Faculty Bibliography

A case report of tooth agenesis and excessive intraarch space due to tooth size discrepancies and malformed teeth is presented. Interdisciplinary treatment including orthodontics, implant surgery, prosthodontics, and laboratory fabrication with dissimilar restoration and material types was used to accomplish an esthetic and functional outcome. Proper diagnosis of individual tooth width and proportion were key elements in treatment. CLINICAL SIGNIFICANCE: Knowledge and understanding of the relationships of the mandibular to maxillary anterior teeth and shade management of dissimilar restoration types will allow the interdisciplinary team to achieve the desired esthetic restorative result.

OBJECTIVE: To explore the impact of fixed labial orthodontic appliances on speech sound production. MATERIALS AND METHODS: Speech evaluations were performed on 23 patients with fixed labial appliances. Evaluations were performed immediately prior to appliance insertion, immediately following insertion, and 1 and 2 months post insertion. Baseline dental/skeletal variables were correlated with the ability to accommodate the presence of the appliances. RESULTS: Appliance effects were variable: 44% of the subjects were unaffected, 39% were temporarily affected but adapted within 2 months, and 17% of patients showed persistent sound errors at 2 months. Resolution of acquired sound errors was noted by 8 months post-appliance removal. Maladaptation to appliances was correlated to severity of malocclusion as determined by the Grainger's Treatment Priority Index. Sibilant sounds, most notably /s/, were affected most often. CONCLUSIONS: (1) Insertion of fixed labial appliances has an effect on speech sound production. (2) Sibilant and stopped sounds are affected, with /s/ being affected most often. (3) Accommodation to fixed appliances depends on the severity of malocclusion.

The incidence of eating disorders (ED) is increasing, not only in Westernized societies, but developing countries as well. Individuals having EDs may develop significant functional impairments across organ systems with serious life-threatening consequences, leading to the highest rates of mortality and morbidity among mental disorders. (C) 2016 Published by Elsevier Inc

White spot lesions (WSLs) are an all too common negative outcome of orthodontic treatment: a disheartening truth in an esthetically driven profession. WSLs are areas of enamel demineralization 100-150-mu m deep, with an intact porous surface layer, which can progress until a complete inward collapse of the surface occurs. Their un-esthetic opaque appearance is potentially reversible, but irreversible once cavitated. Clinically detectable WSLs can occur as early as 1 month after fixed appliance placement. It is estimated that 50% of patients develop WSLs in at least one tooth by the end of orthodontic treatment. Although orthodontists have recognized this issue, the problem still persists. An immediate application of fluoride to a white spot lesion will cause a rapid surface remineralization, leaving deeper layers demineralized, so prevention of lesion progression is necessary for an ideal esthetic outcome. Aside from excellent oral hygiene, fluoride varnish, MI Paste, and smooth surface sealants are currently the primary methods of WSL prevention. There is an existing body of research related to the use of topical fluoride and calcium-phosphate pastes to prevent demineralization during orthodontic treatment, including at-home topical treatments. However, the self-reported compliance rate is approximately 50%. Professional fluoride varnish is thought to have the advantages of reducing demineralization without being technique sensitive. Other methods of WSL prevention are available, such as placement of sealants on facial surfaces of teeth, but preliminary research has shown conflicting results on their effectiveness. Regression of WSLs after treatment is attributed to gradual surface abrasion of tooth structure. Research has shown no improvement in WSLs when comparing non-invasive treatment methods such as MI Paste to routine oral hygiene practice. Success has been shown in treating arrested WSLs with a resin infiltration technique, but this is most useful on a small scale. (C) 2016 Elsevier Inc. All rights reserved

INTRODUCTION: Esthetic considerations play an increasingly important role in patient care, and clinicians need a methodology that includes imaging techniques to capture the dynamic nature of the smile. Photographs of the posed smile are routinely used to guide diagnosis and treatment, but there is no standardized and validated method for recording the dynamic smile. The purposes of this study were to (1) determine whether a posed smile is reproducible, (2) compare visual and verbal cues in eliciting a smile, and (3) compare the diagnostic value of videography and photography in evaluating a patient's smile. METHODS: The smiles of 22 subjects were simultaneously photographed and videotaped on 2 separate occasions. For objective comparisons, measurements of the smile were obtained from 8 x 10 color still photographs and selected digitized video images. A panel consisting of a layperson, an oral surgeon, an orthodontist, and a prosthodontist subjectively assessed the reproducibility of the smile, posed vs spontaneous smiles, and the diagnostic value of video vs still images. RESULTS: Objective measurements showed that the posed smile can be reliably reproduced, whether captured by videography or still photography. However, subjectively, the panel members detected differences between the posed smiles taken on different days 80% of the time. The clinician panel members expressed a strong preference for videography over photography and for the spontaneous over the posed smiles. CONCLUSIONS: This study emphasizes the need to continue to investigate and standardize the methods of eliciting and recording a smile of diagnostic quality.

Introduction: Previously, we reported fluctuation of the levels of the inflammatory mediators interleukin-1 beta (IL-1 beta) and beta-glucuronidase (beta G) in gingival crevicular fluid (GCF) from the maxillary first molars in adolescents undergoing rapid palatal expansion. In this study, we compared the responses of IL-1 beta and beta G in the GCF of the maxillary first molars, first premolars, and central incisors during palatal expansion at the same patients. Methods: Nine patients requiring palatal expansion were selected at the postdoctoral orthodontic clinic at Columbia University College of Dental Medicine. Each patient received periodontal prophylaxis and instructions in proper home care including rinsing with chlorhexidine. Four weeks after periodontal prophylaxis, a modified hyrax appliance was placed. The jackscrew was activated twice daily until the appropriate expansion was achieved. GCF samples were collected before and after periodontal prophylaxis and during passive wearing of the appliance, active orthodontic treatment, and retention. Fluid samples were collected with filter paper strips and analyzed by ELISA and time-dependent fluorometry for IL-1 beta and beta G, respectively. The values recorded after periodontal prophylaxis were used as the baseline. Paired t tests were used to compare mediator levels at baseline with the levels obtained at each subsequent observation. Results: The results validate that IL-1 beta and beta G are present in the GCF of adolescents, and, although their level decreases after a strict regimen of plaque control, it increases during orthodontic or orthopedic movement. Moreover, this study demonstrates that both heavy and light forces evoke increased levels of IL-1 beta and beta G, stronger forces cause higher levels of inflammatory mediators, and both IL-1 beta and beta G respond to direct and indirect application of mechanical force to teeth. Conclusions: This investigation corroborates previous findings that an inflammatory process occurs during application of mechanical force to teeth. Although this inflammation is considered relatively aseptic, additional inflammation, such as that induced by plaque accumulation, must be avoided during orthodontic or orthopedic treatment

Measuring plaster models by hand is the traditional method of assessing malocclusion. Recent technologic advances now allow the models to be digitized, measured with software tools, stored electronically, and retrieved with a computer. OrthoCAD (Cadent, Fairview, NJ) performs this service. The purpose of this study was to evaluate the reliability of the OrthoCAD system. Two independent examiners measured tooth size, overbite, and overjet on both digital and plaster models. The results were compared, and interexaminer reliability was assessed. The study sample consisted of 76 randomly selected pretreatment patients. The results showed a statistically significant difference between the 2 groups for tooth size and overbite, with the digital measurements smaller than the manual measurements. However, the magnitude of these differences ranged from 0.16 mm to 0.49 mm and can be considered clinically not relevant. No difference was found between the 2 groups in the measurement of overjet. Interexaminer reliability was consistent for both the plaster and the digital models

Insulin-like growth factors are mediators of growth hormone and are believed to also stimulate growth independently. Insulin-like growth factor I (IGF-I) null mutant mice exhibit a lower rate of skeletal growth compared with their wild-type (control) littermates. Although their general body dimensions seem proportionate, their heads appear shortened with a blunt nose compared with the controls. The aim of this project was threefold: 1) to investigate whether differences in shape/form exist between the craniofacial skeleton of the IGF-I null mutant mice and their control littermates by using three techniques; 2) to determine whether the three techniques yield similar, different, or complementary information regarding the size and shape of specimens; and 3) to investigate whether the histological sections obtained from the craniofacial skeleton exhibit any differences between the two groups. Thirty adult male mice, 12 mutant and 18 wild type, obtained from 11 litters were examined. Lateral and superio-inferior radiographs of their head were analyzed by the procrustes, the macroelement, and the traditional cephalometric techniques. Later, the animals were processed for routine histological examination. The IGF null mutant mice demonstrated a generalized decrease of craniofacial size (43-64% of the normal adult size) and a non-allometric change of shape when compared with their wild-type littermates. While the mandible did not exhibit any shape changes, the facial and cranial areas demonstrated prominent changes. Examination of histological sections did not reveal any structural difference between the two groups at the adult stage. Furthermore, procrustes and macroelement techniques offer a more complete, detailed, and comprehensive description of the specimens compared