ABO Articles

60. Steiner, Cecil: The use of cephalometrics as an aid to planning and assessing orthodontic treatment: Report of a case (1960)

* A case report *Steiner's Norms: SNA=82 +_ 2 degrees; SNB=78 +_2 degrees *Stiener's Sticks Ideal: ANB=2 degrees, U1-NA=22 degrees, 4mm; L1-NB=25 degrees, 4mm. *For 1 degree increase in ANB, 1mm decrease in U1-NA & 0.25mm increase in L1-NB

35. Sankey, Wayne: Early treatment of vertical skeletal dysplasia: The hyperdivergent phenotype (2000)

*Skeletal hyperdivergence is difficult malocclusion to correct, particularly b/c many ortho appliances tend to increase vertical dimension *Tx options for vertical skeletal dysplasia: 1) high-pull headgear, 2) extraction tx, 3) bite block (posterior), 4) bonded palatal expander *Tx regimen in study utilized Crozat/lip bumper, bonded palatal expander, lip seal exercises and a high pull chin cup: yielded promising case outcomes.

51. Little, Robert: An evaluation of changes in mandibular anterior alignment from 10 to 20 years postretention (1988)

*Study was a continuation to analyze 10-20 yrs. Prior study was through 10 years. *All pts were 4 premolar exo cases. None received CSF. *Clinically acceptable: 3.5mm irregularity index or less. *The majority of post-tx Md crowding occurs during the 1st decade, but changes continue through the next decade (even after active growth ends) *Recommends lifetime retention (fixed or removable) *At 10 yrs, 30% of cases remained acceptable (<5mm irregularity); All cases worsened from 10-20 yrs with an avg irregularity increase of 1mm.

7. Chen, Yan: Critical factors for the success of orthodontic mini-implants: A systematic review (2009)

*Success depends on proper initial mechanical stability and loading quality/quantity *If too high torque is used while placing TADs, it can lead to necrosis and local ischemia of surrounding bone. *Maxilla has higher cumulative survival (suspicion: Mx bone is less dense=>less torque required, less overheating) *Most TADs can withstand 100-200g of horizontal and early/immediate loading *Failures occur more due to torsional stress (moments created on TAD)

28. Kim, Myung-Rip: Orthodontics and temporomandibular disorder: A meta-analysis (2002)

*TMD most common in 15-25 year olds. *No articles linked traditional orthodontic treatment to increased prevalence of TMD (apart from mild or transient signs) *No articles linked a specific orthodontic appliance to increased prevalence of TMD (apart form mild or transient signs) *One article showed extraction ortho tx increased the prevalence, or worsened existing TMD. *No clear conclusion can be drawn, but according to the literature, traditional orthodontics does not increase prevalence of TMD.

31. Santoro, Margherita: Pseudoelasticity and thermoelasticity of nickel-titanium alloys: A clinically oriented review. Part I: Temperature transitional ranges (2001)

*Temperature transitional ranges (TTR): -Martensite (low temperatures, exhibits high electrical resistivity, pliable & easily deformed, BCC) -Austenite (high temperatures, low electrical resistivity, "memorizes" a preformed shape, recovery of the ideal arch form. *Only Austenite phase retains a memorized shape. *Austenite phase lacks the superelastic plateau (ideally would want austenite phase to be set slightly above oral temperature) *Pseudoelasticity: deflections of the wire generate a local martensitic transformation and produce stress-induced martensite (SIM), not dependent on temperature. *Nitinol: stable form, no phase transformation, lacks shape memory effect *Chinese Niti: Phase transformation present, austenitic at oral temp, TTR lower than the oral temperature *Copper NiTi: ternary alloy *2 phenomena of Niti: TTR (temperature related phase transformation) & SIM (stress induced phase transformation)

43. Moss, Melvin: The functional matrix hypothesis revisited. 3. The genomic thesis. (1997)

*The Epigenetic Thesis: Proponents of the epigenetic thesis believe that morphogenesis is driven by factors external to the genome, such as changes in the extracellular matrix, changes in the functional matrices and changes in mechanical loading (ex. odontogenesis in the Chiclid fish). The functional matrix hypothesis supports the epigenetic thesis. *Moss resolves that genomic factors are intrinsic and regulate the initial creation of an organism on the microscopic level. In contrast, epigenetic factors are extrinsic processes that modify the way the DNA blueprint is ultimately expressed on higher, more macroscopic levels. Both the genomic and the epigenetic theories are valid, but insufficient as isolated entities. In combination, they provide a complete explanation of morphogenesis.

1. Greenlee, Geoffrey: Stability of treatment for anterior open-bite malocclusion: A meta- analysis (2011)

*The assumption that NSx tx of AOB is much less stable compared to Sx tx might be unfounded. No consensus for optimal tx for AOB. *Relapse of AOB attributed to: tongue posture, growth pattern, tx parameters, & surgical fragment instability *Surgical group pts: all had Mx impaction, some had Md sx too, 82% mean stability (avg age: 23.3, larger percentage of women). Typically non-growing adults or mature adolescents *Non-surgical group: 75% mean stability (avg age 16.4, majority also women). Additional vertical change could be due to growth. *Both groups produced ~4mm of OB on avg. Sx group had 0.3mm relapse, 0.6 mm in non-ex. *Alternatives: TADs, corticotomy, Md orthognathic sx *Meta-analysis had low level of evidence *Both sx and non-sx can close open bites, success appeared to be greater than 75%. *All studies were case series

45. Konik, Michael: The mechanism of Class II correction in late Herbst treatment (1997)

*The author concludes that the Herbst appliance is equally effective in treating Class II patients in both early and late treatment, but that the ideal time for Herbst treatment is just after the end of the pubertal peak growth velocity. This is because late treatment will allow for a socked in occlusion of permanent teeth at the end of treatment, which allows for a reduced retention period.

68. Ericson, Sune & Kurol, Juri: Incisor Root Resorptions Due to Ectopic Maxillary Canines Imaged by Computerized Tomography: A Comparative Study in Extracted Teeth (2000)

- CT scanning is a reliable method of revealing resorption on maxillary incisor root(s) caused by ectopical eruption of maxillary canines - Dentin loss is well described - Clinical findings and CT scans show high degree of agreement both in the depth and in the pulpal involvement

16. Riolo, Michael: A change in the certification process by the American Board of Orthodontics (2005)

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17. Riolo, Michael: ABO: Diplomate recertification (2004)

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41. Moss, Melvin: The functional matrix hypothesis revisited. 1. The role of mechanotransduction (1997)

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44. Moss, Melvin: The functional matrix hypothesis revisited. 4. The epigenetic antithesis and the resolving synthesis (1997)

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61. Tweed, Charles: Frankfort-Mandibular Plane Angle in Orthodontic Diagnosis, Classification, Treatment Planning and Prognosis (1946)

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67. Kusy, Robert: Orthodontic Biomaterials: From the Past to the Present (2002)

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78. Thilander, Birgit: Basic mechanisms in craniofacial growth (1995)

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79. Mossey: P: The Heritability of Malocclusion: Part 2. The Influence of Genetics in Malocclusion (1999)

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80. Delaire, Jean:Maxillary development revisited: relevance to the orthopaedic treatment of Class III malocclusions (1997)

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85. Kokich, Vincent: Guidelines for managing the orthodontic-restorative patient (1997)

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57. Andrews, Lawrence: The six keys to normal occlusion (1972)

1. Molar relationship: the D surface of the DB cusp of the upper 6 made contact and occluded with the M surface of the MB cusp of the lower 7 (Angle's rule is still applicable) 2. Crown angulation: The gingival portion of the long axes of all crowns was more distal than incisal portion ("Plus reading"). Note: As the anterior portion of an upper rectangular arch wire is lingual torqued, a proportional amount of M-tip of anterior crowns occurs (like converging spokes on a wheel) in a ratio of 4:1. 3. Crown Inclination (labiolingual or buccolingual): 4. Rotation: Should be free of undesireable rotations 5. Tight contacts: No spaces. 6. Occlusal plane: flat to a slight curve of spee. (A flat COS should be a treatment goal as a form of over treatment). Intercuspation of teeth is best when the plane of occlusion is relatively flat.

71. Kusy, Robert: A review of contemporary archwires: Their properties and characteristics (1997)

Applying archwires: *Leveling/aligning - Good range and light forces desired. Multi-stranded SS or NiTi are suggested. *Intermediate stages - Beta-titanium good for formability, springback, range, and modest forces. Large NiTi's also useful. *If sliding mechanics required, smaller gauge of SS recommended. *Final stages - want arch stability and small tooth movements - want high stiffness and limited range. Large gauges of Beta-titanium or SS are best.

83. McNamara J: Occlusion, orthodontic treatment, and temporomandibular disorders: A review (1995)

a. Signs and symptoms of TMD occur in healthy individuals b. S/S of TMD increase with age, particularly during adolescence c. Orthodontic Tx during adolescence does not increase or decrease odds of TMD later in life d. Ortho Tx involving extractions does not increase TMD risk e. No elevated risk for TMD involved in any specific mechanics f. Lack of gnathologic ideal occlusion does not result in TMD g. No method of TMD prevention has been demonstrated h. Simple treatments can alleviate S/S in most cases, even severe cases

29. Sarver, David: The importance of incisor positioning in the esthetic smile: The smile arc (2001)

o Posed smile evaluated based on: • Incisor and gingival display (the upper lip should stop at gingival margin of upper central incisors) • Males tend to show less mx incisors and more md incisors at rest and on smile • More incisor display = more youthful look• Transverse dimension = broadness of smile • Check for buccal corridors; they are influenced by: o Maxillary width o AP dimension relative to lip drape• Smile arc: the relationship of the curvature of the incisal edges of the maxillary incisors and canines to the curvature of the lower lip in the posed smile o Consonant = Maxillary incisal edge is parallel with the upper border of the curvature of the lower lip o Nonconsonant = maxillary incisal curvature is flatter than the curvature of the lower lip• Smile arc flattening can occur in several ways o Leveling and aligning sometimes causes loss of mx incisor curvature relative to the lower lip curvature • Thus, bracket placement is critical; brackets should be placed to extrude anteriors when smile arc is flat, and should be placed to maintain smile arc where necessary • Not every pt should get the same bracket placement; appliance placement should be case specific just like the tx plan itself and should take into account the position of the lower lip during smile and at rest in relation to the mx incisors o Overemphasizing canine guidance can cause relative intrusion of mx incisors while extruding canines • Beware of intruding mx incisors to get rid of a gummy smile; you may flatten the smile arc and create a new problem o Lower bracket placement too far gingival can cause extrusion of lower incisors and thus vertical intrusion of mx incisors to compensate o More vertical growth in the posterior mx than in the anterior mx can cause change in occlusal plane compared to lower lip curvature • Use high-pull HG to keep mx posteriors superior to incisors o Pts with brachyfacial growth patterns have flat SN, PP, and occlusal plane angles • Anterior mx often lacks CW tilt needed for ideal smile arc, and may even have CCW tilt causing even flatter smile arc o Habits such as thumb sucking can disrupt smile arc

Northway, William & Meade, John: Surgically assisted rapid maxillary expansion: A comparison of technique, response, and stability (1997)

• Authors believe that "SARPE for a true buccal crossbite in adults is the easiest and most predictable approach." Conclusion: • Maxillary expansion in adults, both orthopedically (Haas) and surgically assisted is predictable and stable, with typical amounts of expansion as follows: o Intercanine = 3.5 mm o Intermolar = 5.5 mm • Corrected crossbites are stable and remain corrected • Depth of palate is reduced during tx in both surgical groups • Palatal width increases significantly, especially with buccal corticotomies (BC group) • Palatal expansion followed by edgewise orthodontic tx results in controlled and beneficial tipping • Clinical crown lengths increased more in premolar and molar regions in this adult population who were expanded without surgery (Haas-type).

70. Le, Thuan: The Role of Computerized Video Imaging in Predicting Adult Extraction Treatment Outcomes (1998)

• Computer-generated cephalometric VTO predictions found to be accurate in simulating outcome of adult extraction treatment • Upper lip prediction is more accurate • Lower lip consistently predicted to be 1 mm anterior • Video images acceptable for use in patient education and communication as well as for treatment planning • Upper lip showed a relatively consistent 58% hard-to-soft-tissue retraction ratio • Lower lip's variable hard-to-soft-tissue retraction ratio averaged 120%

82. Wilson, W: Prevention of infective endocarditis: Guidelines from the American Heart Association (2008)

• IE prophylaxis is only recommended for the 4 groups of patients outlined in Box 3 * All dental procedures that involve manipulation of gingival tissue or the periapical region of teeth or perforation of the oral mucosa are reasonable to provide prophylaxis for IE. *Placement of removeable ortho appliances, adjustment of ortho appliances, placement of brackets, shedding of primary teeth, and bleeding from trauma to the lips or oral mucosa do not require prophylaxis. *Regimen: Amoxicillin: 2 grams 30-60 min prior to procedure; or Clindamycin (if allergic) 600 mg. Is prophylaxis require for banding, TADs?

65. Baccetti, Tiziano: An Improved Version of the Cervical Vertebral Maturation (CVM) Method for the Assessment of Mandibular Growth (2002)

* Compared to previous CVM (old method, CVMS: new method) method, the presence of a concavity at the lower border of the second cervical vertebra is not a distinctive feature of Cvs 2 when compared to Cvs 1; the two former stages (Cvs 1 and Cvs 2) merge into one single stage *The appearance of a visible concavity at the lower border of the third cervical vertebra is the anatomic characteristic that mostly accounts for the identification of the stage immediately preceding the peak in mandibular growth (former Cvs 3, actual CVMS II) • CVMS I = The peak in mandibular growth will occur not earlier than one year after this stage • CVMS II = The peak in mandibular growth will occur within one year after this stage! o Only C2 and C3 have concavities • CVMS III = The peak in md growth has occurred w/in one or two years before this stage o C2, C3, AND C4 now all have concavities! • CVMS IV = The peak in md growth has occurred not later than one year before this stage • CVMS V = The peak in md growth has occurred not later than two years before this stage • When CVMS I is diagnosed in the individual patient with mandibular deficiency, the clinician can wait at least one additional year for a radiographic re-evaluation aimed to start treatment with a functional appliance o CVMS II represents the ideal stage to begin functional jaw orthopedics, as the peak in mandibular growth will occur within one year after this observation. • The new CVM method is comprised of five maturational stages o CVMS I through CVMS V (instead of Cvs 1 through Cvs 6 in the former CVM method) o The peak in mandibular growth occurs between CVMS II and CVMS III Know how much (mm) the bone can grow per year during the growth peak ‐> 3‐6mm o Cf. before the growth peak ‐> 2‐3mm/year ‐ How many years of growth left after the growth peak for girls vs. boys? o Girls - 3 yrs (i.e. There are ~3 yrs of time window post‐growth peak for girls to continue to grow) o Boys-5yrs

56. Jacobson, A: The "Wits" appraisal of jaw disharmony (1975)

* Inconsistencies inherent to ANB angle: 1) Variations in the A/P relation of N relative to the jaws, 2) Rotation of jaws relative to cranial reference planes (CW or CCW rotation of jaws relative to SN or rotation of SN). CCW of the jaws decreases ANB angle; CW rotation increases ANB angle. *Wits appraisal: perpendicular extensions of A & B point mapped onto the occlusal plane. The occlusal plane is common to both A & B points and is unaffected by changes in cranial reference planes. *Ideal Wits: Males BO 1mm ahead of AO (range -2 to 4mm); Females: Coinciding AO & BO: 0mm (range -4.5 to 1.5).

4. Chen, Stephanie Shih-Hsuan: Systematic review of self-ligating brackets (2010)

*Advantages reduced chair time and 1.5 degrees less Md incisor proclination. *Most other claims are unsupported at this time. *Active: spring clip for rotation and torque control (i.e. In-Ovation, SPEED, Time) *Passive: (Damon, SmartClip)

21. Kokich, Vincent: Surgical and orthodontic management of impacted maxillary canines (2004)

*After the 3rd molars, the Mx canines are the most commonly impacted permanent teeth (2/3 are palatal; 1/3 labial). *4 criteria to evaluate impacted Mx canine: 1) Assess labiolingual position, 2) evaluate vertical position to tooth relative to mucogingival junction, 3) evaluate amount of gingiva in the area of impacted canine, 4) evaluate M-D position of crown. *When the canine crown is displaced mesially and lies over the root of the permanent lateral incisor, an apically positioned flap is the appropriate surgical technique. *When the canine is impacted in the center of the alveolus, closed eruption technique can be used. *Esthetic differences btw closed eruption and apically positioned flap: APF: the crown length is longer than normal due to apical migration of the gingival margin; also crowns tend to reintrude after ortho tx. *The incidence of ankylosed Mx canines is low *Kokich and Matthews recommend uncovering palatally impacted canines early prior to the start of ortho treatment (sometimes during late mixed dentition). Requires full-thickness mucoperiosteal flap and removal of all bone over the crown down to the CEJ, the flap is repositioned and a hole is made through the gingival flap. Usually takes 6-8 months for canines to erupt to level of occlusal plane.

42. Moss, Melvin: The functional matrix hypothesis revisited. 2. The role of an osseus connected cellular network (1997)

*All bone cells, except osteoclasts, are interconnected by gap junctions that form an osseus connected cellular network (CCN). *a CCN has 3 following attributes: a) Developmentally it is self-adapting, can "learn", and self-organizes, b) Operationally it is stable yet dynamic, and permits "feedback," c) Structurally it is nonmodular (permits discrete processing of different signals) *Skeletal muscle contraction is a typical periosteal functional matrix loading event. The contraction of muscles causes strain which is sensed by the osteocytes. The osteocytes are thought to be "tuned" to dynamic frequencies of muscle contraction which then allows the bone to adapt. Muscle contractions are thus a source of the energy needed to produce strain.

30. Bernhardt, Melissa: The effect of preemptive and/or postoperative ibuprofen therapy for orthodontic pain (specifically separators placement) (2001)

*All groups experienced peak pain upon rising the day following sep placement and at 24hrs after placement *Preemptive ibuprofen group had lower pain to biting and to fitting teeth together 2 hrs after, and lower pain to biting at bedtime. (only 2 time points that were statistically significant)

49. Adkins, Michael: Arch perimeter changes on rapid palatal expansion (1990)

*Arch perimeter increase = 70% of arch width increase between the 1st premolars. *RPE leads to a variable decrease in arch length *RPE causes buccal tipping of the Mx anchor teeth *RPE leads to buccal uprighting of the Md molars (more pronounced in pt's who do not display intial posterior Xbite.

11. Johnson, Dustin: Comparison of hand-traced and computerized cephalograms: Landmark identification, measurement, and superimposition accuracy (2008)

*Bjork's method of placing metal implants in the jaws of growing pts is the most accurate method of superimposition. *Melson: Superimposition on anterior cranial base (internal surface of the frontal bone and cribiform plate) are stable at 6-7 yrs. Anterior part of sella is most stable over 5 yrs. *Bjork: Stable mandibular structures: inner cortical structure of symphysis, mandibular canal, and lower contour of the molar germ. *ABO superimposition requires 3 composite tracings: 1) Craniofacial composite (registered on sella and best fit structures of ant. cranial base) assesses growth and tx changes, 2) Mx composite (registered on lingual curvature of the palate & and Mx bone) assesses Mx tooth movt, & 3) Md composite (registered on internal cortical outline of the symphysis and best fit mandibular canal) to assess Md tooth movt and mandibular growth. *No statistical difference btw digital and hand-traced ceps.

64. Murphy, Chris: A Longitudinal Study of Incremental Expansion Using a Mandibular Lip Bumper (2003)

*Lip bumper therapy has been shown to be a useful means to assist in non-extraction treatment by expanding the mandibular arch in both the transverse and A-P dimensions. *For each dimension, the largest percentage of total expansion occurred in the first 100 day segment, and the percentage progressively decreased from time segment to the next. *about 50% of the total expansion occurs in the first 100 days of treatment and that 90% of the total expansion is achieved within about the first 300 days. Any subsequent expansion thereafter is minimal. We, therefore, conclude that it is unnecessary to have the appliance in place for longer than 300 days. *Molars: active expansion; other teeth: passive expansion *No controls in study, sites prior studies

47. Bishara, Samir: Impacted maxillary canines: A review. (1992)

*Canine impactions is twice as common in females (1.17%) as in males (0.51%) *Of all Mx impacted canines, only 8% have bilateral impactions. *Md canine impaction incidence is 0.35%. *It seems that the presence of the lateral incisor root with the right length, formed at the right time, is an important variable needed to guide the mesially erupting canine in a more favorable distal and incisal direction. *Ericson & Kurol: If the deciduous canines are extracted before age 11, 91% of ectopically erupting permanent canines will normalize if distal to the midline of the lateral; 64% if canine crown is mesial to midline of lateral incisor. *Palatal impactions exceed labial impactions 2:1 or 3:1. *For labially impacted canines, 83% showed an arch length deficiency (primary etiologic factor) as opposed to on 17% of palatally impacted canines (where 85% have sufficient space for eruption). *Palatally impacted canines rarely erupt on their own w/o intervention (due to thickness of palatal cortical bone as well as dense, thick, and resistant palatal mucosa. *Palatal impactions tend to be inclined in a horizontal/oblique direction; labial impactions offer more favorable vertical angulations. *The prognosis of successful exposure and alignment is guarded. The canine may be ankylosed, undergo resoption, or become non-vital. *Retention: Consider fiberotomies to minimize rotational relapse, fixed lingual retention, "halfmoon-shaped wedge" of tissue from the lingual aspect may be removed from canine to minimize lingual drift.

3. Marshall, Steven: Self-ligating bracket claims (2010)

*Claims supported by peer-reviewed data: 1. Reduced chair time: 20 sec less per arch 2. Better control of Md angulation (1.5 degrees less) *Some data, but Insufficient peer-reviewed data: 1. Reduced tx time 2. Faster alignment 3. faster space closure 4. less friction 5. better alignment 6. better arch dimension 7. lower clinical forces 8. less pain during tx 9. more hygienic *Unsupported claims: 1. ability to "grow" bone 2. lateral expansion from AW is similar to expansion by RME 3. lateral expansion of the dental arch is stable in long term.

20. Bailey, L. 'Tanya: Stability and predictability of orthognathic surgery (2004)

*Condylar changes occur in 5-10% of pts who have sx to advance the mandible, but a long-term increase in Md length (i.e., growth at the condyles) is as likely as a decrease because of resorption, and, after open bite correction, a long-term increase in overbite is more likely than return of the open bite. *Transverse rotation of the condyles always accompanies ramus sx to advance/set back the mandible, and transverse displacement also is highly likely. *Condylar remodeling occurs after orthognathic sx. *TMD does occur in a minority of orthognathic sx pts and is thought to be related to how much the condyles have been displaced and particularly whether transverse displacement has occurred. Rigid internal fixation (RIF) has been suggested as a factor in postsurgical TMD because placement of RIF can displace the condyles.

34. Ngan, Peter: Evaluation of treatment and posttreatment changes of protraction facemask treatment using the PAR index (2000)

*Describes PAR (Peer Assessment Rating) index scoring: 5 individual traits-upper and lower segments, right and left buccal segments, overjet, overbite, and centerline. ...

15. Berger, Jeffrey: Long-term comparison of treatment outcome and stability of Class II patients treated with functional appliances versus bilateral sagittal split ramus osteotomy (2005)

*Differences btw groups: Functional appliances=> flared Md incisors; Sx group: steeper occlusal plane & more vertical relapse *Both options successfully corrected class II malocclusions with stable results *For functional group (Frankel or Herbst, removed after permanent dentition erupted), continued growth following discontinuation of appliance was a major factor of correction.

23. Schaefer, Abbie: A cephalometric comparison of treatment with the Twin-block and stainless steel crown Herbst appliances followed by fixed appliance therapy (2004)

*Differences btw two tx approaches were modest with a few exceptions: 1) more favorable change in sagittal intermaxillary relationships and greater vertical activation seen in Twin-block group. 2) Timing of Md response: skeletal changes seen almost entirely during active class II correction in Twin-block group vs. distributed almost equally between 2 phases in Herbst group.

6. O'Brien, Kevin: Early treatment for Class II Division 1 malocclusion with the Twin-block appliance: A multi-center, randomized, controlled trial (2009)

*Early orthodontic treatment with twin-block does not result in any meaningful long-term differences when compared with 1 course of treatment *Disadvantages: Increased attendance burden for patient; Cost; Length of treatment; Inferior final occlusal result. *Benefits: Interim changes in OJ reduction, small skeletal changes, improved self-esteem, 15% of pts did not need phase 2 (satisfied with occlusion) *No real difference in final result.

55. Burstone, Charles: Deep overbite correction by intrusion (1977)

*Factors to consider when determining the proper level of the occlusal plane: natural plane of occlusion (original axial inclinations and alignment of the posterior teeth), anterior esthetics (incisal display), amount of attached gingiva present in the Md incisor region, and the A-B discrepancy. Burstone believes most Class II pt's need a relatively flat occlusal plane and not more than 3mm of incisal display. *It is important not to make any individual tooth movements beyond minor adjustments during intrusion, only changes made should be to the intrusion arch. 6 Major Principles of Intrusion a) Controlling Force magnitude and constancy with low load-deflection springs • Excess force causes extrusion and tip back of posterior anchors and root resorption of incisors; use lowest force possible. • Mx incisors =25 g/ea, Md incisors =12 g/ea and canines =50 g/ea b) Anterior single point contacts • Eliminate unintended torques (labial torque may cause anchorage loss and lingual torque reduces intrusion and may extrude incisors) • Exception: place intrusion arch into bracket when intruding only 1's. c) Selection of point of force application respecting center of resistance (CoR) • Significantly protruded incisors require intrusive arches hooked to distal extensions of anterior arch segment to target incisor CoR. This tends to cause labial root movement and relatively slower intrusion. d) Selective intrusion based on anterior tooth geometry • Often incisors should be intruded to infraoccluded canines, rather than the easier movement of canine extrusion to level of occlusion. • Indiscriminate anterior leveling may make it intrusion impossible. e) Control of the reactive units by formation of a posterior anchorage unit • At minimum should include 5's and 6's. • Intrusion arch consists of a 0.018x0.022 or 0.018x0.025 wire with a 3mm helix wound 2.5x mesial to auxiliary tube • Occipital headgear can be used as auxiliary, although may overwhelm moment of intrusive arch and cause posterior forward tipping. • TPA/Lingual arch resists force toward buccal crown tip of anchors and maintain arch width. • Should be considered as a single multirooted tooth at midline, not individual teeth. f) Avoiding extrusive mechanics • Avoid Class II or Class III elastics, cervical headgear with high outer bows and lower arch reverse curve of Spee to preserve posterior. • Avoid use of continuous arch when canine crown is distal to root to avoid incisor extrusion.

39. Casko, John: Objective grading system for dental casts and panoramic radiographs (1998)

*Field tests, determined that 85% of all inadequacies resulted form 8 of the 15 categories (alignment, marginal ridges, B/L inclinations, over jet, occlusal relationships, occlusal contact, & root angulation, interproximal contacts) *A measuring instrument was developed to score casts reliably. *Alignment: Functioning areas-Mx incisal/lingual surfaces, Md incisal/labial surfaces; Mx M-D central grooves, Md buccal cusps (Mx & Md laterals and Md 2nd molars most commonly malaligned teeth) *Marginal ridges: want same level w/in 0.4mm *B/L inclination: there should be no significant difference btw the heights of the buccal and lingual cusps of the posterior teeth, this allows for maximum intercuspation and avoids balancing interferences. Lingual cusps should be w/in 1mm of buccal cusps compared to a flat surface. *Occlusal relationships: MB cusp of Mx 1st molar must align w/in 1mm of the B-groove of the Md 1st molar. *Occlusal contacts: functioning posterior cusps need to be in contact with the opposing arch→ no deductions, if the cusps is out of contact by 1mm or less → 1 point deduction; if the cusp is out of contact by more than 1mm→ 2 point deduction. *OJ: assesses the transverse relationship of the post. teeth and the A/P relationship of the ant. teeth. b. The mand incisal edges should be in contact with the lingual surfaces of the max anterior teeth *Interproximal contacts: All spaces should be closed *Root angulations: Roots should be parallel to one another and oriented perpendicular to the occlusal plane, graded on Pano. (most common mistakes found in Mx lateral incisors, canines 2nd premolars and Md 1st premolars) *Passing: loss of 30+ points is a fail, want to loose < 20 points to pass. Quality of records, appropriateness of tx plan, and objectives for positioning of the Mx, Md, Mx dentition, Md dentition, & facial profile also considered in grading.

25. Cangialosi, Thomas: The ABO's 75th anniversary: a retrospective glance at progress in the last quarter century (2004)

*Founded in 1929 in Estes Park, Colorado under guidance of Dr. Albert H. Ketcham *Ketcham Memorial Award: most prestigious ABO award. *ABO's first executive director: Dr. Earl Shepard, in Clayton, MO

18. Fransson, Anette: Influence on the masticatory system in treatment of obstructive sleep apnea and snoring with a mandibular protruding device: A 2-year follow-up (2004)

*Frequencies of signs and symptoms of masticatory system (TMJ sounds, TMJ or masticatory mms tender to palpation, muscle and joint pain, and headache) DECREASED *MPD acting as a kind of occlusal splint -> reduce signs and symptoms of TMD *In the short term (6 months), the risk for developing signs and symptoms in the masticatory system b/c of treatment with MPD could be present. But, the risk seems to be LOW in a long-term perspective. *MPD treatment has many advantages and should be considered the 1st choice of treatment on a wider set of patients if an optimal amount of MPD advancement is used. (Positive effects > possible adverse effects) *REDUCTION in OJ and OB *14% developed lateral open bites -> no influence on compliance rate, very few patients noticed an alteration in occlusions *Conclusion: The signs and symptoms from the masticatory system were reduced and the mean range of mandibular mobility increased slightly. The high compliance rate after 2 yrs of MPD use is a good indication that the therapy is well-tolerated. (Benefit > risk)

5. Weltman, Belinda: Root resorption associated with orthodontic tooth movement: A systematic review (2010)

*Heavy force application produces significantly more OIRR compared to light force application or control *Active RR usually stops after tx, but RCT may be indicated if root resorption does not stop. *Many flaws in current studies:

19. Suri, Lokesh: Delayed tooth eruption: Pathogenesis, diagnosis and treatment. A literature review (2004)

*In 1962, Gron demonstrated that tooth eruption begins when 3/4 of its final root length is established. * "Normal biologic eruption time" is defined as tooth eruption that occurs when the dental root is approximately 2/3 its final length. *Most common supernumerary tooth is mesiodens, followed by 4th molar in Mx arch. *Supernumerary teeth have been found to be responsible for DTE (in Apert syndrom, cleidocranial dysostosis, and Gardner syndrome). *Delayed development of isolated teeth has also been most commonly seen in the premolar region. Higher frequency of DTE in posterior teeth. *Permanent tooth agenesis (excluding 3rd molars) reported to range from 1.6-9.6%. Tooth agenesis in primary teeth ranges from 0.5-0.9%. *After 3rd molars, most commonly missing teeth are Md 2nd premolars followed by Mx lateral incisors.

12. Suri, Lokesh: Surgically assisted rapid palatal expansion: A literature review (2008)

*Incidence of Mx transverse deficiency (MTD) is 8-18% in mixed dentition, unknown in adults. *Dx: more difficult than AP or vertical dx. Assess Mx arch form & symmetry, shape of palatal vault, width of buccal corridors on smiling, occlusion, mode of breathing, alar base depth, soft tissue thickness, unilateral/bilateral Xbite, severe crowding, Md shift on closure. Also need to consider relative vs absolute MTD (place casts in class I). *Eval of buccolingual inclination of posterior teeth is an essential part of dx: distinguish dental vs. skeletal etiology. *Age criteria for OME vs SARPE unclear in literature. *Expansion <5mm (camouflage); >5mm (SARPE). *Two-stage vs. Singular segmental sx: Segmental is less stable. *Latency Period: want callus formation prior to activation, more stability due to rapid ossification. *Ortho considerations prior to SARPE: need enough space btw upper centrals, may need to diverge roots. Want to decompensate lower arch (post. buccolingual inclination) to accurately assess how much transverse expansion is needed (prevents postexpansion relapse).

52. Skieller, Vibeke & Bjork, Arne: Prediction of mandibular growth rotation evaluated from a longitudinal implant sample (1984)

*Intermolar angle o Increases in forward rotation of the mandible o Decreases in backward rotation of the mandible *Shape of anterior lower border of the mandible o Convex with forward rotation of the mandible (due to apposition at the anterior lower border) o Linear with backward rotation of the mandible (more apposition at the angle of the mandible) *Symphysis o Retroclined symphysis = forward growth rotation of mandible o Proclined symphysis = backward growth rotation of the mandible o Useful except in cases of extreme backward rotating cases *Three components of rotation: o Total rotation = rotation of mandibular corpus relative to anterior cranial base (increases steadily during growth) o Matrix rotation = rotation of soft-tissue matrix relative to anterior cranial base (pendulum like changes during growth) o Intramatrix rotation = rotation of mandibular corpus within its soft-tissue matrix (increases steadily during growth)

48. Sadowsky, Cyril: The risk of orthodontic treatment for producing temporomandibular mandibular disorders: A literature overview. (1992)

*Know 4 cardinal signs and symptoms of TMD (know difference between signs and symptoms) *Condylar Position and Orthodontic Treatment - NO DIFFERENCE in condylar position between exo group and untreated group. *TMJ Sounds - occur in 20-30% of general pop.; most frequent sign of TMD, however "do not usually progress to TMD;" recommend No Tx *Progression of TMD - clicking is benign, non-pathognomonic *Conclusions a. Seligman and Pullinger - extensive lit review concluded that there is a limited role of intercuspal occlusal factors in TMD b. Tallents - may not be a strong association between incisal relationships, condylar position and TMD c. Based on 14 studies of 1300 patients, either cross-sectional or longitudinal, there is no link between orthodontic treatment as a child/adolescent and TMD years later.

76. Haas, A: Long-Term Posttreatment Evaluation of Rapid Palatal Expansion (1980)

*Long term report of 10 cases tx'd by Haas • Haas' six indications for RPE tx: 1. Real and relative maxillary deficiency 2. Cases of nasal stenosis 3. All types of Class III cases: pseudo, dental, & skeletal. 4. A mature cleft palate patient 5. A/P maxillary deficiency cases: eg. Negative ANB's, negative point A to facial plane, or negative Wits. In these cases, RPE tx can loosen the maxillary sutures to facilitate with max protraction. 6. Selected arch length problems in mature good morphogenetic skeletal patterns. • Nasal cavity and apical base width changes demonstrated total stability. From the 10 cases presented, the average increase in apical base width was 9mm and nasal cavity width was 4.5mm. • If effective midpalatal suture opening is achieved, the maxilla will also be displaced downward and forward. As these unstable articulations begin to reorganize, the pull of the viscera, muscles, connective tissues, etc would cause the maxilla to move up and backward again towards its original position; thus if the maxillary displacement is desired, it needs to be retained via protraction during the suture reorganization period. Haas prefers to use a protraction chin cup for this (Fig. 4) • Haas usually does not extract premolars in an upper arch if RPE is used • Good orthopedic technique demands that most, if not all, RPE cases should have the mandibular arch completely contained by the max. arch at the conclusion of expansion (Fig. 12). The minimum expansion should be 10 mm, and the average should be 12 mm. *Haas considers the dentofacial orthopedic width dimension to be the most important (in regards to the 3 planes of space), since facial growth of the width dimension is completed the earliest and changes the least. "It is possible to ignore the skeletal A/P and vertical dimensions and still obtain a satisfactory & stable dental occlusion, albeit poor skeletal result."

40. Vig, Katherine: Nasal obstruction and facial growth: The strength of evidence for clinical assumptions (1998)

*Long-face syndrome ("Adenoidal facies"): increase in lower facial height, lip incompetency, narrow alar base, mouth breathing, narrow Mx arch with high palatal vault, and posterior x-bite with class II malocclusion *Current debate: how much nasal obstruction is clinically significant, at what age is nasal obstruction critical, how long does the nasal obstruction need to exist before a growth effect may be anticipated? *Assumed sequence of events: nasal obstruction → lip apart posture → mouth-breathing → modification of facial growth *Sensitivity: True positive *Specificity: True negative

77. Thesleff, Irma: The genetic basis of normal and abnormal craniofacial development (1998)

*MSX1 gene mutation involved in oligodontia. ...

50. Edwards, John: A long-term prospective evaluation of the circumferential supracrestal fiberotomy in alleviating orthodontic relapse (1988)

*Main fibers causing relapse after ortho: believed to be the supraalveolar fibers and principal fibers. *Statistically significantly less relapse in CSF pt's compared to controls. Relapse also tends to occur later: 9-11 yrs later (compared to controls 4-6 yrs later). *No significant alteration in epithelial attachment or gingival levels/measurements occurred 1-6 months post tx. *The efficacy of the CSF procedure appears to be less in the Md 3-3 compared to the Mx 3-3 (12-14 yrs out)

36. Baccetti, Tiziano: Treatment timing for Twin-block therapy (2000)

*Main objective of Twin Block tx: induce supplementary lengthening of the mandible by stimulating increased growth in condylar cartilage (ultimately depends on growth rate of mandible) *Puberty growth peak occurs on avg btw CVMS 3-4 (late mixed or early permanent dentition). *Appliance worn 24hrs a day. Start by posturing 4-6mm, then reactivated until edge-to-edge (or start edge-to-edge). 5-7mm of vertical opening in the region of posterior bite blocks. *Advantage of being able to control vertical development of molars and premolars *Results: Skeletal 55%, dental 45%; 4.6mm OJ correction, 4.7mm molar correction, significantly proclined lower incisors. *The optimal timing for T.B. tx is during or slightly after the onset of the pubertal peak in growth velocity, late Twin-block tx (CVMS 3-5) produces more favorable effects.

66. English, Jeryl: Does Malocclusion Affect Masticatory Performance? (2002)

*Malocclusion has little effect on ability to thrive *Median particle size and broadness of particle distribution was significantly smaller in the control group versus the three malocclusion groups, indicating that the participants with a normal occlusion were better able to break down foods than their peers with malocclusion *In order of ability to break down food: Normal occlusion > Class I malocclusion > Class II malocclusion > Class III malocclusion *Malocclusion had no effect on the number of chews required to swallow almonds and jerky 3 factors that influence masticatory performance: o Number and area of occlusal contacts o Occlusal forces as reflected by maximum bite force o The amount of lateral excursion during mastication ‐ Orthognathic surgery improves masticatory fxns in which Angle Class(es)? o Class III for sure; Class II with mixed results

32. Santoro, Margherita: Pseudoelasticity and thermoelasticity of nickel-titanium alloys: A clinically oriented review. Part II: Deactivation forces (2001)

*Martensite is the low stiffness phase; Austenite is the higher stiffness phase *At least 2mm of deflection is necessary to activate the conversion to SIM phase. * "Hysteresis" phenomenon where the linear region corresponding to the deactivation plateau is lower than the activation plateau and parallel to it. Clinical relevance: force delivered to the periodontal structures is lower than the force necessary to activate the wire. *A NiTi wire with a TTR located @ oral temp, the so-called martensitic active wires, would present both thermoelastic & pseudoelastic properties and can be considered the long-awaited NiTi alloy. *There is a decrease in SIM with increase in temperature. *RCTs failed to demonstrate a significantly better performance of superelastic wires compared with conventional alloys, such as multi-stranded stainless steel wires.

54. Bishara, Samir: Third molars: A review (1983)

*No conclusive evidence to indicate 3rd molars as the major etiologic factor in post-Tx changes in incisor alignment/crowding *Crowding of lower incisors caused by many factors (tooth size, shape, narrowing of inter-canine dimensions, retrusion of incisors, growth changes) *3:2 Female:Male ratio of congenitally missing 3rd molars *Ortho contraindications for 3rd molar exo: 1) when Md premolars are extracted or missing, 2) exo of 1st or 2nd molars is needed.

9. Felippe, Nanci: Relationship between rapid maxillary expansion and nasal cavity size and airway resistance: Short- and long-term effects (2008)

*Short term effect of RME: 1) mean increases in palatal area, volume, and intermolar distance 2) mean reduction of nasal airway resistance 3) mean increases in total nasal volume and nasal valve area. *Long term findings of RME (also factor in fixed appliances and growth): 1) relapse with palatal area and intermolar distance reduction, 2) nasal airway resistance was stable, 3) mean nasal cavity volume and minimal cross-sectional area increased, 4) 61.3% of pts reported subjective improvement in nasal respiration.

84. Bishara, Samir: Class II Malocclusions: Diagnostic and Clinical Considerations With and Without Treatment (2006)

*Order of malocclusion incidences: Class III (2.9%) < Class II, Div 2 (3.4%) < Class II, Div 1 (23.8%) < Class I malocclusions (69.9%) The magnitude of the downward and forward growth of the mandible usually exceeds that of the maxilla and as a result the bony face becomes less convex with age. A/P discrepancies between the maxilla and mandible in Class II's are often present early and are maintained unless corrected orthodontically. Bishara & coworkers observed that all cases that started with a distal step in the deciduous denttion proceeded to have a class II molar relationship in the permanent dentition; none of these cases self corrected. Mandibular growth differential alone is not enough to correct a dental malocclusion. Once the class II molar relationship is established (in deciduous, mixed, or permanent dentition) it does not self-correct. The authors argue that its not worth trying to predict the timing of the growth spurt, duration and magnitude because you can't do it accurately. Thus the clinician should rather take advantage of the significant growth that is continuously occurring in the preadolescent as well as early adolescent years. With mild to moderate dental or skeletal discrepancies, tx could be postponed until the late mixed or early permanent dentition stages With more severe discrepancies tx can be started as early as the patient is able to cooperate or tolerate wearing the appliances. If tx is initiated in the early mixed dentition, the clinician should be aware where the 2nd molars are to prevent their impaction when using extraoral/distalizing appliances. An optimal relationship is when the crowns of the 2nd permanent molars have erupted past the apical 1/3 of the roots of the 1st molars.

27. Turley, Patrick: Managing the developing Class III malocclusion with palatal expansion and facemask therapy (2002)

*Palate expander + facemask is effective cl. III tx, and while tx in early mixed may result in better orthopedic response, late mixed/early permanent treatment timing can produce positive results. *Early intervention results in increased overall tx time. *Overcorrection is recommended, especially in early tx. *Treatment to overcorrection shows good short term stability (2-3 y) *Some cases require continued facemask in phase 2 *Study looked at Mx expansion and if it helps max protraction, the results suggest that w/o other reasons for expansion, expansion does not significantly aid in Class III correction.

10. Grubb, John: Radiographic and periodontal requirements of the ABO: A modification in the case requirements for adult and periodontally involved adolescent and preadolescent patients (2008)

*Perio involvement in adults as young as 18 y.o. has been documented in 50% of subjects and most adult patients over 45 years of age. *ABO requirements for pt's over 18 y.o. AND adolescent pt's with signs of perio disease: 1) full mouth periodontal probing before and after ortho tx, or 2) pretreatment pano, vertical or conventional bite wings, and Mx & Md periapical radiographs, or 3) Full mouth x-ray series.

37. Vastardis, Heleni: The genetics of human tooth agenesis: New discoveries for understanding dental anomalies (2000)

*Permanent teeth affected more than primary teeth *Incidence of permanent tooth agenesis: 1.6-9.6% (excluding 3rd molars) *Incidence of primary teeth agenesis: 0.5-0.9%. *3rd molars most commonly missing (20%), debate if Mx laterals or Md 2nd premolars are the second most common. *Muller: lateral incisors are the most frequently missing teeth when only 1-2 teeth are absent, but Md 2nd premolars are the most frequently missing teeth when more than 2 teeth are absent. *Garn & Lewis: if a 3rd molar is absent, the molars and premolars of the same quadrant are delayed in formation and eruption. ...

38. Brennan, Matthew & Gianelly, Anthony: The use of the lingual arch in the mixed dentition to resolve incisor crowding (2000)

*Protocol: LLHA placed w/in 3 months of initial records if lower arch is intact; if one primary canine was missing, contralateral canine was extracted and midline was allowed to self correct for 3 months (then LLHA placed); if both primary canines missing, placed LLHA immediately. *Intercanine dimension: increased (1.49mm) due to labial migration into leeway space *Interpremolar width: increased (2.27mm) *Intermolar width: increased 0.72 mm which is normal even w/o LLHA *LLHA is a poor form of anchorage (both transversally and sagittally) *LLHA can provide adequate space to correct 4-5mm of crowding if leeway space can be preserved. *Should not use lower lingual arch as anchorage since you can still get forward shift of the molars and flaring of the incisors as growth occurs. Can also get transverse changes in the molars as well with LLHA in place.

63. McNamara, James: Rapid Maxillary Expansion Followed by Fixed Appliances: A Long-term Evaluation of Changes in Arch Dimensions (2003)

*RME and fixed appliances tx have to be considered an effective tx option to gain space on the dental arches in order to relieve tooth-size/arch-size discrepancies of mild-to-moderate degree. *Maxilla is ~80% normal after tx --> amt of correction for deficiency in maxillary arch perimeter was ~80%, whereas in mandible a full correction was achieved. *1mm of transpalatal width increase in premolar region --> 0.7mm increase in maxillary arch perimeter *RME led to 6mm of long‐term net gain in maxillary arch perimeter & 4.5mm in mandibular arch perimeter

8. Bartzela, Theodosia: Medication effects on the rate of orthodontic tooth movement: A systematic literature review (2009)

*Results mostly from animal studies *Eicosanoids (leukotrienes, thromboxanes, prostacyclins, and prostoglandins) will increase tooth movement *NSAIDs will decrease tooth movement * Acetaminophen has no effect on OTM. *Corticosteroids, parathyroid hormone, & thyroxin all increase OTM. *Vitamin D3 stimulates tooth movt. *Dietary calcium may reduce OTM. *Bisphosphonates strongly inhibit OTM.

2. Viglianisi, Azzurra: Effects of lingual arch used as space maintainer on mandibular arch dimension: A systematic review (2010)

*Results showed that fixed lingual appliance (FLA) is effective for controlling mesial movt of molars and prevent collapse of Md incisors in a lingual direction when used during space maintenance. *Maintaining Md arch length in the mixed dentition comes at the expense of slight Md incisor advancement and tipping. *FLA's can be used to resolve marginal crowding. *Only 2 studies fulfilled inclusion criteria. *Intro: premature loss of 51% of primary 1st molars and premature loss of 70% of primary 2nd molars effects malposition of permanent teeth.

26. Mihalik, Colin: Long-term follow-up of Class II adults treated with orthodontic camouflage: A comparison with orthognathic surgery outcomes (2003)

*Skeletal Class II causes: for Sx pt's, 2/3 were due to Md deficiency. Another cause downward-backward rotation of the mandible due to vertical Mx excess. *Selection bias: camouflage pts have less severe dx *Ideal camouflage pt: 1) reasonably good facial esthetics initially, 2) Overjet resulting more from Mx protrusion than Md retrusion, 3) normal pt self-perception.

81. Segal, G: Meta analysis of the treatment-related factors of external apical root resorption (2004)

*The maxillary incisor consistently averages more apical root resorption than any other tooth, and the maxillary incisor is also moved greater distances than any other tooth. • Recently, it was reported that variations in the IL-1b allele 1 cytokine is strongly associated with an increased risk of EARR. Patients who were homozygous for the IL-1b allele 1 had a 95% chance of having root resorption greater than 2mm. o These findings suggest that variation in outcome associated with EARR is largely beyond the practitioner's control o In contrast, despite decades of work there is no conclusive evidence that implicates a definitive treatment-related factor for EARR. • EARR is always preceded by hyalinization. • Of all the treatment-related variables, treatment duration is most often correlated with apical root loss. Still, several recent publications report no association between treatment duration and EARR • Total apical displacement is highly correlated with mean apical root resorption o There was a higher correlation between treatment duration and mean apical root resorption (r 1⁄4 0.852), but one study threw off the numbers to make this correlation

46. Steenbergen, Edsard; Nanda, Ravindra: Biomechanics of orthodontic correction of dental asymmetries (1995)

*This paper argues that the use of inter arch elastics to correct dental asymmetries is a poor design from a mechanics viewpoint and can lead to many adverse side effects. *The authors go further to provide their own suggested mechanics to common asymmetries to minimize these side effects *Typical cantilever AW is 17x25 TMA *Multiple figures presented in article to apply mechanics.

33. Wolford, Larry: Considerations for orthognathic surgery during growth, Part 1: Mandibular deformities (2001)

*Tongue reaches adult size by age 8, surgical reduction of the tongue can improve stability and predictability of surgical outcomes. *Md hypoplasia: growth rate is essentially unaltered by surgery, maintained throughout growth *Md hyperplasia: tongue size and position must be evaluated before surgery; Mx growth deficiency must be ruled out (different type and timing of tx); increase in Md growth rate almost always occurs in the condyles. Sx should be performed after the majority of Mx growth is complete (14 y.o. girls, 17 y.o. boys) ...

14. Schmidt, Andrew & Kokich, Vincent: Periodontal response to early uncovering, autonomous eruption, and orthodontic alignment of palatally impacted maxillary canines (2007)

*Treating palatally impacted Mx canines has minimal effects on periodontium *Overall consequences to impaacted canines with this technique seem better than with the closed exposure and early traction of canines. *Consequences to adjacent teeth (laterals/premolars) were similar in both closed or open exposures. *Increased root resorption of lateral and canine noted on impacted side. *Advantages of open exposure with autonomous eruption: 1) Fewer subsequent exposures, 2) Shorter treatment time, 3) Improved hygiene during treatment

13. Vargo, Julie: Treatment effects and short-term relapse of maxillomandibular expansion during the early to mid mixed dentition (2007)

*Tx: Expansion was slow - one turn per week for bonded expander (for 24-32 weeks), and quad helix and crozat were active for similar times. Appliances remained in place after expansion complete for avg. of 12 months. No retention after appliances removed. *All arch measurements increased in max and mand after tx, and all experienced 'mild to moderate' relapse at follow-up. However, relapse of mandibular intercanine width was not statistically significant (but this conflicts with previous studies). *Mand incisor irregularity decreased avg. of 3.6 mm. Mand incisor irregularity increased 0.7 mm post-tx (not statistically significant). *Expansion was greater posteriorly, and arch perimeter increase was mainly due to increase in arch width, not depth. *Less relapse was found compared to rapid maxillary expansion, but author notes that this may relate to younger age of patients rather than type of expansion.

75. Fishman, Leonard: Radiographic Evaluation of Skeletal Maturation (1982)

*Useful 1st step = determine whether the adductor sesamoid can be seen (SMI 4) o If not -> SMI associated with widening of epiphysis (SMI 1-3) o If present -> capping or fusion (SMI 5 or later)- Facial growth demonstrated a close direct association between variations in the growth rate and in skeletal maturation - Maxilla and mandible reached their maximum growth rate later than statural height, w/ the highest velocities occurring before the growth peak for both facial and statural growth - Maxilla showed more growth completed than the mandible until the final growth stage, when the mandible tended to catch up

73. Grubb, John: Clinical and scientific applications/advances in video imaging (1996)

*Video imaging: 1. Provides the most realistic representation to date of a patient's potential treatment outcome 2. Allows the patient to see the esthetic outcomes of treatment, thereby facilitating the decision of whether or not to proceed with treatment 3. Provides the most accurate way to rapidly evaluate different treatment alternatives and make the most prudent treatment decisions 4. Facilitates communication between different professional specialties and between professionals the patients to ensure expectations are addresses and met.

Huang, Greg: Occlusal adjustment for treating and preventing temporomandibular disorders (2004)

*While many clinicians find that TMD symptoms improve after occlusal adjustment, it is more likely due to reassurance or spontaneous improvement. *May still be the case that occlusal adjustment has some positive effect, but no studies demonstrating this have been strong enough to be considered significant evidence. *Author offers personal preference for the use of occlusal adjustment in ortho practice: uses minor adjustments to normalize unusual conditions, such as unequal cusp heights on PM's or thick marginal ridges on incisors that interfere with ideal occlusal relationships. Considers it in the same way as IPR for Bolton discrepancy. NOT to treat or prevent TMD

58. Bjork, A: Prediction of mandibular growth rotation (1969)

Growth Pattern of the Mandible, determined by implant studies: • Growth in length of the mandible occurs mainly at the condyles. • The anterior aspect of the chin is extremely stable. o Thickening of the symphysis takes place by apposition on its posterior and lower borders. • Resorption occurs below the angle of the mandible. • Direction of growth of condyle varies greatly, but usually occurs in forward direction. Points of superimposition for ceph images were determined: 1. Anterior border of chin 2. Inferior border of inner cortex of symphysis 3. Mandibular canal 4. Lower contour of a molar germ (before roots begin to develop) Seven signs of extreme growth rotation of mandible: Determined by structural/ implant method. The more signs present, the stronger the prediction. 1. Inclination of condylar head: limited use because of difficulty identifying on ceph. 2. Curve of mandibular canal: in vertical condylar growth, canal curve > mand contour. In sagittal growth, canal straight or less curved than mand contour. 3. Shape of lower border of mandible: Vertical growth - concavity at angle, anterior rounding with thick cortical layer at symphysis. Sagittal - convex angle, thin cortical layer at symphysis. 4. Inclination of symphysis: vertical growth - symphysis swings forward - prominent chin. Sagittal growth - symphysis swings back - receding chin. 5. Interincisal angle: (not explained well, but I think he means that extreme growth rotation is demonstrated by an interincisal angle that obviously deviates from the norm.) 6. Inter-molar and inter-premolar angles: (not really explained but I think its basically the same as 5. There is an image of an open-bite patient with extreme vertical growth - pt only occludes on one molar, so there is a large inter-premolar angle relative to the flat angle of a normal occlusal plane) 7. Lower face height: (also not really explained - I think he means overdeveloped LFH is sign of vertical growth, underdeveloped LFH is sign of sagittal growth.) • Note that inclination of the lower border of the mandible and rest facial height are not reliable signs.

74. Vermette, Michael: Uncovering labially impacted teeth: apically positioned flap and closed- eruption techniques (1995)

IV. Conclusions a. Labially impacted maxillary anterior teeth uncovered by APF have more unesthetic sequelae than CE. b. Negative esthetic effects from APF include increased width of attached gingiva, gingival scarring and intrusive relapse. c. Periodontal attachment differences vs. control were not clinically significant in either APF or CE.

69. Bowman, S & Johnston, Lysle: The Esthetic Impact of Extraction and Nonextraction Treatments on Caucasian Patients (2000)

Rickett's E‐line - tip of nose to ST pogonion (affected by the nose) ‐ "In a normal white person at maturity, the lips are contained within a line from the nose to the chin, the outlines of the lips are smooth in contour, the upper lip is slightly posterior to the lower lip when related to that line, and the mouth can be closed with no strain" ‐ Lower lip should be 2 (±3)mm posterior to the E‐line ‐ Upper lip should be 4mm posterior to the E‐line Burstone B‐line - ST subnasale to ST pogonion ‐ In normal adolesncenets, upper and lower lips fall forward of the B‐line. ‐ Upper lip 3.5mm anterior to the line ‐ Lower lip 2.2mm anterior to the line ‐ Upper lip inclination to the palatal plane 97.5° ‐ NL angle 73.8° Holdaway H‐line - Upper lip to ST pogonion ‐ In an ideal case (both upper and lower lips are on the H line), proportions of the nose to the upper lip form a harmonious S curve ‐ STpointAtotheHline=3‐7mm Steiner S1‐line - ST pogonion to the center of S‐shaped curve between tip of nose and subnasale Sushner S2‐line - ST nasion to ST pogonion

62. Solomon, Michael: Long-Term Stability of Lip Bumper Therapy Followed by Fixed Appliances (2006)

• Lip bumper tx results in significant gains in arch width, the greatest amount occurs at the premolars and least at the canines. • Generally the greatest arch width gain occurs at the premolars and least at the canines. • Majority of arch width gains occurred during active lip bumper treatment alone, with statistically insignificant changes during fixed tx. Relapse should be expected, however there significant gains were maintained during the overall treatment. • A decrease in incisor irregularity shows that lip bumper combined with fixed appliances is an effective means to relieve anterior crowding. The lip bumper tx alone accounted for 41% (1.55 mm) of irregularity reduction while the total decrease during treatment was 3.73mm. After relapse the overall irregularity decrease was 2.97mm.• Fixed cuspid-to-cuspid retention leads to greater stability of the intercanine width and irregularity but has no effect on the arch width stability of the teeth not directly involved in the retention. • The lip bumper along with fixed appliances is an effective means to obtain long-term increases in arch width and decreases in the irregularity index.

59. Bolton, Wayne: The clinical application of a tooth-size analysis, (1962)

• Over-all mean ratio: 91.3, S.D. 1.91 • Anterior mean ratio: 77.2, S.D. 1.65 • Interincisal angle: 177.0 degrees• An anterior ratio of 77.2 (w/ S.D. 1.65) should result in a normal overbite-overjet with proper canine intercuspation (if incisor angulation and labiolingual thickness is not excessive) o In general, mandibular premolars are larger than maxillary premolars, causing the overall ratio to frequently deviate from the mean (becoming smaller than the mean)

53. Cangialosi, Thomas: Skeletal morphologic features of anterior open bite (1984)

• Posterior face height is shorter and overall anterior face height is greater in open-bite subjects • Lower face height is greater in relation to upper anterior face height in persons with open bite. • The mandibular plane angle and the gonial angle are larger in persons with open bite. • The PP-GoGn angle is greater in persons with open bite, and this is due mostly to downward tipping of the mandibular plane. • The ratios and angles measured remained relatively constant with age (except for UFH/LFH ratio), which implies that the proportionality of the human face should remain constant, there is a change in size but no alteration in shape ("Gnomic Growth"). • Skeletal open bite subjects have significantly different ceph measurements compared to subjects designated as having dentoalveolar open bites (except for the SN-PP angle) • The amount of eruption of the teeth is also useful in distinguishing between skeletal or dentoalveolar open bites: o Skeletal open bite: normal eruption or over eruption o Dentoalveolar open bite: under-erupted teeth. o (This claim was thrown into the discussion section while referencing figures 1 & 2, however no actual measurements were made regarding eruption levels of teeth in the study.) • It is difficult to distinguish between skeletal and habitual/dentoalveolar open bites due to open bite malocclusions having both skeletal and dental dysplasia. • "Most investigators believe that tongue thrust cannot be considered the primary etiologic factor in the majority of open-bite cases."