Ariane Hohoff

Publications of Ariane Hohoff

• Control of mandibular incisors with the combined Herbst and completely customized lingual appliance--a pilot study.

  Authors: Dirk Wiechmann, Rainer Schwestka-Polly, Hans Pancherz, Ariane Hohoff

  Head & face medicine. 03/2010; 6:3.

  The traditional Herbst appliance induces mandibular incisor proclination independent of the anchorage system used. The dental effects of the Herbst appliance as an element of a completely customizedThe traditional Herbst appliance induces mandibular incisor proclination independent of the anchorage system used. The dental effects of the Herbst appliance as an element of a completely customized lingual orthodontic (LO) appliance (Incognito, 3 M) has not been analyzed yet and the aim of this paper was to measure the effect of mandibular incisor proclination using this Herbst-LO device. Retrospective study. Inclusion criteria: a) Class II >or= 5 mm molar relationship; b) Herbst appliance >or= 9 months in situ; and c) finished active treatment. Incisor position was measured on digital models before treatment, on the digital target setup, and on digital models obtained at the day of debonding. All measurements were performed by one investigator. Twelve patients (8 females, 4 males) out of 632 cases treated with a lingual appliance were included in the study. The measurement error computed with Dahlberg's formula was 0.2 degrees . Seven cases had planned (target setup) mandibular incisor uprighting (ccr), and five cases had proclination (clockwise rotation). There was no statistical difference (p > 0.05) between planned incisor rotations of the target setup and achieved incisor rotations at the day of debonding. The overall mean difference was 2.2 degrees +/- 1.0 degrees. The Incognito-Herbst combination is the first Herbst device with full control over mandibular incisor movement. Using this system, anchorage loss or anchorage gain is independent of the Herbst treatment. It depends only on the planned tooth position of the individual target setup.

• Herbst appliance in lingual orthodontics.

  Authors: Dirk Wiechmann, Rainer Schwestka-Polly, Ariane Hohoff

  American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics. 10/2008; 134(3):439-46.

  INTRODUCTION: The aims of this article were to outline a technique for attaching Herbst telescopes to a customized lingual orthodontic (LO) appliance and to demonstrate the treatment phases andINTRODUCTION: The aims of this article were to outline a technique for attaching Herbst telescopes to a customized lingual orthodontic (LO) appliance and to demonstrate the treatment phases and outcome with a case report. METHODS: The interface between the LO appliance and the telescopes consists of a computer-aided design/computer-aided manufacturing (CAD/CAM), custom-made labial pivot base connected to the custom-made bands of the maxillary molars and mandibular canines. The individual CAD depiction of the interface ensures an optimal 3-dimensional tube-and-plunger position for correct and smooth function of the telescope mechanism. Because of the lingual location of the brackets, a small buccal tooth-to-telescope distance can be achieved, increasing patient comfort. Various options of anchorage are possible with only 1 device. After bite jumping, the telescopes and pivot bases can be removed easily without debonding the bands or removing the archwires. RESULTS: Experience from the first patient suggests that the Herbst-LO appliance facilitates treatment control during all phases, decreases the risk of interface breakage and mandibular incisor flaring, and might reduce overall treatment time. CONCLUSIONS: These initial clinical observations justify further research to provide evidence about the efficacy of Herbst-LO appliances.

• Prediction of oral discomfort and dysfunction in lingual orthodontics: a preliminary report.

  Authors: Dirk Wiechmann, Joachim Gerss, Thomas Stamm, Ariane Hohoff

  American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics. 04/2008; 133(3):359-64; quiz 476.e1.

  INTRODUCTION: The purpose of this prospective study was to examine the influence of malocclusion on the amount of discomfort of patients who were treated with Incognito lingual brackets (T.O.P.INTRODUCTION: The purpose of this prospective study was to examine the influence of malocclusion on the amount of discomfort of patients who were treated with Incognito lingual brackets (T.O.P. Service, Ormco, Amersfoort, the Netherlands; ibraces in North and South America, Lingualcare, Dallas, Tex). METHODS: Twenty-one female patients (mean age, 24.8 years; SD 10.7) participated in the investigation and completed a standardized questionnaire before and the day after placement of the appliance. One experienced orthodontist, blinded to the results of the questionnaires, evaluated their initial cephalograms and casts with respect to the parameters SNA, SNB, and ANB angles; overjet; overbite; maxillary and mandibular anterior contact-point displacement; crossbite; open bite; and missing teeth. RESULTS: Malocclusion measured on the casts had no significant impact on the amount of discomfort or dysfunction reported by the patients. The SNA (r = -0.619, P = .003) and SNB (r = -0.615, P = .003) angles, however, correlated significantly with the restriction of tongue space; patients with an SNB angle that was smaller than 1 SD from the norm were significantly more prone to experience severe restriction of tongue space (P = .003). CONCLUSIONS: The SNA and SNB angles are predictors for the level of tongue-space restriction after placement of lingual brackets: the smaller the angles, the more prone the patients are to experience discomfort.

• Principles of cartilage tissue engineering in TMJ reconstruction.

  Authors: Christian Naujoks, Ulrich Meyer, Hans-Peter Wiesmann, Janine Jäsche-Meyer, Ariane Hohoff, Rita Depprich, Jörg Handschel

  Head & face medicine. 02/2008; 4:3.

  Diseases and defects of the temporomandibular joint (TMJ), compromising the cartilaginous layer of the condyle, impose a significant treatment challenge. Different regeneration approaches, especiallyDiseases and defects of the temporomandibular joint (TMJ), compromising the cartilaginous layer of the condyle, impose a significant treatment challenge. Different regeneration approaches, especially surgical interventions at the TMJ's cartilage surface, are established treatment methods in maxillofacial surgery but fail to induce a regeneration ad integrum. Cartilage tissue engineering, in contrast, is a newly introduced treatment option in cartilage reconstruction strategies aimed to heal cartilaginous defects. Because cartilage has a limited capacity for intrinsic repair, and even minor lesions or injuries may lead to progressive damage, biological oriented approaches have gained special interest in cartilage therapy. Cell based cartilage regeneration is suggested to improve cartilage repair or reconstruction therapies. Autologous cell implantation, for example, is the first step as a clinically used cell based regeneration option. More advanced or complex therapeutical options (extracorporeal cartilage engineering, genetic engineering, both under evaluation in pre-clinical investigations) have not reached the level of clinical trials but may be approached in the near future. In order to understand cartilage tissue engineering as a new treatment option, an overview of the biological, engineering, and clinical challenges as well as the inherent constraints of the different treatment modalities are given in this paper.

• The influence of lead thyroid collars on cephalometric landmark identification.

  Authors: Dirk Wiechmann, Alain Decker, Ariane Hohoff, Johannes Kleinheinz, Thomas Stamm

  Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics. 10/2007; 104(4):560-8.

  OBJECTIVE: To investigate whether the application of thyroid collars (TCs) affects cephalometric landmark identification. STUDY DESIGN: A randomized and observer-blinded diagnostic study with headOBJECTIVE: To investigate whether the application of thyroid collars (TCs) affects cephalometric landmark identification. STUDY DESIGN: A randomized and observer-blinded diagnostic study with head films taken from 2 groups was undertaken, with 1 group wearing TCs during radiography (n = 100) and 1 group not wearing TCs (n = 100). The interobserver reproducibility of 15 landmarks was evaluated using 1-way analysis of variance and independent samples t test to compare the groups. RESULTS: The total mean error radius of the non-TC group (1.28 +/- 1.47 mm) was smaller (P < or = .001) than that of the TC group (1.57 +/- 1.58 mm). Three landmarks located on the hyoid bone and on the second and third cervical vertebrae were identified as the main confounding factors. CONCLUSIONS: Personal lead shielding of the thyroid gland affects landmark identification, but the overall clinical effect is negligible. Thyroid collars should be routinely applied during cephalometric radiography if cephalometric analyses are limited to structures above the second cervical vertebra.

• The spectrum of Apert syndrome: phenotype, particularities in orthodontic treatment, and characteristics of orthognathic surgery.

  Authors: Ariane Hohoff, Ulrich Joos, Ulrich Meyer, Ulrike Ehmer, Thomas Stamm

  Head & face medicine. 02/2007; 3:10.

  In the PubMed accessible literature, information on the characteristics of interdisciplinary orthodontic and surgical treatment of patients with Apert syndrome is rare. The aim of the present articleIn the PubMed accessible literature, information on the characteristics of interdisciplinary orthodontic and surgical treatment of patients with Apert syndrome is rare. The aim of the present article is threefold: (1) to show the spectrum of the phenotype, in order (2) to elucidate the scope of hindrances to orthodontic treatment, and (3) to demonstrate the problems of surgery and interdisciplinary approach.Children and adolescents who were born in 1985 or later, who were diagnosed with Apert syndrome, and who sought consultation or treatment at the Departments of Orthodontics or Craniomaxillofacial Surgery at the Dental School of the University Hospital of Münster (n = 22; 9 male, 13 female) were screened. Exemplarily, three of these patients (2 male, 1 female), seeking interdisciplinary (both orthodontic and surgical treatment) are presented. Orthodontic treatment before surgery was performed by one experienced orthodontist (AH), and orthognathic surgery was performed by one experienced surgeon (UJ), who diagnosed the syndrome according to the criteria listed in OMIM. In the sagittal plane, the patients suffered from a mild to a very severe Angle Class III malocclusion, which was sometimes compensated by the inclination of the lower incisors; in the vertical dimension from an open bite; and transversally from a single tooth in crossbite to a circular crossbite. All patients showed dentitio tarda, some impaction, partial eruption, idopathic root resorption, transposition or other aberrations in the position of the tooth germs, and severe crowding, with sometimes parallel molar tooth buds in each quarter of the upper jaw.Because of the severity of malocclusion, orthodontic treatment needed to be performed with fixed appliances, and mainly with superelastic wires. The therapy was hampered with respect to positioning of bands and brackets because of incomplete tooth eruption, dense gingiva, and mucopolysaccharide ridges. Some teeth did not move, or moved insufficiently (especially with respect to rotations and torque) irrespective of surgical procedures or orthodontic mechanics and materials applied, and without prognostic factors indicating these problems. Establishing occlusal contact of all teeth was difficult. Tooth movement was generally retarded, increasing the duration of orthodontic treatment. Planning of extractions was different from that of patients without this syndrome.In one patient, the sole surgical procedure after orthodontic treatment with fixed appliances in the maxilla and mandible was a genioplasty. Most patients needed two- jaw surgery (bilateral sagittal split osteotomy [BSSO] with mandibular setback and distraction in the maxilla). During the period of distraction, the orthodontist guided the maxilla into final position by means of bite planes and intermaxillary elastics.To our knowledge, this is the first article in the PubMed accessible literature describing the problems with respect to interdisciplinary orthodontic and surgical procedures. Although the treatment results are not perfect, patients undergoing these procedures benefit esthetically to a high degree.Patients need to be informed with respect to the different kinds of extractions that need to be performed, the increased treatment time, and the results, which may be reached using realistic expectations.

• Objective growth monitoring of the maxilla in full term infants.

  Authors: Ariane Hohoff, Thomas Stamm, Ulrich Meyer, Dirk Wiechmann, Ulrike Ehmer

  Archives of oral biology. 04/2006; 51(3):222-35.

  OBJECTIVE: To develop a non-invasive method for longitudinal maxillary volume measurements and to provide first normative data. DESIGN: Thirty-four healthy infants served as a gold standard for aOBJECTIVE: To develop a non-invasive method for longitudinal maxillary volume measurements and to provide first normative data. DESIGN: Thirty-four healthy infants served as a gold standard for a growing population sample. Alginate impressions were taken of the upper jaw within the first week after birth, and consecutively at different stages of development. The plaster casts were digitised by an optical scanner generating a high resolution polygon mesh of each object. The digital models were aligned to a reference coordinate system with an iterative, landmark-independent procedure. Biometric linear and volume measurements were obtained by using feature-dependent calculations independent of landmark placements. Intra-investigator reproducibility was tested by repeated alignments and measurements of 30 randomly selected casts. To assess the effect of mesh resolution, the reproducibility test was repeated with low resolution models. The method was proved to be valid on the defined gold standard consisting of 96 consecutive edentulous casts. RESULTS: Feature-dependent, linear distances are less error prone (0.56-2.66%) compared to subjectively determined measurements (0.88-3.65%). The same applies to feature-dependent volume calculations (4.34%) compared to subjectively determined volumes (4.95%). Mesh resolution shows an effect (p<or=0.001) only on two linear measurements: palatal depth and palatal length. Growth of the individuals in the population sample was evidently confirmed by the maxillary volume measurements (asymptotic pattern) and by comparisons of head circumference (proportional pattern). CONCLUSION: The described method is non-invasive, precise and without any risk for the infant. Maxillary volume calculation could serve as an important biometric measurement for bone growth evaluation.

• Palatal development of preterm and low birthweight infants compared to term infants - What do we know? Part 3: Discussion and conclusion.

  Authors: Ariane Hohoff, Heike Rabe, Ulrike Ehmer, Erik Harms

  Head & face medicine. 12/2005; 1:10.

  BACKGROUND: It has been hypothesized that prematurity and adjunctive neonatal care is 'a priori' a risk for disturbances of palatal and orofacial development which increases the need for laterBACKGROUND: It has been hypothesized that prematurity and adjunctive neonatal care is 'a priori' a risk for disturbances of palatal and orofacial development which increases the need for later orthodontic or orthognathic treatment. As results on late consequences of prematurity are consistently contradictory, the necessity exists for a fundamental analysis of existing methodologies, confounding factors, and outcomes of studies on palatal development in preterm and low birthweight infants. METHOD: A search of the literature was conducted based on Cochrane search strategies including sources in English, German, and French. Original data were recalculated from studies which primarily dealt with both preterm and term infants. The extracted data, especially those from non-English paper sources, were provided unfiltered in tables for comparison (Parts 1 and 2). RESULTS: Morphology assessment of the infant palate is subject to non-standardized visual and metrical measurements. Most methodologies are inadequate for measuring a three-dimensional shape. Several confounding factors were identified as causes contributing to disturbances of palatal and orofacial development. CONCLUSION: Taking into account the abovementioned shortcomings, the following conclusions may be drawn for practitioners and prospective investigators of clinical studies. 1) The lack of uniformity in the anatomical nomenclature of the infant's palate underlines the need for a uniform definition. 2) Metrically, non-intubated preterm infants do not exhibit different palatal width or height compared to matched term infants up to the corrected age of three months. Beyond that age, no data on the subject are currently available. 3) Oral intubation does not invariably alter palatal morphology of preterm and low birthweight infants. 4) The findings on palatal grooving, height, and asymmetry as a consequence of orotracheal intubation up to the age of 11 years are inconsistent. 5) Metrically, the palates of orally intubated infants remain narrower posteriorly, beginning at the second deciduous molar, until the age of 11 years. Beyond that age, no data on the subject are currently available. 6) There is a definite need for further, especially metrical, longitudinal and controlled trials on palatal morphology of preterm and low birthweight infants with reliable measuring techniques. 7) None of the raised confounding factors for developmental disturbances may be excluded until evident results are presented. Thus, early orthodontic and logopedic control of formerly premature infants is recommended up to the late mixed dentition stage.

• Palatal development of preterm and low birthweight infants compared to term infants - What do we know? Part 2: The palate of the preterm/low birthweight infant.

  Authors: Ariane Hohoff, Heike Rabe, Ulrike Ehmer, Erik Harms

  Head & face medicine. 11/2005; 1:9.

  BACKGROUND: Well-designed clinical studies on the palatal development in preterm and low birthweight infants are desirable because the literature is characterized by contradictory results. It couldBACKGROUND: Well-designed clinical studies on the palatal development in preterm and low birthweight infants are desirable because the literature is characterized by contradictory results. It could be shown that knowledge about 'normal' palatal development is still weak as well (Part 1). The objective of this review is therefore to contribute a fundamental analysis of methodologies, confounding factors, and outcomes of studies on palatal development in preterm and low birthweight infants. METHODS: An electronic literature search as well as hand searches were performed based on Cochrane search strategies including sources of more than a century in English, German, and French. Original data were recalculated from studies which primarily dealt with both preterm and term infants. The extracted data, especially those from non-English paper sources, were provided unfiltered for comparison. RESULTS: Seventy-eight out of 155 included articles were analyzed for palatal morphology of preterm infants. Intubation, feeding tubes, feeding mode, tube characteristics, restriction of oral functions, kind of diet, cranial form and birthweight were seen as causes contributing to altered palatal morphology. Changes associated with intubation concern length, depth, width, asymmetry, crossbite, and contour of the palate. The phenomenon 'grooving' has also been described as a complication associated with oral intubation. However, this phenomenon suffers from lack of a clear-cut definition. Head flattening, pressure from the oral tube, pathologic or impaired tongue function, and broadening of the alveolar ridges adjacent to the tube have been raised as causes of 'grooving'. Metrically, the palates of intubated preterm infants remain narrower, which has been examined up to the age of the late mixed dentition. CONCLUSION: There is no evidence that would justify the exclusion of any of the raised causes contributing to palatal alteration. Thus, early orthodontic and logopedic control of formerly orally intubated preterm infants is recommended, as opposed to non-intubated infants. From the orthodontic point of view, nasal intubation should be favored. The role that palatal protection plates and pressure-dispersing pads for the head have in palatal development remains unclear.

• Palatal development of preterm and low birthweight infants compared to term infants - What do we know? Part 1: The palate of the term newborn.

  Authors: Ariane Hohoff, Heike Rabe, Ulrike Ehmer, Erik Harms

  Head & face medicine. 11/2005; 1:8.

  BACKGROUND: The evidence on prematurity as 'a priori' a risk for palatal disturbances that increase the need for orthodontic or orthognathic treatment is still weak. Further well-designed clinicalBACKGROUND: The evidence on prematurity as 'a priori' a risk for palatal disturbances that increase the need for orthodontic or orthognathic treatment is still weak. Further well-designed clinical studies are needed. The objective of this review is to provide a fundamental analysis of methodologies, confounding factors, and outcomes of studies on palatal development. One focus of this review is the analysis of studies on the palate of the term newborn, since knowing what is 'normal' is a precondition of being able to assess abnormalities. METHODS: A search profile based on Cochrane search strategies applied to 10 medical databases was used to identify existing studies. Articles, mainly those published before 1960, were identified from hand searches in textbooks, encyclopedias, reference lists and bibliographies. Sources in English, German, and French of more than a century were included. Data for term infants were recalculated if particular information about weight, length, or maturity was given. The extracted values, especially those from non-English paper sources, were provided unfiltered for comparison. RESULTS: The search strategy yielded 182 articles, of which 155 articles remained for final analysis. Morphology of the term newborn's palate was of great interest in the first half of the last century. Two general methodologies were used to assess palatal morphology: visual and metrical descriptions. Most of the studies on term infants suffer from lack of reliability tests. The groove system was recognized as the distinctive feature of the infant palate. The shape of the palate of the term infant may vary considerably, both visually and metrically. Gender, race, mode of delivery, and nasal deformities were identified as causes contributing to altered palatal morphology. Until today, anatomical features of the newborn's palate are subject to a non-uniform nomenclature. CONCLUSION: Today's knowledge of a newborn's 'normal' palatal morphology is based on non-standardized and limited methodologies for measuring a three-dimensional shape. This shortcoming increases bias and is the reason for contradictory research results, especially if pathologic conditions like syndromes or prematurity are involved. Adequate measurement techniques are needed and the 'normal palatal morphology' should be defined prior to new clinical studies on palatal development.

• Potential and limitations of cephalometric analysis of maxillofacial bone movement in the case of LeFort III-distraction.

  Authors: Carsten Lippold, Gholamreza Danesh, Ulrich Meyer, Ariane Hohoff, Matthias Kelker, Johannes Kleinheinz

  Journal of orofacial orthopedics = Fortschritte der Kieferorthopädie : Organ/official journal Deutsche Gesellschaft für Kieferorthopädie. 10/2005; 66(5):388-96.

  BACKGROUND UND METHOD: The treatment of craniofacial deformities by means of distraction osteogenesis has become an established therapeutic procedure. Evaluation of the success of an operation isBACKGROUND UND METHOD: The treatment of craniofacial deformities by means of distraction osteogenesis has become an established therapeutic procedure. Evaluation of the success of an operation is usually carried out via conventional cephalometry. Conventional forms of analysis seem problematic due to surgically-induced changes in the skull base. In this study we investigated the movement of the midface in the presence of a syndromerelated surgical indication employing two different types of analysis, namely those of Ricketts and Delaire. RESULTS: It seems that neither procedure is suitable for determining this type of bone movement conclusively. Comparing the two, the Delaire analysis possessed greater informative value in view of the altered geometry, and a combination of both procedures made more exact determination possible of the final position achieved.

• A subjective comparison of two lingual bracket systems.

  Authors: Thomas Stamm, Ariane Hohoff, Ulrike Ehmer

  European journal of orthodontics. 09/2005; 27(4):420-6.

  The purpose of this prospective, longitudinal study was to compare the influence of two lingual bracket systems on subjective oral comfort, speech, mastication and oral hygiene. Forty-two nativeThe purpose of this prospective, longitudinal study was to compare the influence of two lingual bracket systems on subjective oral comfort, speech, mastication and oral hygiene. Forty-two native speakers of standard German (32 females, 10 males; mean age 27.1 years, standard deviation 12.2) were enrolled and completed a standardized questionnaire directly before insertion of lingual brackets (T0), within 24 hours of bond-up (T1) and 3 months (+/- 1 week) later (T2). Eighteen of the patients were treated with prefabricated brackets (Ormco, seventh generation) (PB group) and 24 with customized brackets (Incognito) (CB group).While no significant intergroup differences were recorded at any of the times with respect to tongue position, conversation pattern, swallowing or oral hygiene, the CB group experienced significantly fewer tongue space restrictions, speech disturbances and impairments in chewing and biting than the PB group at T1 and T2. At T2, pressure sores, reddening or lesions to the tongue were recorded significantly less often in the CB group than in the PB group.This enhanced patient comfort in the CB group was attributed to the smaller dimensions of the customized brackets. This aspect could play a role in attracting more patients to lingual orthodontics in the future. Information given to the patient on the duration and extent of the restrictions associated with lingual orthodontics must be differentiated according to the bracket system used.

• Accuracy of third-order bends of nickel-titanium wires and the effect of high and low pressure during memorizing heat treatment.

  Authors: Thomas Stamm, Ariane Hohoff, Dirk Wiechmann, Jan Sütfeld, Dirk Helm

  American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics. 10/2004; 126(4):476-85.

  This study evaluated the accuracy of third-order bends of nickel-titanium wires and determined the effect of high and low pressure for maintaining the wire shape during memorizing heat treatment. AThis study evaluated the accuracy of third-order bends of nickel-titanium wires and determined the effect of high and low pressure for maintaining the wire shape during memorizing heat treatment. A computer-aided bending machine was used to incorporate 200 randomly determined torsional angles between 0 degrees and 60 degrees into 30 linear 0.016 x 0.022-in NeoSentalloy F80 (GAC International, Central Islip, NY) wires. The torsional bendings were randomized into 2 groups. Bends assigned to group 1 (n = 100) received heat treatment of 1.6 MPa (16 bar) pressure, and bends assigned to group 2 (n = 100) received heat treatment of 50 MPa (500 bar) pressure. Cross-sectional cuts from the bent wires were prepared by using standard metallurgical techniques, and the torsional angles were analyzed under computer control. The results of our study show that third-order bends </= 30 degrees can be made with adequate clinical accuracy with an error of 1.89 degrees +/- 1.75 degrees (0 degrees to 10 degrees ) and 3.57 degrees +/- 1.57 degrees (20 degrees to 30 degrees ), irrespective of the pressure applied. With bends > 30 degrees but </= 40 degrees , the method with the higher pressure offers fundamentally greater precision than that with the lower pressure. With torque bends > 40 degrees , the bending error with both methods is clinically unacceptable. In addition to the variability in the dimension and composition of nickel-titanium wires, the scale of the incorporated plastic deformations makes a substantial contribution to the bending error. As far as permitted by the clinical situation, then, the bend should be distributed over the maximum possible wire length. Third-order bends in the first rectangular pseudoelastic nickel-titanium wires represent an efficient means of effecting torque at an early stage. This individualization allows the full therapeutic potential of these archwires to be exploited right from the initial phase of treatment.

• On the three-dimensional physiological position of the temporomandibular joint.

  Authors: Thomas Stamm, Ariane Hohoff, Andreas Van Meegen, Ulrich Meyer

  Journal of orofacial orthopedics = Fortschritte der Kieferorthopädie : Organ/official journal Deutsche Gesellschaft für Kieferorthopädie. 08/2004; 65(4):280-9.

  Despite intensive research regarding the position of the temporomandibular joint, only few evidence-based facts are known about a three-dimensional physiological condyle-fossa relationship. The aimDespite intensive research regarding the position of the temporomandibular joint, only few evidence-based facts are known about a three-dimensional physiological condyle-fossa relationship. The aim of this systematic literature review was therefore to summarize the existing literature regarding the condyle position and to draw conclusions about a standardized three-dimensional condyle position.An extended search profile based on the search strategy of the Cochrane Oral Health Group and applied to twelve medical databases was used to identify existing studies. Articles which were not electronically accessible (mainly those published before 1960) were identified from reference lists and bibliographies. These publications were assessed independently by two clinicians with reference to points based on specified criteria. The interexaminer agreement was assessed on the basis of the kappa coefficient.1903 articles published in the period 1899-2001 and relating to condyle position were identified. These studies showed a pronounced variability in their methodological approaches, with only 49 of them meeting the inclusion criteria. The interexaminer agreement yielded a kappa-value of 0.92. Although numerous studies used three-dimensional data, no physiological three-dimensional condyle position was determined. The most frequent analytic method was two-dimensional projection of the temporomandibular joint onto a subjectively selected sagittal plane. This evaluation method revealed a noticeable shift over time in condyle position from posterior to anterior, suggesting a clear-cut publication bias. Publications with the highest evidence level favored no specific position (p > 0.05).Simplification of the three-dimensional structure of the temporomandibular joint to a two-dimensional projection is questionable for therapeutic positioning of the condyle in relation to the fossa.

• Nonlinear behavior of search strategies for identifying relevant orthodontic articles.

  Authors: Thomas Stamm, Ariane Hohoff

  The Angle orthodontist. 07/2004; 74(3):316-8.

  The communication process with electronic literature databases permitting a freetext search is prone in part to nonlinear, chaotic behavior. Even very minor changes in the initial conditions (searchThe communication process with electronic literature databases permitting a freetext search is prone in part to nonlinear, chaotic behavior. Even very minor changes in the initial conditions (search query) have a dramatic impact on the concluding event (search outcome). This statement has been verified with reference to alterations to the term "orthodontic" in search strategies of published systematic reviews. The results showed that a variation in one letter led to an average of 152 papers, 81% of them of orthodontic relevance, failing to be localized. Yet, the opposite effect, the elimination of papers (-418), was also observed, confirming the underlying nonlinear pattern. Search queries for orthodontic articles should invariably be equipped with the robust truncation "orthodon*." Truncation variants of key words should be used as a matter of principle to verify the outcome.

• Comparison of the effect on oral discomfort of two positioning techniques with lingual brackets.

  Authors: Ariane Hohoff, Thomas Stamm, Ulrike Ehmer

  The Angle orthodontist. 05/2004; 74(2):226-33.

  Using a standardized questionnaire, 41 patients (12 men, 29 women; mean age 31.5 +/- 12.1 years) were interviewed prospectively on their subjective oral comfort, various oral functions, andUsing a standardized questionnaire, 41 patients (12 men, 29 women; mean age 31.5 +/- 12.1 years) were interviewed prospectively on their subjective oral comfort, various oral functions, and professional qualification before indirect application of lingual brackets (T0), within 24 h of application (T1), and three months later (+/- 1 week) (T2). In 22 of the 41 patients, the brackets were positioned with the Bonding with Equalized Specific Thickness (BEST) technique (BEST group) and in 19 patients by the Transfer Optimized Positioning (TOP) method (TOP group). Despite positive adaptation, the patients in both groups still reported a significant deficiency in tongue space at T2 as well as significantly more frequent lesions to the tongue. The BEST group was affected significantly more often by these problems than the TOP group. At T2, the tongue position was also rated as changed significantly more often in the BEST group than in the TOP group. Although the BEST positioning technique leads to greater impairments in oral comfort than the TOP technique, it offers the orthodontist the advantage of less bending input. In both techniques, there is a need for detailed briefing of patients about the extent and duration of impairments induced by lingual brackets.

• Comparison of 3 bonded lingual appliances by auditive analysis and subjective assessment.

  Authors: Ariane Hohoff, Thomas Stamm, Gerhard Goder, Cristina Sauerland, Ulrike Ehmer, Eberhard Seifert

  American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics. 01/2004; 124(6):737-45.

  The aim of this prospective study was to compare for the first time the influences of lingual appliances of different dimensions on sound performance and oral comfort. The study group comprised 12The aim of this prospective study was to compare for the first time the influences of lingual appliances of different dimensions on sound performance and oral comfort. The study group comprised 12 subjects (10 women, 2 men; mean age, 33.96 years). Their sound production was recorded by means of a digital audio tape recorder before, 10 minutes after, and 24 hours after placement of the different appliances for semiobjective assessment by 3 blinded speech professionals. This was followed by supplementary subjective ratings of sound performance and oral comfort by the patients. All lingual appliances induced significant impairment in sound performance and oral comfort. However, they varied significantly with respect to the degree of impairment. The smaller the appliance, the less pronounced the impairments it induced. The smallest changes were induced by a bonded canine-to-canine retainer, followed by customized lingual brackets and prefabricated lingual brackets. By using lower-profile customized brackets, the orthodontist can significantly enhance patient comfort and significantly reduce impairments of sound performance in comparison with prefabricated brackets with larger dimensions. Before placing a lingual appliance, however, patients should be briefed on possible effects such as impaired sound production and decreased oral comfort.

• Validity of a three-dimensional public-domain system for contemporary endodontic research.

  Authors: Thomas Stamm, Markus Kaup, Ariane Hohoff, Tobias Meier, Ulrich Meyer

  Journal of endodontics. 01/2004; 29(12):801-5.

  The purpose of this study was to evaluate the limits and benefits of a visualization system based on public-domain software for contemporary three-dimensional (3-D) endodontic research purposes.The purpose of this study was to evaluate the limits and benefits of a visualization system based on public-domain software for contemporary three-dimensional (3-D) endodontic research purposes. Three-dimensional bio-models of six human teeth and of one bone-implant specimen were generated using cross-sectional imaging. To evaluate the overall performance in processing large data sets and in reproducing accurate 3-D morphology, slices with a thickness varying from 100 microm to 10 microm were cut. Auto-outlining and segmenting techniques were tested. The 3-D bio-models represented in accurate detail the different morphological aspects of the specimen. Voxel volumes of 0.116 x 10(-5) mm3 could be realized and were only restricted by the computer hardware limitations. The system is not limited to dental hard tissues. Hypomineralized material and soft tissues as well as bone- and allogeneic-implant material could be visualized. The method presented is valid and meets current requirements applying to endodontic research. The broad-based use of high-quality, public-domain software and the resulting exchange of experience help to manage resources and may contribute to enhancing the in-process quality of research.

• Effects of a mechanical interdental cleaning device on oral hygiene in patients with lingual brackets.

  Authors: Ariane Hohoff, Thomas Stamm, Nicola Kühne, Dirk Wiechmann, Stephan Haufe, Carsten Lippold, Ulrike Ehmer

  The Angle orthodontist. 11/2003; 73(5):579-87.

  This study was aimed at determining the influence of a battery-operated interdental cleaning device (icd) (WaterPik Flosser) on the oral hygiene of 32 female right-handed patients (mean age 25.9This study was aimed at determining the influence of a battery-operated interdental cleaning device (icd) (WaterPik Flosser) on the oral hygiene of 32 female right-handed patients (mean age 25.9 years) with lingual brackets in the upper (n = 29) and or in the lower arch (n = 25). Approximal plaque index (API) and bleeding on probing (BOP) were recorded at the lingual surfaces by a single blinded examiner before application (t0), on average 38.6 days after (t1), and again on average 46.0 days after (t2) the application of the icd. The patients used the icd once a day in the second and fourth quadrants only (icdq). In all quadrants (icdq and non-icd quadrants [n-icdq]), oral hygiene was performed with a manual toothbrush. Of the patients enrolled in the study, 96.9% found the icd subjectively very helpful to moderately helpful for cleaning their teeth and 65.6% had the subjective impression that their teeth were cleaner with the appliance. Despite those positive subjective assessments, an objective comparison of the icdqs with the n-icdqs revealed no statistically significant differences in the mean changes in API and BOP from t0 to t1, from t0 to t2, or from t1 to t2. Because there were spectacular improvements in API in all quadrants, the improvements could be interpreted as an outcome of the instruction and motivation given to the patients, the increasing awareness of oral hygiene, and the greater skill in using the toothbrush in the course of time.

• Interdisciplinary study of orthopedic and orthodontic findings in pre-school infants.

  Authors: Carsten Lippold, Louwrens van den Bos, Ariane Hohoff, Gholamreza Danesh, Ulrike Ehmer

  Journal of orofacial orthopedics = Fortschritte der Kieferorthopädie : Organ/official journal Deutsche Gesellschaft für Kieferorthopädie. 10/2003; 64(5):330-40.

  BACKGROUND AND AIM: The assessment of correlations between orthopedic and orthodontic data based on interdisciplinary studies is of scientific and practical interest in the differentiation ofBACKGROUND AND AIM: The assessment of correlations between orthopedic and orthodontic data based on interdisciplinary studies is of scientific and practical interest in the differentiation of preventive diagnostic and therapeutic fields between orthodontics and orthopedics. In the published literature there are various studies analyzing the correlations between specific Angle classes and orthopedic parameters. Results of these studies indicate a potential correlation between scoliosis and Class II malocclusion as well as between weak body posture and Class II malocclusion. The aim of the present interdisciplinary study was to examine correlations between orthodontic and orthopedic findings in pre-school infants and to evaluate them with respect to preventive recommendations. PATIENTS AND METHOD: 59 pre-school infants (29 boys, 30 girls) aged 3.5-6.8 years (mean: 5.0 years) were enrolled in this study. A standardized orthodontic and orthopedic examination protocol was used. RESULTS: The orthodontic examination showed Angle class distributions comparable with those in non-selected groups (Class I: 63%, Class II: 32%, Class III: 5%). The orthopedic examination revealed pathologic findings in 52% of the subjects, with statistically significant correlations between scoliosis and Class II malocclusion (p = 0.033) and between weak body posture and Class II malocclusion (p = 0.028). CONCLUSION: It can be concluded from the results that the orthodontic finding of Angle Class II in pre-school infants should induce prophylactic screening. The orthodontist could then not only initiate early orthodontic treatment to prevent incisor trauma in patients with extreme overjet, but could also take account of potential orthopedic malformations on a preventive interdisciplinary basis in pre-school infants with Class II malocclusions.