Faculty Bibliography

The purpose of this study was to test and compare the accuracy and reliability of soft tissue profile predictions generated from two computer software programs. The presurgical and postsurgical cephalometric radiographs of 28 patients were digitized onto each computer program. A customized analysis was created to determine the amount of surgical movement, as well as to compare the actual postsurgical soft tissue profile with the computer-generated prediction. The results demonstrated that, on the average, the predictions were not significantly different from the actual postsurgical profile changes. While each program generated statistically similar prediction results, marked variability was noted. There was no significant difference found in the prediction errors between patients who had one-jaw surgery and those who had two-jaw surgery. This study found that a linear relationship existed between the surgical movement and the prediction error. In general, the greater the magnitude of the surgical movement, the larger the prediction error

The mesh analysis is a proportionate cephalometric analysis that enables a patient to serve as his or her own control to create a template from which to assess skeletal, dental, and craniofacial disharmonies. The norms for this analysis were originally created from a white, European American sample. The purposes of this study were: (1) to create a normal mesh diagram from a black, African American population; (2) to compare mesh diagrams from black and white Americans; and (3) to evaluate the usefulness of a panel of diverse members in selecting subjects. All subjects were black Americans of African descent, had no prior orthodontic treatment, and had Class I dental occlusion with minimal crowding (4 mm or less). The panel selected as esthetically pleasing 18 males and 25 females from a group of 77 patients meeting the study criteria. Male and female normal mesh diagrams were created from the cephalographs and compared with Caucasian normal diagrams developed by Moorrees in 1976. Linear and angular components of the hard and soft tissues were compared. Comparisons were also made with previously published normal values. Differences between the African American and Caucasian samples were more notable close to the dentoalveolar complex. Similarities were limited to the soft tissue of the upper face, the cranial base, and the midface. Analysis of the panel selection results did not suggest any trends between or within race, sex, or occupation of the panel members. However, agreement between the races was good

PURPOSE: The purpose of this study was to evaluate the accuracy and reproducibility of linear measurements obtained from three-dimensional reconstructions of computed tomography (CT) scans. MATERIALS AND METHODS: Ten rectangular acrylic blocks were prepared with titanium molybdenum alloy (TMA) markers spaced from 1 to 10 mm, respectively. A plastic sphere was prepared with 10 sets of TMA markers spaced at variable intervals of 1 to 10 mm. Each object was scanned three times at 3-mm slice thicknesses and 1.5 mm with 0.5 mm overlap slice thicknesses, as well as positioned in the CT scanner in two different directions (perpendicular and parallel) to the scanning beam. Intermarker distances of the reconstructed objects were then measured using the measurement tool of the MediCAD software and compared with measurements taken by hand with a vernier caliper. RESULTS: Using the 3-mm cut protocol, the data indicated that inconsistency exists between intermarker distance in the scans when the rectangular objects were scanned parallel to the scanning beam. This finding was not seen using the 1.5-mm with 0.5-mm overlap slice thickness protocol. The intermarker distances for objects scanned perpendicular to the scanning beam were consistent but subject to demagnification in the range of 17% to 20% for both scanning protocols. CONCLUSION: The orientation of the object to the scanning beam and slice thickness protocol appear to have an impact on the accuracy and variability of linear measurements taken in the x, y, z axes.

Before the 1970s, Begg and Edgewise appliances were the most commonly used appliances in orthodontics. With the introduction of preadjusted appliances, many have made claims of superiority. These claims are often unsubstantiated, as few, if any, have ever been tested in a controlled, prospective in vivo study. The purpose of this study was to compare the time required to retract canine teeth by using two different preadjusted bracket systems (Tip-Edge, TP Orthodontics, LaPorte, Ind., versus A-Company straight wire, Johnson and Johnson, San Diego, Calif.) in a human sample. Anchorage loss as a result of this movement was also evaluated. A sample of 12 patients was randomly selected from the new patient pool at the postgraduate orthodontic clinic of Montefiore Medical Center. All patients required the removal of first premolars in one or both arches as a part of their orthodontic treatment. The rate of retraction and anchorage loss were evaluated. Paired t tests were performed separately for the rates of retraction and anchorage loss. The mean rates of retraction were 1.88 mm per 3-week period and 1.63 mm per 3-week period for the Tip-Edge and A-Company brackets, respectively. There was no statistically significant difference in the rates (p > 0.05). The mean anchorage loss was 1.71 mm for the Tip-Edge bracket, and 2.33 mm for the straight wire bracket. The difference in the amount of anchorage loss was inconclusive as the sample size was too small (power was 10%)

Cephalometric radiography has become a standard and invaluable means of obtaining diagnostic information for the management of malocclusion and skeletal disharmony. However, concerns over radiographic exposure, particularly in growing individuals, may limit its use, especially in longitudinal analyses. Less invasive means of obtaining vital information would be desirable. A recently introduced system (Digigraph, Dolphin Imaging Systems; Valencia, Calif) provides sonically produced representations of cranial landmarks and has been introduced by its manufacturer as an alternative to standard cephalometric radiography. The purpose of the study was to compare the validity and reproducibility of cephalometric values generated sonically on a digital image analyzer (Digigraph) with those obtained from standard cephalometric radiographs for 43 different measurements. Although 58.1% of the sonically produced measurements showed significant correlation with radiographically produced measurements, there were no trends observed for correlation, either in dental or skeletal structure classifications. Additionally, this study found the data generated from the digital image analyzer to be markedly variable, while the radiographically obtained data were reproducible

A study was conducted to evaluate the impact of practice modifications on treatment time for patients in a private orthodontic office. Two patient groups were studied, consisting of Class I nonextraction, adult dentitions treated by one of the authors. One group (28 cases) was treated with the standard Begg technique and conventional motivation, hygiene, and finishing practices. The other (25 cases) was treated with the Tip-Edge appliance along with specific modifications to motivation, hygiene and finishing techniques. The average treatment time for the Tip-Edge group was 12.80 months versus 20.89 months for the Begg group. The use of motivational techniques and a specific mission and philosophy within a private orthodontic practice can help reduce total treatment time. The Tip-Edge appliance may reduce treatment time in Class I nonextraction therapy

Nickel is one of the most common causes of allergic contact dermatitis and produces more allergic reactions than all other metals combined. Currently, several brands of orthodontic wires are made of nickel titanium alloy and potentially have a high enough nickel content to provoke manifestations of allergic reactions in the oral cavity. The objectives of this study were (1) to determine if standard orthodontic therapy can sensitize patients to nickel, and (2) to assess gingival response to nickel-containing orthodontic appliances in patients who are nickel sensitive before treatment. Nickel sensitivity patch tests were conducted to confirm hypersensitivity to nickel. Twenty-nine patients from the Division of Orthodontics, Albert Einstein/Montefiore Medical Center were tested, ranging in age from 12 to 48 years. Of the 29 patients, there were 18 female and 11 males. Five of the patients had a positive nickel patch test, a rate of 18.5%. The five patients that tested positive were all female, meaning that the overall rate for females was 27.7% (5:18). The five female patients sensitive to nickel were followed monthly by intraoral photos and gingival and plaque index scores. The remaining patients began routine orthodontic therapy and were retested 3 months into treatment to see whether sensitization occurred. Two patients converted from an initial negative patch test to a positive test. There may be a risk of sensitizing patients to nickel with long-term exposure to nickel-containing appliances as occurs in routine orthodontic therapy

A review of anesthesia and sedation records of children with nursing caries was undertaken. The weights of these 115 children with otherwise noncontributory medical histories were compared to subjects matched for age, gender, race, and socioeconomic status. Nursing caries children were treated using either sedation or general anesthesia and received treatment for at least one pulpally involved tooth. Comparison subjects had no gross carious lesions. The average age for both the comparison and test groups was 3.2 years (SD = 1.01 and 0.98, respectively). While comparison patients weighed 16.2 +/- 3.08 kg, patients with nursing caries weighed only 15.2 +/- 2.66 kg. This difference was statistically significant (P < 0.005). Of the nursing caries patients, 8.7% weighed less than 80% of their ideal weight, compared with only 1.7% of the comparison patients (P < 0.02). Of nursing caries children, 19.1% were in the 10th percentile or less for weight, compared with only 7.0% of comparison subjects (P < 0.01). The mean age of 'low weight' patients with nursing caries was significantly greater than for patients at or above their ideal weights, indicating that progression of nursing caries may affect growth adversely

The craniofacial characteristics of two syndromes commonly associated with Robin sequence were compared for 49 subjects. Lateral cephalograms were analyzed for four groupings: Group I--Stickler syndrome with versus without Robin, Group II--velocardiofacial (VCF) syndrome with versus without Robin, Group III--Stickler without Robin compared to VCF without Robin, and Group IV--Stickler with Robin compared to VCF with Robin. Thirty-two skeletal and 18 soft tissue measurements were compared. In Group I, three skeletal measurements were significantly different (SNA, SNB, and SNPg). In Group II, no significant difference was found for any of the 50 measurements. In Group III, a significant difference was demonstrated for seven parameters (one skeletal, six pharyngeal and airway). In Group IV, two skeletal and eight airway measures were significantly different. The findings indicate that the relative maxillary and mandibular retrognathia observed in Stickler/Robin patients may predispose them to the Robin sequence and vice versa; the Robin features in VCF may be caused by hypotonia rather than any craniofacial or physical obstruction of the airway; Stickler and VCF are similar in craniofacial morphology but show marked differences in pharyngeal and airway morphology; and cephalometrics should not be the sole prognosticator of the Robin sequence and its association with Stickler and VCF