New technique for creating permanent experimental alveolar clefts in a rabbit model.

Alveolar bone grafting is an adjunctive procedure that has become increasingly popular in the rehabilitation of patients with cleft lip and palate. A histologic basis of the performance of bone grafts is required to evaluate properly different grafting materials. This, however, cannot be provided by clinical studies on humans. Therefore, an animal model with a simulated alveolar cleft is needed. A number of animal models has been previously proposed by other investigators. The problems associated with each model are presented and a surgical technique for the creation of permanent alveolar clefts in rabbits is described. Clinical and histologic findings 6 weeks postoperatively confirm the establishment of a 1-cm wide defect with oronasal communication and healthy epithelial lining. This animal model can be efficiently used for the testing of various bone grafting materials.

Arch length considerations due to the curve of Spee: a mathematical model.

Arch length analysis should consider discrepancies not only within the sagittal plane but also within the vertical and transverse planes. The vertical deviation of the occlusal plane from a flat plane is known as the curve of Spee. The purpose of this study was to produce a mathematical model of the mandibular arch form in three planes of space and to determine the effect that the curve of Spee has on arch circumference. Two mandibular arch forms, the catenary and the Bonwill-Hawley, were examined. The curve of Spee was modeled as a cylinder perpendicular to the midsagittal plane centered on the arch anteroposteriorly. A mathematical distance formula was used to calculate arch circumferences from the central fossa of the first molars for 10 arches with curves of Spee ranging from 0 to 10 mm. This procedure was repeated for arch circumferences extending from the central fossa of the second molars. Plots for the difference in arch circumferences verses depth of the curve of Spee showed that the relationship between these two variables is not linear and is less than one to one. This model showed that clinical practice of allowing 1 mm of arch circumference for leveling each millimeter of curve of Spee overestimates the amount of arch circumference needed to flatten the curve of Spee.

A comparison of the effects of first premolar extractions on third molar angulation.

The effect of third molars on the stability of orthodontic treatment has been studied extensively. Yet the effect of orthodontic treatment, particularly premolar extractions, on third molars has not been substantially studied. The purpose of this investigation was to compare the changes in third molar angulation in patients treated with and without extractions. Records of 45 Class I, nonextraction and 33 Class I, first premolar extraction patients were examined. The pretreatment and posttreatment pantographs were digitized, and the angles between the third molar long axes and the occlusal plane were measured. Changes in third molar angulation from pretreatment to posttreatment for the two groups were compared for statistical differences using a Student's t-test. Statistical analysis revealed there were no significant differences in the change in third molar angulation in either group. On average, the maxillary and mandibular third molars showed an improvement in angulation relative to the occlusal plane. The results suggest that factors other than first premolar extractions may influence third molar angulation.

Increase in arch perimeter due to orthodontic expansion.

A mathematical model was developed to compare quantitatively the effects of various types of orthodontic expansion on mandibular arch perimeter. Mandibular arch form was modeled with spline interpolation to fit a smooth curve between assigned molar, canine, and incisor positions. Starting with average arch dimensions, intermolar width, intercanine width, and midline arch length were increased individually and in combination in millimeter increments up to 5 mm, and the consequent changes in arch perimeter were measured. Increasing midline arch length by incisor advancement was nearly four times as effective in increasing arch perimeter as was molar expansion; canine expansion had an intermediate effect. Arch perimeter increments increased slightly with successive amounts of expansion for the molar, canine, and incisor. Combinations of molar-canine and canine-incisor expansion yielded results comparable to the total effects achieved by expansion of those teeth individually. Combined molar-canine expansion created increases in arch perimeter that were only slightly less than those generated by incisor advancement alone.

Tooth diameters and arch perimeters in a black and a white population.

This study was undertaken to test the hypothesis that a sample of black patients will have larger mesiodistal tooth diameters and larger dental arch perimeters than a corresponding sample of white patients. In this study, the black sample's mean canine, first and second premolar, and first molar mesiodistal diameters were significantly larger than those of the white sample. The dental arches of the black patients were significantly wider and deeper but did not show significantly more crowding. Gender and race differences did exist, but gender differences were controlled by sampling procedures. The black sample also had a larger mean MP-SN angle but this was not accompanied by the increased crowding and the narrower dental arches that had been reported associated with high-angle white samples.

Development of supernumerary premolars in an orthodontic population.

Seven cases exhibiting supernumerary premolar development were detected during a 2-year period during the routine care of approximately 1,100 orthodontic patients. This 0.64% prevalence is more than twice as high as has been previously reported and represents an occurrence rate of 1 per 157 patients. This report describes the summary data for the cases detected and briefly reviews the available literature.

Frictional resistance of ceramic and stainless steel orthodontic brackets.

Frictional resistance of orthodontic appliances is recognized by most clinicians to be detrimental to tooth movement. The purpose of this study was to compare planar, static frictional forces among stainless steel and ceramic brackets. Both nitinol and stainless steel rectangular arch wires were passed freely through the slots of a pair of brackets from each type. Tests were carried out in air and in artificial saliva. A 300-gm load was suspended from the arch wire to simulate the normal force, and an incremental horizontal force was applied until movement of the arch wire was initiated. Under all conditions, the stainless steel brackets had lower coefficients of friction than the ceramic brackets. The stainless steel wire generated less friction than nitinol, and friction increased in the presence of artificial saliva in comparison with air alone. These results show that, under experimental conditions, ceramic brackets, nitinol arch wires, and saliva all increase static frictional resistance.

Influence of vertical growth pattern on faciolingual inclinations and treatment mechanics.

Control of faciolingual tooth inclinations is obtained by using rectangular wire with third-order bends and standard edgewise brackets or by using a straight wire in a preadjusted appliance system. Ideal faciolingual inclinations have been determined previously by measuring facial surface contours relative to coronal long axes. This study evaluates faciolingual inclinations based on occlusal table inclinations relative to occlusal planes. The samples compared include untreated ideal occlusions and malocclusions in three different vertical skeletal growth patterns. Faciolingual inclinations of first molars and central incisors were measured relative to the occlusal plane and to selected cephalometric angular measurements. Statistical comparisons between groups revealed significant differences in the inclinations of the upper incisor relative to the occlusal plane (U1-OP) and the inclination of the occlusal plane relative to sella nasion (OP-SN). No statistically significant intergroup differences were found in the inclination of the lower incisor relative to the occlusal plane (L1-OP) or in the faciolingual inclinations of the maxillary and mandibular first molars. On the basis of the large intergroup differences in the mean angle between the occlusal plane and sella nasion (OP-SN), the use of straight-wire appliance therapy is discussed in terms of the potential for creating differential moments. Because differential moments may facilitate or hinder treatment goals, the practitioner must know the biomechanical sequelae resulting from occlusal plane-sella nasion variations, which differ from normative values when preadjusted brackets are used.

The morphology of canines in relation to preadjusted appliances.

The canine occupies the transition from anterior to posterior occlusion. Following orthodontic treatment the canine's incisal edge occlusion demonstrates the tip and torque present in the appliance that was used. The effective torque of the bracket, however, is influenced by the tooth morphology at the bracket's base. The morphology of the facial surface can be described by an angle formed between the tangent at the point of bracket placement and the long axis of the crown. In this study, tangent angles at four millimeters and five millimeters from the cusp tip of 100 maxillary and 70 mandibular canines were determined. There was a significant difference between tangent angles at the same location on different canine teeth and also at different locations on the same canine tooth. Proximal collum angles were also measured in this study and there was a significant negative proximal collum angle in maxillary canines and a significant positive proximal collum angle in mandibular canines. The presence of these normal biologic variables will either enhance or minimize the torque supplied by preadjusted appliances, depending on a combination of prescription used and biologic variable present.

Three biologic variables modifying faciolingual tooth angulation by straight-wire appliances.

The facial surface contours of 600 maxillary and mandibular teeth, including 50 of each type of tooth from central incisors to first molars, were measured. Facial contours present at the same location, facial contours from occlusal/incisal to gingival surfaces and the angle formed by the coronal and radicular long axes varied among teeth of the same type. The magnitude of the variation found was so great as to suggest that differences between patients or differences in height of bracket placement are greater than the differences between the standard torque prescriptions now used in orthodontics. No single point, including the coronal midpoint (LA point), was found to be constant among teeth of the same type. Variation in facial surface contour tended to be greater in the posterior teeth than in the anterior teeth. Future custom construction of brackets, adjusted to individual facial contour differences, will also require information regarding optimal tooth position in the head, including compensations necessary for variations in facial skeletal pattern.

The effects of forceps delivery on facial growth.

Postnatal growth of the face is a composite function of genetic and environmental factors. A sudden traumatic insult due to the use of forceps at birth could have long-term effects which could detrimentally influence growth and development. This study examines the development of the skeletal and dental components of forceps vs. non-forceps-delivered patients. The association between delivery methods as related to TMJ problems, bruxism, posterior crossbites, and molar arch width differences was evaluated in 16 forceps-delivered and 29 naturally delivered patients. Results showed no statistically significant difference between delivery method and TMJ problems, posterior crossbites, bruxism, or molar arch width. It was noted that the non-forceps group had a higher incidence of posterior crossbite and narrower molar arch width. The forceps-delivered group had a higher percentage of bruxism and TMJ pain and/or noise. It was also noted that the small sample size may have influenced the statistical relationships.

3-Phenyl-5-[2,2,2-trifluoro-1-hydroxy-1-(trifluoromethyl)ethyl]indole-2-carbonitrile, a potent inhibitor of prostaglandin synthetase and of platelet aggregation.

A number of indoles containing the 2,2,2-trifluoro-1-hydroxy-1-(trifluoromethyl)ethyl side chain have been prepared by standard methods. Alternate, novel syntheses of indole-2-carboxamides and indole-2-carbonitriles have been developed. The title compound, 7e, was found to be a potent inhibitor of bovine prostaglandin synthetase in vitro and to lower serum prostaglandin levels after oral or intraperitoneal administration to rats. Consistent with prostaglandin synthetase inhibition, 7e prevented arachidonic acid induced diarrhea in mice and also collagen, ADP, or epinephrine induced platelet aggregation in human platelet-rich plasma. In contrast to many prostaglandin synthetase and platelet-aggregation inhibitors, 7e had neither ulcerogenicity nor systemic antiinflammatory activity in rats.