Judging orthodontic treatment complexity

Objective: The aim of the present study was to investigate possible relations between anticipated overall treatment complexity (AOTC) of an orthodontic case and malocclusion characteristics. Methods: Two groups of orthodontists (groups A and B) were asked to define perceived treatment complexity (PTC) of orthodontic cases based on 16 characteristics of malocclusion by means of a questionnaire. Each question was answered on a six-point ordinal scale, with one "not applicable" option (score 0). Group A was also asked to give the AOTC of the specific case on a five-point ordinal scale. The index of orthodontic treatment need (IOTN) score of the specific cases as well as the malocclusion characteristics were assessed by one author. Results: There is a significant relationship between IOTN and AOTC (p< 0.0001), 22% of variability is explained by differences in IOTN. Adding objective characteristics of malocclusion to explain AOTC does not significantly increase the explained variability (p = 0.086). In judging interobserver agreement, a weighted Kappa of 0.60 for group A and 0.56 for group B was found. The weighted Kappa for agreement in AOTC equals 0.06. Conclusion: The relation between IOTN and AOTC was found to be significant. Moderate agreement on PTC among observers and a low level agreement regarding AOTC were found in the present study.

Objetivo: o objetivo do presente estudo foi investigar possíveis relações entre a previsão da complexidade geral do tratamento (AOTC, Anticipated Overall Treatment Complexity) de um caso ortodôntico e as características da má oclusão. Métodos: dois grupos de ortodontistas (Grupo A e Grupo B) foram orientados a definir, por meio de um questionário, sua percepção da complexidade do tratamento (PTC, Perceived Treatment Complexity) de casos ortodônticos, com base em 16 características da má oclusão. Cada questão foi respondida em uma escala ordinal de seis pontos, com a opção "não aplicável" (nota 0) disponível. Pediu-se ao Grupo A que também determinasse, em uma escala ordinal de cinco pontos, a AOTC de cada caso. A nota relativa ao índice de necessidade de tratamento ortodôntico (IOTN,Index of Orthodontic Treatment Need) de casos específicos e as características das más oclusões foram avaliadas por um dos autores. Resultados: existe uma relação significativa (p < 0,0001) entre o IOTN e a AOTC. Diferenças no IOTN são a causa de 22% da variabilidade. Adicionar características objetivas da má oclusão para explicar a AOTC não aumentou significativamente essa variabilidade mencionada (p = 0,086). Ao se avaliar a concordância interexaminadores, foram encontrados valores de Kappa ponderado de 0,60 para o Grupo A e 0,56 para o Grupo B. O valor de Kappa ponderado para a concordância quanto à AOTC foi de 0,06. Conclusão: a relação encontrada entre o IOTN e a AOTC foi considerada significativa. Verificou-se uma moderada concordância interexaminadores com relação à PTC, e um baixo nível de concordância com relação à AOTC.

Morphological and Structural Characterization of Two Types of As-Received and In vivo Orthodontic Stainless Steel Brackets.

Aims: To perform a) a topographical analysis of the bracket slot of 12 as-received stainless steel brackets and of in vivo used stainless steel brackets from 7 patients and b) a compositional characterization of the constituting materials of two types of brackets. Study Design: In vitro laboratory study. Methodology: 12 as-received brackets and in vivo used brackets of seven patients were analysed. Two commercially available brackets were used for this study. A SEM analysis evaluated the topographic features of each bracket slot while an EDAX analysis was performed to analyse the constituting parts of each bracket. Results: As-received ORMCO brackets show more traces of plastic deformation than GAC brackets. On the contrary, pits, crevices and grain boundaries were observed on all as-received brackets. An increased plastic deformation and amount of scratches was noticed on ORMCO and GAC brackets after orthodontic treatment. Elemental analysis revealed that base and wing materials were not identical in GAC nor in Ormco brackets. In addition, both ORMCO and GAC brackets consist each of two parts assembled using a different brazing material. Conclusion: Both as-received brackets show different damage patterns on their slot surface. Increase of damage patterns was visualized after intra-oral use. As a consequence of the use of different constituting materials for the manufacturing of the two types of brackets investigated, galvanic corrosion is likely to occur.

Transformation Behaviour, Bending Properties and Surface Quality of 22 Commercial Nickel- Titanium Wires: A Batch-to-Batch Evaluation.

Aims: The aims of this study were to investigate batch-to-batch differences in mechanical and thermal properties of 22 commercial nickel-titanium wires and evaluate the surface quality. Secondly the percentages of superelasticity at mouth temperature were measured. Study Design: In vitro laboratory study. Place and Duration of Study: Sample: Department of Oral Health Sciences – Orthodontics and Metallurgy and Materials Engineering KU Leuven, between January 2010 and May 2011. Methodology: The sample comprised 22 NiTi wires of the upper jaw from 7 different manufacturers. For each brand two different batches were investigated (LOT A, LOT B). Three different investigations were carried out. First transformation behaviour and transition temperatures were determined by differential scanning calorimetry, second a three point bending test was done to evaluate the mechanical properties and third scanning electron microscopy was performed on all samples to evaluate surface quality. Results: Absolute batch-to-batch differences in the investigated properties were all deviating from zero, although most differences were clinically acceptable. Significant interbatch differences in thermal properties were found in 4 wires. Mechanical interbatch differences were found remarkable for 5 wires. Percentage of elasticity showed a non- superelastic curve below a deflection of 1500 μm, which represents clinical small deflections. Surface topography showed also interbatch differences for 4 wires. Conclusion: This study shows that batch-to-batch differences are obvious in each sample. One has to be careful in the selection of archwires. Therefore more standardized consument information should be provided.

Virtual autopsy in forensic sciences and its applications in the forensic odontology / A autópsia virtual nas ciências forenses e sua aplicação na Odontologia forense

Nowadays, technological advances are becoming more and more important in forensic sciences. Yet autopsy is still one of the very traditional methods. This also applies for dentalautopsies, in which visual, photographic and radiological evidences are collected. In this context, Virtual Autopsy appears as a helpful and complementary tool for dental and medical cadaveric examination. Usinghigh-tech radiological approaches, Virtual Autopsy may provide, through images, an efficient and more accurate view on the individual case. This critical review aims to update the dental professionalspresenting the first national paper with explanations on Virtual Autopsy.

Atualmente os avanços tecnológicos se fazem cada vez mais importantes nas ciências forenses. Por outro lado a autópsia ainda é uma abordagem tradicional na prática médica-odontológica, na qual evidências são coletadas por meio fotográfico e radiológico. Neste contexto, a Autópsia Virtual surge como uma ferramenta útil e complementar para o exame cadavérico. Através da alta tecnologia radiológica a Autópsia Virtual fornece uma visão eficiente e precisa do caso a ser analisado. Esta revisão crítica tem o objetivo de atualizar os Cirurgiões-dentistas apresentando o primeiro trabalho com o conteúdo voltado a Autópsia Virtual.