Lay attitudes to dental appearance and need for orthodontic treatment.

In provision of advice about aesthetic treatment need, visual stimuli as a tool in communication may have some advantages compared with verbal descriptions, in particular when children are addressed. The Aesthetic Component (AC) of the Index of Orthodontic Treatment Need is an illustrated scale for rating of dental attractiveness developed in the UK and based on lay adults' ratings of dental photographs. This scale has also been recommended for use in patient education. The purpose of the present study was to establish a sociocultural standard of reference for Norway related to the AC, in order to examine the applicability of the scale as a tool in patient information. Samples of 137 children, 126 of their parents and 98 young adults were shown the 10 photographs comprising the AC. The subjects were asked to assess the photographs for dental attractiveness and orthodontic treatment need on a four-category rating scale. The findings indicated that, in general, photographs with an increasing scale point were rated as increasingly more unattractive. The majority (80-100 per cent) of the parents and young adults rated the five photographs on the unattractive end of the scale to be in need of treatment. The children were significantly less critical in their aesthetic judgements. Photographs representing borderline need, identified for these groups to be scale points 5 and 6, have a potential in guiding patients and parents in making informed decisions about aesthetic treatment need.

Instant assessment of pulpal blood flow after orthodontic force application.

The purpose of the present investigation was to measure the effect of tooth intrusion and extrusion on pulpal blood flow in man. The flow changes were measured in 10 lateral incisors (6 subjects) by means of laser Doppler flowmetry (Perimed, Sweden) applied on the buccal surface through metal tubes bonded to the teeth. Brackets were bonded onto teeth 13 and 23, and intrusive and extrusive forces of 2 N were applied in random order to the experimental tooth for 5 min before unloading. The contralateral tooth served as a control. Extrusion of the teeth gave no significant changes in pulpal blood flow during loading or unloading. However, intrusion of the teeth reduced the pulpal blood flow by 20% during the first minute after force application. The pulpal blood flow gradually increased towards the preloading flow values for the next 4 min, and was returned to the prestimulus level 3 min after unloading. In conclusion orthodontic intrusion of teeth with a 2 N force evoked a temporary reduction in the pulpal blood flow, whereas extrusion had no effect on the pulpal blood flow.

[The practical aspects of using "superelastic" arch wires in the edgewise technic]. / Praktische Aspekte der Verwendung von "superelastischen" Drahtbögen in der Edgewisetechnik.

Ever increasing refinements in orthodontic treatment and the corresponding increase in technical demands are challenges to both the dentist in his/her practice and to the manufacturers of orthodontic materials. One interesting development has been the introduction of "super-elastic" arch wires, which have now been on the market for some years. Such arch wires are characterized by an excellent "shape memory", various levels of super-elasticity, a remarkable hysteresis, and temperature sensitivity. On the basis of findings from temperature controlled tests of arch wires in a "Lloyd 1000 R" testing machine, the following conclusions can be drawn. Shape memory can, from a clinical point of view, be regarded as being a positive feature. "Super-elasticity" is of lesser value, because conventional activation of edgewise arches rarely reaches the level of deformation necessary for super-elasticity to be called into play. Hysteresis and temperature sensitivity make a biomechanical control of the arch wires difficult. Reducing active forces by chilling the archwire brings relief to sore teeth. Whether this possibly leads to an improvement in blood circulation in the periodontal tissue, which would be biologically advantageous, should be made the subject of further research.

[Maxillofacial functions and dysfunctions. 1. Their clinical significance in orthodontics]. / Kiefer-Gesichts-Funktionen und -Dysfunktionen. Teil 1: Klinische Bedeutung in der Kieferorthopädie.

Predicting the course of treatment for the individual case on the basis of traditional, morphological diagnostic records only, is at best uncertain. Current literature and clinical observations indicate that genetics and the individual's potential of adapting oro-facial functions to morphological changes play a crucial role. The problem of predictability obviously is multifactorial, and should be studied accordingly. In part 1 of this study, based on conventional documentation of two treated cases, the inadequacy of traditional diagnostic documentation limited to morphology and the subsequent uncertainty of predictions based thereon are demonstrated and discussed.

Pulpal response to orthodontic tooth movement in adolescents: a radiographic study.

The purpose of this study was to examine the effect of routine orthodontic treatment on the pulp and periodontal ligament. In a group of adolescent patients who were treated consecutively, radiographs were taken before orthodontic intervention, at the end of retention, and approximately 5 years out of retention. These were compared with radiographs taken at comparable time intervals of a group of patients who had not received orthodontic treatment. Damage to the pulp and the periodontal ligament similar to that seen after traumatic injury was observed only occasionally. A narrowing of the pulp canal was observed from before to after appliance therapy and during the follow-up period in the experimental group. A narrowing of the pulp canal was also seen in the untreated group. Thus this narrowing was interpreted as a normal aging process.

Patient characteristics and treatment variables associated with apical root resorption during orthodontic treatment.

Multivariate analysis of patient characteristics and clinical variables was carried out with the maximum single maxillary incisor apical root resorption for each patient as the dependent variable. Root lengths were measured in standardized intraoral radiographs from 485 consecutively treated patients, 11.5 to 25 years of age. The correlation matrix revealed a complex pattern of positive and negative associations between the six pretreatment and seven treatment variables. Variables found to contribute significantly to apical root resorption were overjet, history of trauma to maxillary incisors before initiation of treatment, time of treatment with rectangular arch wires, time of treatment with Class II elastics, lip/tongue dysfunction, and/or history of finger-sucking habits persisting beyond the age of 7 years, and impacted maxillary canines to be corrected orthodontically. Clinical application of an open activator was significantly correlated with overjet but negatively correlated with apical root resorption, with the use of rectangular arch wires and/or Class II elastics, and with total banding time.

The role of the general practitioner and the orthodontist in the provision of orthodontic care.

Orthodontics is a small branch of dentistry but one of the oldest and most widespread of dental specialties. It is characterized by long-term treatment objectives which are related to dentofacial morphology and function, growth, facial balance and maturation. Owing to the lack of baseline data it has not been included in the recommendations of the FDI for a stepwise procedure towards 'Health for All by the Year 2000'. Serious efforts should be made to allow inclusion of orthodontics by overcoming this data problem. It is strongly recommended that an internationally acceptable index for orthodontic purposes at the community level be developed. Problems of integration of orthodontic services within oral health care programmes are most significant at medium resource levels when priorities have to be established among many highly desirable dental services. In upper resource levels with less caries and periodontal disease than before the general practitioner should be aware of the rapidly increasing needs for service among elderly people due to improved oral health in adults. For the sake of efficiency, control and quality orthodontic treatment should preferably be carried out by appropriately educated orthodontists, even if the case appears simple in the beginning. Simple cases treated by specialists consume fewer resources than are needed for a system of effective communication and delegation to the general practitioner. Continuing education of all practitioners and other members of the dental team should be carried out in personnel categories and across the boundaries between them.