Faculty Bibliography

BACKGROUND: A 270-degree partially tubed pectoralis major myocutaneous flap (PMMF) is an excellent option for total circumferential pharyngoesophageal defects in patients who are not candidates for more complex reconstructions. METHODS: Patients undergoing circumferential pharyngoesophageal reconstruction with partially tubed PMMF were reviewed. End points were stricture, fistula, resumption of oral intake, perioperative death, and recurrence. RESULTS: Eleven patients underwent 270-degree PMMF for reconstruction: 6 (55%) were men and 5 (45%) were women (mean, 62 years; range, 42-78 years). Three patients (27%) developed fistulas and 2 (18%) developed stenosis. Ten patients (91%) were able to resume adequate nutrition via oral intake. There were no perioperative deaths. CONCLUSIONS: Patients with severe comorbidities, metastatic disease, a lack of donor vessels, or a potentially hostile abdomen may not be ideal candidates for free tissue transfer. For these patients, partially tubed PMMF using the prevertebral fascia provides a reliable alternative for reconstruction with excellent functional results.

BACKGROUND: The purpose of this study was to compare the shear bond strength and adhesive remnant index (ARI) at the enamel-bonding interface of precoated and conventionally bonded brackets, utilizing standardized procedures. METHODS: The test sample consisted of 90 recently extracted bovine permanent mandibular incisors. The teeth were bonded using the same protocol and were tested in three different situations. A material testing systems machine was utilized for debonding, and the remaining adhesive on the tooth was recorded. RESULTS: Immediately after bonding, we found that the shear bond strength of the precoated brackets (6.27 MPa) was significantly higher than that of conventional brackets (5.37 MPa) (p<0.05). However, no significant differences in bond strength were found between the two bracket systems after 24 h of bonding or after thermocycling. The conventional brackets had higher ARI scores than the precoated bracket systems immediately after bonding and after 24 h. CONCLUSIONS: Since there were no significant differences in the bonding strength after 24 h, the immediate bonding strength of the precoated brackets during the first day does not appear to be a major advantage over the conventional bracket systems. However, less adhesive on the tooth after debonding is an advantage of precoated brackets.

OBJECTIVE: The main objective of this in vivo study was to determine the incidence and location of fracture in round nickel-titanium (NiTi) and round stainless steel orthodontic archwires, both commonly used in orthodontics. Secondarily, this study sought to determine if there is any correlation between archwire fracture and gender, diameter of the archwire, arch type (maxillary/mandibular) or bracket used. DESIGN: In vivo study. MATERIALS AND METHODS: One thousand orthodontic patients (1434 archwires) were evaluated during regular treatment visits to assess archwire fracture and location. The patient's gender, age, type of archwire (round NiTi and round stainless steel), diameter of the archwire, arch type, location of fracture (anterior or posterior) and period of service before fracture were recorded. STATISTICAL ANALYSIS: Chi-square statistical test was utilized to address the frequency and the correlation between the different variables. Level of statistical significance (alpha) was set at 0.05. RESULTS: Twenty-five archwire failures were reported (1.7%) of the total sample size. All fractured archwires were NiTi, and 76% of the fractures were located in the posterior region. No statistical significance was found between archwire fracture and gender, arch type (maxillary/mandibular), archwire diameter or bracket type. CONCLUSION: The frequency of archwire fracture during regular orthodontic visits is very low. The most common archwire fracture site is the posterior region. NiTi wires are the most commonly fractured archwire. No statistically significant correlation exists between archwire fracture and gender, arch type, bracket type or diameter of archwire.