Can Velopharyngeal MRI be Used in Individuals with Orthodontic Devices?

OBJECTIVE: To evaluate the influence of common pediatric orthodontic appliances on velopharyngeal (VP) MRI and to compare MR image sequences to determine if sequence parameters impact the visibility of key VP structures commonly assessed in clinical VP MRI. DESIGN: Participants undergoing orthodontic treatment completed a VP MRI study. Level of distortion caused by orthodontic devices on 8 anatomical sites of interest and using variable MRI sequences was evaluated. SETTING: Single institution. PARTICIPANTS: Nineteen participants undergoing orthodontic treatment. MAIN OUTCOME: Level of distortion caused by metal artifacts and MR sequence used. RESULTS: The results of this study demonstrate that appliances such as hyrax palatal expanders and braces with stainless steel brackets are acceptable for a VP MRI, while class II corrector springs are not recommended. The HASTE MRI sequence with 2D imaging techniques should be utilized if the child has orthodontic devices, while FSE and 3D imaging techniques are not recommended. The presence of wire spring coils and molar bands are likely to not to interfere with the MRI evaluation. CONCLUSIONS: Findings from this study suggest that the presence of orthodontic appliances does not hinder visualization of all velopharyngeal structures during an MRI. Therefore, careful consideration must be made prior to disqualifying or recommending patients for VP MRI.

Orthodontic and oral health literacy in adults.

OBJECTIVE: The primary aim of the study was to determine levels of literacy in both oral health and orthodontics in an adult population. The secondary study aim was to investigate differences in literacy between males and females. METHODS: Participants included individuals 18 years or older seeking dental treatment at the East Carolina University (ECU) School of Dental Medicine. To determine levels of oral health literacy (OHL) and orthodontic literacy (OrthoL), validated instruments were administered, including the Rapid Estimate of Adult Literacy in Medicine and Dentistry, the Oral Health Literacy Instrument and its separate scales, and a questionnaire on orthodontic literacy. Summary statistics were computed, and statistical significance was set at 0.05. RESULTS: One hundred seventy-two individuals participated in the study and had a mean age of 55.03 (range:18-88). Greater than 70% of the sampled population exhibited inadequate or marginal oral health knowledge. Additionally, greater than 70% of the sample possessed no more than an 8th grade reading level, with regard to basic medical and dental terms. Higher education was weakly associated with higher OrthoL and OHL. Higher age was also weakly associated with lower OrthoL and OHL. Males on average exhibited significantly higher OHL (p < .05) but there were no OrthoL differences between males and females. Dental visit frequency was not associated with OrthoL or OHL. CONCLUSION: Low levels of OrthoL and OHL were observed in the study. While males demonstrated a higher level of OHL than females, neither age nor the occurrence of dental appointments significantly influenced levels of literacy.

Incorporation of Arginine to Commercial Orthodontic Light-Cured Resin Cements-Physical, Adhesive, and Antibacterial Properties.

(1) Background: The amino acid arginine is now receiving great attention due to its potential anti-caries benefits. The purpose of this in vitro study was to evaluate the shear bond strength (SBS), ultimate tensile strength (UTS), and antimicrobial potential (CFU) of two arginine-containing orthodontic resin cements. (2) Methods: Forty bovine incisors were separated into four groups (n = 10): Orthocem, Orthocem + arginine (2.5 wt%), Transbond XT, and Transbond XT + arginine (2.5 wt%). The brackets were fixed to the flat surface of the enamel, and after 24 h the SBS was evaluated using the universal testing machine (Instron). For the UTS test, hourglass samples (n = 10) were made and tested in a mini-testing machine (OM-100, Odeme). For the antibacterial test (colony forming unit-CFU), six cement discs from each group were made and exposed to Streptococcus mutans UA159 biofilm for 7 days. The microbiological experiment was performed by serial and triplicate dilutions. The data from each test were statistically analyzed using a two-way ANOVA, followed by Tukey's test (α = 0.05). (3) Results: The enamel SBS mean values of Transbond XT were statistically higher than those of Orthocem, both with and without arginine (p = 0.02033). There was no significant difference in the SBS mean values between the orthodontic resin cements, either with or without arginine (p = 0.29869). The UTS of the Transbond XT was statistically higher than the Orthocem, but the addition of arginine at 2.5 wt% did not influence the UTS for either resin cement. The Orthocem + arginine orthodontic resin cement was able to significantly reduce S. mutans growth, but no difference was observed for the Transbond XT (p = 0.03439). (4) Conclusion: The incorporation of arginine to commercial orthodontic resin cements may be an efficient preventive strategy to reduce bacterial growth without compromising their adhesive and mechanical properties.

Total IgA and IgA reactivity to antigen I/II epitopes in HLA-DRB1*04 positive subjects.

Bacterial adherence to the acquired dental pellicle, important in dental caries (caries), is mediated by receptor-adhesins such as salivary agglutinin binding to Streptococcus mutans antigen I/II (I/II). Ten selected I/II epitopes were chosen to determine their reactivity to human salivary IgA. Previous studies suggested that a specific HLA biomarker group (HLA-DRB1*04) may have differential influence of immune responses to I/II. However, it was not known whether secretory IgA (SIgA) responses to the selected epitopes from HLA-DRB1*04 positive subjects were different compared to controls, or across other caries-related factors such as total IgA (TIgA). Thirty-two total subjects were matched according to HLA type, gender, ethnicity and age. HLA genotyping, oral bacterial, immunoglobulin and antibody analyses were performed. A large observed difference emerged with regard to the natural immune reservoir of TIgA in HLA-DRB1*04 positive subjects, specifically, a 27.6% reduction compared to controls. In contrast to all other epitopes studied, HLA-DRB1*04 positive subjects also exhibited reduced reactivity to I/II epitope 834-853. HLA-DRB1*04 positive subjects exhibited lower specific SIgA activity/TIgA to 834-853 and also a lower specific reactivity to 834-853/whole cell S. mutans UA159. Furthermore, HLA-DRB1*04 positive subjects exhibited lower responses to I/II in its entirety. The large observed difference in TIgA and the 834-853 reactivity pattern across multiple measures suggest potentially important connections pertaining to the link between HLA-DRB1*04 and caries.

Edward H. Angle and the motives behind his school of orthodontia.

Despite the century that has passed since Dr. Edward Hartley Angle (1855-1930) launched a new dental specialty, his personal vision of why he believed orthodontics needed to separate from dentistry has remained somewhat obscure. This study seeks to provide more clarity to this question. Angle followed a very distinct pattern of secession or separation throughout his life, a pattern which ended up benefitting the orthodontic specialty's elevation as an independent and advanced science within dentistry. Even so, it was ultimately those things he disliked about the academic community, the very community within which dentistry flourished, that finally moved him to force the issue by separating himself from that community. The separation of orthodontics from dentistry provided a singular environment in which orthodontics could bear fruit that the average patient could benefit from, thus providing the groundwork for accelerated orthodontic developments.

Health science education: reviewing a framework for problem-based learning.

Although problem-based learning (PBL) has become one pedagogical approach to gain currency in recent decades, its foundational underpinnings have remained obscure. This investigation seeks to elucidate the theoretical framework or assumptions upon which PBL operates. We have situated core PBL principles in the larger context of health science education, which underwent dramatic changes at the beginning of the twentieth century. The fundamental problem at that time in dental education was moving beyond a lecture-based and apprentice curriculum (students memorizing facts) to a critical thinking-based curriculum. We trace these developments and especially the principles that one thinker, who does not easily fit into any one school of thought, used to frame the problem. We found that the principles underlying the idea of PBL have existed for over a century in varying academic alleys outside of dentistry (including constructivist thought). Despite our technological advances, many of the core challenges of a century ago remain challenges today. Although PBL is certainly not the only way to provide dental students an opportunity to best develop critical thinking, it nevertheless provides an environment in which the learning process may be enhanced.

Determination of growth and maintenance coefficients by calorespirometry.

This study describes a calorespirometric method for determining the coefficients of the correlation of specific respiration and growth rates. To validate the calorespirometric method, coefficients obtained from calorespirometric data are compared with coefficients obtained from mass and elongation growth rates measured at three temperatures on oat (Avena sativa L.) shoots. Calorespirometric measurements were also made on leaf tissue of varying age from Verbascum thapsus L., Convolvulus arvensis L., and Helianthus tuberosus Nutt. Measurements on A. sativa, C. arvensis and H. tuberosus at several temperatures show maintenance coefficients generally increase with temperature, but, in disagreement with accepted theory, growth coefficients for C. arvensis and A. sativa vary with temperature. A comparison of rates expressed as intensive and extensive quantities showed that the decline in specific respiration and growth rates with age is caused by dilution-by-growth, not down-regulation of respiration rate by reduced demand. The ratio of heat rate to CO2 rate increases with leaf age, and, for fully mature leaves, exceeds the maximum possible value for carbohydrates. This shows that the catabolic substrate may vary with leaf age in immature leaves and cannot be assumed to consist only of carbohydrates in mature leaves. Dilution-by-growth, substrate variation, and inseparability of the variables in the growth-maintenance model all complicate physiological interpretation of the slope and intercept of plots of specific respiration rates v. specific growth rates.