The Angle Orthodontist (ANGLE ORTHOD )

Publisher: Angle Orthodontists Research and Education Foundation; Edward H. Angle Society of Orthodontists

Description

The official publication of the Edward H. Angle Society of Orthodontists published bimonthly in February, April, June, August, October and December by the EH Angle Education and Research Foundation.

  • Impact factor
    1.18
  • 5-year impact
    1.43
  • Cited half-life
    9.00
  • Immediacy index
    0.14
  • Eigenfactor
    0.01
  • Article influence
    0.51
  • Website
    Angle Orthodontist, The website
  • Other titles
    Angle orthodontist (Online), The Angle orthodontist
  • ISSN
    1945-7103
  • OCLC
    60639114
  • Material type
    Document, Periodical, Internet resource
  • Document type
    Internet Resource, Computer File, Journal / Magazine / Newspaper

Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective: To investigate the body of evidence in the literature about the most favorable time for initiating orthodontic treatment in patients with severe crowding caused by tooth size arch length deficiency (TSALD). Materials and Methods: Electronic databases (PubMed, Ovid Medline, Scopus, Virtual Health Library, and The Cochrane Library) were searched for articles published between 1900 and April 2014. Studies were included that evaluated treatment of patients with severe crowding caused TSALD, who were treated with first premolar extraction. The association between the stage of development of occlusion at which treatment was started, and the primary and/or secondary outcomes of early and late treatment were investigated. Results: After application of the eligibility criteria and reading of the full texts, six articles were included in the final review. Of these six articles, all of which were retrospective, four showed that the primary outcome (correction of severe crowding) of the early and late groups was improved, but without statistically significant differences after treatment. Therefore, the findings of secondary outcomes in the literature (postretention crowding relapse, duration of total and active treatment [treatment with appliances], external apical root resorption, and soft tissue profile) were the target of this study. These studies presented low or moderate methodological quality and control of bias. Conclusions: Both early and late extraction had a similar effect on correction of crowding. Early treatment had two favorable secondary outcomes (less relapse and reduced active treatment time) vs late treatment. However, the levels of evidence were not sufficient to assert which protocol was superior.
    The Angle Orthodontist 09/2014;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective: To investigate changes in maxillary alveolar bone thickness after maxillary incisor proclination and extrusion during anterior crossbite correction in a group of growing patients with Class III malocclusion. Materials and Methods: Maxillary incisors of 15 growing patients with anterior crossbite were proclined and extruded with 0.016″ beta-titanium advancing loops and Class III elastics. Lateral cephalograms were recorded before advancement (T0) and 4 months after a normal overjet and overbite were achieved (T1). Changes in alveolar bone thickness surrounding the maxillary incisors at the crestal (S1), midroot (S2), and apical (S3) levels were measured using cone-beam computed tomography (CBCT). Paired t-tests were used to determine the significance of the changes. A Spearman rank correlation analysis was performed to explore the relationship between thickness changes and the rate and amount of incisor movements. Results: Although statistically significant decreases were observed in palatal and total bone thickness at the S2 and S3 level (P < .05), the amounts of these changes were clinically insignificant, ranging from 0.34 to 0.59 mm. Changes in labial bone thickness at all levels were not significant. Changes in palatal bone thickness at S3 were negatively correlated with changes in incisor inclination. (r = -0.71; P < .05). Conclusion: In a group of growing patients with Class III malocclusion undergoing anterior crossbite correction, controlled tipping mechanics accompanied by extrusive force may produce successful tooth movement with minimal iatrogenic detriment to the alveolar bone.
    The Angle Orthodontist 09/2014;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective: To assess lateral differences between ossification events and stages of bone development in the hands and wrists utilizing Fishman's skeletal maturation indicators (SMIs). Materials and Methods: The skeletal ages of 125 subjects, aged 8 to 20 years, were determined with left and right hand-wrist radiographs using Fishman's SMI assessment. Each subject was also given the Edinburgh Handedness Questionnaire to assess handedness. The skeletal ages of both hand-wrist radiographs were analyzed against each other, handedness, chronologic age, and gender. Results: There were no significant differences overall in right and left SMI scores (P = .70); 79% of all patients showed no difference in right and left SMI scores, regardless of handedness, gender, or age. However, when patients were categorized based on clinical levels of SMI score for the right hand-wrist, there was a significant difference (P = .01) between the SMI 1-3 group and the SMI 11 group. Subjects in the SMI 1-3 group were more likely to show a left > right SMI score, while subjects in the SMI 11 group were likely to show a right > left SMI score. Conclusion: Although no significant overall lateral differences in SMI scores were noted, it may be advisable to obtain a left hand-wrist radiograph and/or additional diagnostic information to estimate completion of growth in young surgical patients.
    The Angle Orthodontist 09/2014;
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    ABSTRACT: Objective: To compare metal ion release from samples welded with silver soldering and laser welding when immersed into mouthwashes with different ingredients. Materials and Methods: A total of 72 samples were prepared: 36 laser welded and 36 silver soldered. Four samples were chosen from each subgroup to study the morphologic changes on their surfaces via scanning electron microscopy (SEM). Each group was further divided into four groups where the samples were submerged into mouthwash containing sodium fluoride (NaF), mouthwash containing sodium fluoride + alcohol (NaF + alcohol), mouthwash containing chlorhexidine (CHX), or artificial saliva (AS) for 24 hours and removed thereafter. Subsequently, the metal ion release from the samples was measured with inductively coupled plasma mass spectrometry (ICP-MS). The metal ion release among the solutions and the welding methods were compared. The Kruskal-Wallis and analysis of variance (ANOVA) tests were used for the group comparisons, and post hoc Dunn multiple comparison test was utilized for the two group comparisons. Results: The level of metal ion release from samples of silver soldering was higher than from samples of laser welding. Furthermore, greater amounts of nickel, chrome, and iron were released from silver soldering. With regard to the mouthwash solutions, the lowest amounts of metal ions were released in CHX, and the highest amounts of metal ions were released in NaF + alcohol. SEM images were in accord with these findings. Conclusions: The laser welding should be preferred over silver soldering. CHX can be recommended for patients who have welded appliances for orthodontic reasons.
    The Angle Orthodontist 09/2014;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective: To evaluate and compare skeletal effects and the amount of molar distalization in maxilla using modified palatal anchorage plate (MPAP) vs headgear appliances in adolescent patients. Materials and Methods: Pre- and posttreatment lateral cephalograms of 45 Class II malocclusion patients were analyzed; 24 were treated with MPAP appliances (age, 12.4 years) and 21 with headgear (age, 12.1 years). Fixed orthodontic treatment started with the distalization process in both groups. Thirty-two variables were measured and compared between both groups using multivariate analysis of covariates. Results: There was no significant main effect of the appliance type on the treatment results (P = .063). Also, there was no significant main effect of the appliance type on both pre- and posttreatment comparisons (P = .0198 and .135, respectively). The MPAP and headgear groups showed significant distalization of maxillary first molars (3.06 ± 0.54 mm and 1.8 ± 0.58 mm, respectively; P < .001). Sagittal skeletal maxillomandibular differences were improved after treatment (P < .001), with no significant differences between the two groups. No significant difference in treatment duration was found between the groups. Conclusions: The MPAP showed a significant skeletal effect on the maxilla. Both MPAP and headgear resulted in distalization of maxillary first molars. Therefore, it is recommended that clinicians consider the application of MPAP, especially in noncompliant Class II patients.
    The Angle Orthodontist 09/2014;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Abstract Objective: To assess skeletal and dentoalveolar effects of fixed functional appliances, alone or in combination with multibracket appliances (comprehensive treatment), on Class II malocclusion in pubertal and postpubertal patients. Materials and Methods: Literature survey was conducted using the Medline, SCOPUS, LILACS, and SciELO databases and The Cochrane Library, and through a manual search. The studies retrieved had to have a matched untreated control group. No restrictions were set regarding the type of fixed appliance, treatment length, or to the cephalometric analysis used. Data extraction was mostly predefined at the protocol stage by two authors. Supplementary mandibular elongation was used for the meta-analysis. Results: Twelve articles qualified for the final analysis of which eight articles were on pubertal patients and four were on postpubertal patients. Overall supplementary total mandibular elongations as mean (95% confidence interval) were 1.95 mm (1.47 to 2.44) and 2.22 mm (1.63 to 2.82) among pubertal patients and -1.73 mm (-2.60 to -0.86) and 0.44 mm (-0.78 to 1.66) among postpubertal patients, for the functional and comprehensive treatments, respectively. For pubertal subjects, maxillary growth restraint was also reported. Nevertheless, skeletal effects alone would not account for the whole Class II correction even in pubertal subjects with dentoalveolar effects always present. Conclusions: Fixed functional treatment is effective in treating Class II malocclusion with skeletal effects when performed during the pubertal growth phase, very few data are available on postpubertal patients.
    The Angle Orthodontist 09/2014;
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    ABSTRACT: Objective: To investigate the effects of growth hormone (GH) on local receptor activator of nuclear factor-kappa ligand (RANKL), OPG, and IGF-I expression during orthodontically induced inflammatory root resorption in rats. Materials and Methods: Forty Wistar rats (gender: male; age: 7 weeks) were randomly divided into control and experimental groups. A force of 50 g was applied to move the right upper first molars mesially. The experimental and control groups received daily subcutaneous injections of recombinant human growth hormone (GH; 2 mg/kg) and equivalent volumes of saline, respectively. The rats were sacrificed on days 1, 3, 7, and 14. Micro-computed tomography-reconstructed images of the upper right first molars were used to survey root resorption and tooth movement. Horizontal sections of the maxillae were prepared for hematoxylin and eosin, tartrate-resistant acid phosphatase, and immunohistochemical staining. Results: Resorption lacunae appeared on the compressed side of the distal buccal root of the right first molar on days 7 and 14. Compared with the control groups, GH-treated groups showed more RANKL-positive cells and osteoclasts on day 3 and more OPG- and IGF-I-positive cells and fewer odontoclasts on days 7 and 14. Indexes of root resorption were lower and tooth movement was faster in the GH-treated groups than in the control groups on days 7 and 14. Conclusions: The inhibitory effect of GH on root resorption by heavy force might be mediated by RANKL/OPG and IGF-I. Short-term GH administration may be a method with which to reduce root resorption and shorten treatment time, especially in patients who are susceptible to root resorption.
    The Angle Orthodontist 09/2014;
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    ABSTRACT: Abstract Objectives: To evaluate the short- and long-term effects of the mandibular anterior repositioning appliance (MARA) on mandibular dimensions in patients with Class II malocclusion and to assess the stability of the MARA results. Materials and Methods: Multiple electronic databases were searched for articles published in any language until March 2014. A manual search was also performed of reference lists of retrieved articles. The primary outcomes were the short-and long-term effects of the MARA appliance on mandible dimensions. The secondary outcome was postretention stability. Outcome measures were total mandibular unit length, corpus length, and ramus height. Two reviewers examined all articles independently and assessed their methodologic quality. Meta-analyses were conducted using random-effects models. The Cochrane test and the I(2) statistic were used to assess heterogeneity. Sensitivity analyses were performed and publication bias was evaluated. Results: Seven retrospective clinical controlled studies that compared MARA with controls were included. Three of the studies were medium quality; the rest were low quality. Meta-analysis of the short-term effects revealed a significant increase in total mandibular unit length (1.16 mm/y) and ramus height (1.58 mm/y) with MARA and a nonsignificant increase in corpus length (0.21 mm/y). Analyses of the long-term effects showed a statistically significant advantage of MARA over controls for all three variables, but the effect sizes were small. More high-quality studies are warranted. Conclusions: The MARA appliance produced statistically significant mandibular growth enhancement in the short- and long-term. These findings, however, may not be clinically significant.
    The Angle Orthodontist 09/2014;
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    ABSTRACT: Abstract Objective: To describe, using a three-dimensional finite element (FE) model, the initial force system generated during bodily movement of upper canines with plastic aligners with and without composite attachments. Materials and Methods: A CAD model of an upper right canine, its alveolar bone and periodontal ligament, thermoformed plastic aligner, and two light-cured composite attachments were constructed. A FE model was used to analyze the effects of imposing a distal movement condition of 0.15 mm on the aligner (simulating the mechanics used to produce a distal bodily movement) with and without composite attachments. Results: In terms of tension and compression stress distribution, without composite attachments a compression area in the cervical third of the distal root surface and a tension area in the apical third of the mesial surface were observed. With composite attachments, uniform compression areas in the distal root surface and uniform tension area in the mesial root surface were observed. Compression areas in the active surfaces of the composite attachments were also observed. In terms of movement patterns, an uncontrolled distal inclination, with rotation axis between the middle and cervical root thirds, was observed without composite attachment. Distal bodily movement (translation) was observed with composite attachment. Conclusions: In a three-dimensional FE analysis of a plastic aligner system biomechanically supplementary composite attachments generate the force system required to produce bodily tooth movement; the absence of biomechanically supplementary composite attachments favors the undesired inclination of the tooth during the translation movements.
    The Angle Orthodontist 09/2014;
  • The Angle Orthodontist 09/2014; 84(5):935.
  • The Angle Orthodontist 09/2014; 84(5):933.
  • The Angle Orthodontist 09/2014; 84(5):934.
  • The Angle Orthodontist 09/2014; 84(5):931-2.
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    ABSTRACT: Objective: To examine differences in the shear bond strength of orthodontic brackets on differently mineralized enamel surfaces after applying a caries infiltrant or conventional adhesive. Materials and Methods: A total of 320 bovine incisors were assigned to eight pretreated groups, and the shear force required for debonding was recorded. Residual adhesive was evaluated by light microscopy using the adhesive remnant index. Statistical analysis included Kolmogorov-Smirnov, analysis of variance (ANOVA), and Scheffé tests. Results: The highest bond strength (18.8 ± 4.4 MPa) was obtained after use of the caries infiltrant. More residual adhesive and fewer enamel defects were observed on infiltrated enamel surfaces. Brackets on demineralized enamel produced multiple enamel defects. Conclusions: Acceptable bond strengths were obtained with all material combinations. A caries-infiltrant applied before bracket fixation has a protective effect, especially on demineralized enamel.
    The Angle Orthodontist 08/2014;
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    ABSTRACT: Abstract Objective: To assess orthodontic treatment outcome at debonding and at 3 and 5 years after orthodontic treatment and to investigate the influence of different retention protocols on anterior tooth alignment. Materials and Methods: Using the Peer Assessment Rating (PAR) Index, 169 patients (74 boys, 95 girls) were analyzed at four stages: pretreatment (T0), posttreatment (T1), 3 years posttreatment (T3), and 5 years posttreatment (T5). The PAR anterior component scores (ACSs) were compared between groups with different retention protocols. In the maxilla, protocols were removable retainer until T3 (MAX1), removable and fixed retainer until T3 (MAX2), and removable retainer until T3 and fixed retainer until T5 (MAX3). In the mandible, protocols were no retainer (MAND1), fixed 3-3 retainer until T3 (MAND2), and fixed 3-3 retainer until T5 (MAND3). Results: Mean weighted improvement in PAR score was 88.3% at T1, 86.4% at T3, and 82.1% at T5. The ACS for the maxilla showed no significant differences between the retention protocols at any time point. In the mandible, the group without retention showed a gradual but not significant deterioration in ACS throughout the posttreatment period. At T5 there was a significant difference in ACS between the group that had the retainer removed at T3 and the group that kept the retainer. Conclusion: The 5-year treatment outcome, as measured by the PAR Index, was good. Stability of the maxillary anterior alignment 5 years posttreatment did not appear to be influenced by choice of retention protocol. Mandibular anterior alignment was significantly better for the group using a fixed retainer compared with the group where the retainer was removed 3 years posttreatment.
    The Angle Orthodontist 08/2014;
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    ABSTRACT: Abstract Objective: To assess camouflage effects by concealment of postorthodontic white-spot lesions (WSLs) to sound adjacent enamel (SAE) achieved over 12 months with resin infiltration (Icon, DMG, Hamburg, Germany). Methods: Twenty subjects (trial teeth nteeth = 111) who had received resin infiltration treatment of noncavitated postorthodontic WSLs were contacted for a 1-year follow-up assessment of CIE-L*a*b* colors (T12). Color and lightness (CIE-L*a*b*) data for WSLs and SAE were compared to baseline data assessed before infiltration (T0) and those assessed after 6 months (T6), using a spectrophotometer. The target parameter was the difference between the summarized color and lightness values (ΔEWSL/SAE). Intergroup (WSL, SAE) and intertime comparisons (T0 vs T6, T12) were performed using paired t-tests at a significance level of α = 5%. Results: Nine subjects (trial teeth nteeth = 49; male/female ratio 5/4; age range 13-19 years) were available at T12. After the highly significant reduction of ΔEWSL/SAE discrepancies between T0 and T6, analysis of 12-month records revealed color and lightness discrepancy of WSL vs SAE that was significantly decreased compared with baseline, indicating an assimilation of WSL color to SAE appearance after infiltration, while an additional reduction of discrepancies between T6 and T12 was not significant. Conclusion: As color and lightness characteristics of the Icon infiltrant as well as the esthetic camouflage effects achieved by WSL infiltration were not altered significantly or clinically relevant after 12 months, the method of resin infiltration can be recommended for an enduring esthetic improvement of postorthodontic WSL.
    The Angle Orthodontist 08/2014;
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    ABSTRACT: Abstract There have been several orthodontic modalities for maxillary transverse control with most addressing symmetric control. The asymmetric transverse control of maxillary dentition is challenging to orthodontists due to the lack of certain modalities and possible dental side effects. Skeletal anchorages provide biomechanics without orthodontic side effects, but reports of their utilization for transverse control of maxillary dentition are scarce. The purpose of this article is to introduce a novel method utilizing two midpalatal orthodontic miniscrews and a connecting wire system for the asymmetric transverse control of maxillary dentition. Records of two patients consecutively treated with this system are reported, and the related biomechanical considerations are presented.
    The Angle Orthodontist 08/2014;

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