity with procedures and techniques applied to enhance soft tissue aesthetics

In attempting to provide a restorative solution for cases that have been compromised by spatial considerations, clinicians have traditionally opted for an orthodontic approach that did not provide optimal aesthetics due to changes in tooth morphology, specifically tooth size and shape as a result of dental deterioration. With the advent of contemporary aesthetic materials and preparation techniques, clinicians and technicians are now empowered to deliver a penultimate result with minimal compromise to the surrounding dentition. This article presents the clinical and laboratory considerations that must be addressed when providing a prosthetic restoration for crowded teeth

Cleft palate is a common birth defect, but its etiopathogenesis is mostly unknown. Several studies have shown that cleft palate has a strong genetic component. Robin sequence consists of three of the following four findings: micrognathia, glossoptosis, obstructive apnea, and cleft palate. While cleft palate is mainly nonsyndromic, about 80 percent of Robin sequence cases are associated with syndromes. Mutations in genes coding for cartilage collagens II and XI, COL2A1, COL11A1 and COL11A2, have been shown to cause chondrodysplasias that are commonly associated with Robin sequence, micrognathia or cleft palate. We therefore analyzed a cohort of 24 patients with nonsyndromic Robin sequence, 17 with nonsyndromic cleft palate and 21 with nonsyndromic micrognathia for mutations in COL11A2. A total of 23 Robin sequence patients were also analyzed for mutations in COL2A1 and COL11A1. We detected two disease-associated mutations in patients with Robin sequence, an Arg to stop codon mutation in COL11A2 and a splicing mutation in COL11A1. Two putatively disease-associated sequence variations were found in COL11A1 in Robin sequence patients, one in COL11A2 in a patient with micrognathia and one in COL2A1 in two patients with Robin sequence. The results showed that sequence variations in these genes can play a role in the etiology of Robin sequence, cleft palate and micrognathia but are not common causes of these phenotypes

Prediction of the movement ratio of soft to hard tissues is an important part of an orthodontic and orthognathic treatment plan. Previous studies have shown that various ethnic populations have significantly different average cephalometric measurements when compared to European-American norms. Therefore, a difference may exist in soft to hard tissue movement ratios in different ethnic populations. This study was undertaken to create norms for soft to hard tissue movement ratios for orthognathic surgery in a Hispanic population. These results were compared to previously published data on European-American populations. Presurgical and postsurgical cephalographs were traced and analyzed. The data were divided into 3 groups based on the surgical procedure performed: maxillary surgery alone, mandibular surgery alone, and treatment with a combination of maxillary and mandibular surgery. The results indicate that differences exist in soft to hard tissue ratios between the European-American and Hispanic populations. It is important to incorporate ratios for patients of Hispanic descent into a treatment planning protocol so that these patients are treated appropriately

The Goshgarian transpalatal bar is a fixed appliance that can be used inthe treatment of Class II malocclusions. This study examines the effects of the appliance on the maxillary molars and determines the force-activation characteristics of the appliance with a laboratory model. The pretreatment and posttreatment cephalometric films and dental cast records of 11 patients with Class II malocclusions are evaluated. Results show that Class II correction is achieved as a result of distobuccal rotation and distal tipping of the activated molar. A potential negative side effect on the nonactivated molar is a slight mesial movement. Both intermolar and interbicuspid widths were substantially increased with buccal root torquing. Intrusion and extrusion of the molars did not occur. The distal and transverse forces generated by the Goshgarian palatal bar were linear, however, when distal activation exceeded 35 degees, the appliance became plastic. Transverse forces were twice as great as with a quad helix and distal forces were one fourth to one eighth of those generated with a headgear