Amy L Counts

Jacksonville University, Jacksonville, Florida, United States

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Publications (28)27.13 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: The purposes of this study were to assess and determine the range of a well-balanced anteroposterior lip position as evaluated by orthodontic patients from a series of varying lip positions in facial silhouettes, and whether the rater's sex and age were factors in the assessment. The average profiles were constructed from 30 Japanese male and female subjects with normal occlusion. A series of 13 profiles was developed for males and females, respectively. The lips were protruded or retruded by 1-mm increments from the average profile. One hundred fifty Japanese orthodontic patients were asked to choose the top 3 most-favored, well-balanced profiles for each sex. The orthodontic patients tended to prefer a slightly retruded lip position than the average facial profile for both the male and female profiles. There was no significant difference between male and female raters in selecting the top 3 most-favored profiles. In the comparison of age groups, the over 30-year-old patients significantly preferred a more retruded lip position than did the 15- to 19-year-old and the 20- to 29-year-old patients for the female profile. These results suggest that, when we formulate a treatment plan, we should ask the patients about lip position before we start treatment.
    American journal of orthodontics and dentofacial orthopedics: official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics 04/2011; 139(4):e291-7. DOI:10.1016/j.ajodo.2009.06.030 · 1.44 Impact Factor
  • Hideki Ioi, Shunsuke Nakata, Amy L Counts
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    ABSTRACT: The aim of this study was to evaluate the influence of the amount of gingival display on smile aesthetics as assessed by Japanese orthodontists and dental students. A coloured photograph of a smiling female, displaying the first molar to first molar, whose upper lip was tangent to the upper gingival margin of the upper central incisors (zero point), was constructed from different subjects. Gingival displays were modified by moving the teeth within the lip frame in 1 mm increments, from -5 to 5. Using a visual analogue scale (VAS), 31 Japanese orthodontists and 55 Japanese dental students rated the attractiveness of the 11 smiles with altered gingival display. There was no significant difference when judging the effects of the gingival display on the smile attractiveness between the male and the female raters for both the orthodontists and dental students. Kruskal-Wallis tests revealed significant differences in the median aesthetic scores for both the orthodontists and dental students. For the orthodontists, the median aesthetic score increased gradually from -5 to 0 mm and then decreased from 0 to 5 mm. In particular, it decreased to become clinically significant (15 per cent VAS difference) from 0 to 3 mm. For the dental students, the median aesthetic score increased gradually from -5 to -2 mm and then decreased from -2 to 5 mm. The dental students were less tolerant of a more 'gummy' smile than the orthodontists.
    The European Journal of Orthodontics 12/2010; 32(6):633-7. DOI:10.1093/ejo/cjq013 · 1.39 Impact Factor
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    ABSTRACT: The aim of this study was to examine the effects of retraction of anterior teeth and the initial soft tissue profile variables on upper and lower lip changes in Japanese adults. Pre- and post-treatment cephalometric radiographs of 33 Japanese female adults (aged 23.0±5.0 years), with a Class II division 1 malocclusion, who had two or four first premolars extracted, were evaluated. Lateral cephalograms taken with the lips in a voluntary relaxed position were traced and compared. Nine linear and eight angular measurements were constructed for the hard tissue measurements and 16 linear and 2 angular for the soft tissue measurements. Stepwise multiple regression analysis revealed that the horizontal upper lip position could be explained by the position of the maxillary incisor cervical point and the occlusal plane to SN with a 54 percent contribution ratio, and horizontal lower lip position, maxillary incisor tip position, initial interlabial gap, and aesthetic line to the tip of lower lip with a 51 percent contribution ratio. All parameters employed explained the horizontal position of the upper and lower lip with higher than 96 percent confidence. While the horizontal positions could not be predicted by a limited number of parameters, the vertical positions of lips could be explained by three parameters with higher than 62 percent confidence. The predictability found in this study could be beneficial for orthodontists in treatment planning.
    The European Journal of Orthodontics 10/2010; 33(4):419-26. DOI:10.1093/ejo/cjq095 · 1.39 Impact Factor
  • Hideki Ioi, Shunsuke Nakata, Amy L. Counts
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    ABSTRACT: The purpose of this study was to investigate the influence of buccal corridors on smile attractiveness as judged by Korean and Japanese dental students. One female smiling photograph, displaying first molar to first molar was constructed. Buccal corridors were modified digitally in 5% increments, from standard composite smile to 25% buccal corridor compared with the inner commissure width. Using a visual analog scale (VAS), 14 Korean and 55 Japanese dental students rated the attractiveness of six smiles with altered buccal corridors. The Wilcoxon rank-sum test was conducted to compare the distributions of the median scores between the male and female raters for each of the groups. Differences in the median esthetic scores were analyzed using Kruskal–Wallis test. We used 15% VAS difference to determine the clinical significance of the esthetic scores. There was no significant difference in judging the effects of buccal corridors on the smile attractiveness between male and female raters for both the Koreans and Japanese. There were significant differences in the median esthetic scores for both the Korean and Japanese dental students. Both the Korean and Japanese dental students tended to prefer broader smiles to medium or narrow smiles.
    Orthodontic Waves 12/2009; 68(4):166-170. DOI:10.1016/j.odw.2009.03.004
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    ABSTRACT: The purpose of this retrospective study was to investigate the relationship between the unilateral temporomandibular joint (TMJ) osteoarthritis/osteoarthrosis (OA), mandibular asymmetry and electromyographic (EMG) activity of the masticatory muscles. Twenty-two Japanese women (aged 23.2 +/- 5.4 years) and 10 Japanese men (aged 22.4 +/- 2.8 years) exhibiting unilateral TMJ OA were included in this study. Two angular and seven linear measurements were obtained for the analysis of the skeletal hard tissues. The cephalometric measurement values (CV) were normalized using the CV ratio for the evaluation of the degree of mandibular asymmetry. The EMG was recorded during maximal voluntary clenching efforts for 10 s in the intercuspal position. The average values of integral EMG (iEMG) of three trials were normalized using the iEMG ratio for the evaluation of the functional balance of the masticatory muscles. The mandibular midline was shifted to the TMJ OA side with a median value of 9.85 mm. The CV ratio of the ramus height of the TMJ OA side was significantly smaller than that of the non-OA side. For the masseter muscle, the iEMG ratio of the TMJ OA side was significantly larger than that of the non-OA side (P < 0.05). These results suggest that unilateral TMJ OA is related to the dentofacial morphology, thus resulting in a mandibular midline shift to the affected side and it is associated with a masticatory muscle imbalance.
    Journal of Oral Rehabilitation 11/2009; 37(2):85-92. DOI:10.1111/j.1365-2842.2009.02026.x · 1.93 Impact Factor
  • Hideki Ioi, Shunsuke Nakata, Amy L Counts
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    ABSTRACT: To test the hypothesis that the amount of buccal corridor has no influence on smile evaluations of Japanese orthodontists and dental students. One photograph of a smiling female, displaying first molar to first molar, was constructed. Buccal corridors were modified digitally in 5% increments, from 0% to 25% buccal corridor compared with the inner commissural width. Using a visual analog scale (VAS), 32 Japanese orthodontists and 55 Japanese dental students rated the attractiveness of six smiles with altered buccal corridors. The Wilcoxon rank-sum test was conducted to compare the distributions of the median scores between the male and female raters for each of the rater groups. Differences in the median esthetic scores were analyzed using the Kruskal-Wallis test. We used 15% VAS difference to determine the clinical significance of the esthetic scores. There was no significant difference in judging the effects of buccal corridors on the smile attractiveness between the male and female raters for both the orthodontists and dental students. There were significant differences in the median esthetic scores for both the orthodontists and dental students. The median esthetic score decreased to become clinically significant from 10% to 25% buccal corridor for both the orthodontists and dental students. The hypothesis was rejected. Both the orthodontists and dental students preferred broader smiles to medium or narrow smiles.
    The Angle Orthodontist 08/2009; 79(4):628-33. DOI:10.2319/080708-410.1 · 1.28 Impact Factor
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    ABSTRACT: To compare frictional resistance of the plastic preadjusted brackets ligated with the low-friction ligatures with those of the conventional elastomeric ligatures. In vitro study. Department of Orthodontics, Faculty of Dentistry, Kyushu University, Fukuoka, Japan. The testing model consisted of four 0.022-inch plastic preadjusted brackets for the first premolar, the canine, the lateral incisor, and the central incisor. A superelastic nickel-titanium 0.014-inch wire and a stainless steel 0.019 x 0.025-inch wire were used for this test. The brackets were either aligned or out of line by 0.5, 1.0, 1.5 and 2.0 mm for the 0.014-inch wire and aligned for the 0.019 x 0.025-inch wire. The frictional forces in plastic preadjusted brackets with low-friction ligatures and conventional elastomeric ligatures were measured at a pulling speed of 0.1 mm/second. Welch t-tests were used to compare the mean differences of each testing measurement between the low-friction and the conventional elastomeric ligatures. In both use of the superelastic nickel-titanium 0.014-inch wire and the stainless steel 0.019 x 0.025-inch wire, the brackets with the low-friction ligatures showed significantly lower frictional forces than those of the conventional elastomeric ligatures in both aligned and all misaligned brackets (P < 0.0001). The study found the significantly lower frictional forces for the low-friction ligatures than those of the conventional elastomeric ligatures.
    Journal of Orthodontics 04/2009; 36(1):17-22; discussion 13. DOI:10.1179/14653120722887
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    ABSTRACT: To compare the kinetic frictional force of a conventional plastic preadjusted bracket with thermoplastic low-friction module ligation and a self-ligating bracket. The testing model consisted of four 0.022-inch conventional plastic preadjusted brackets; four 0.022-inch self-ligating brackets for the first premolar, canine, and lateral and central incisors; and a 0.014-inch superelastic nickel-titanium and a 0.019 × 0.025-inch stainless steel wire. The brackets were either aligned for both wires or out of line by 0.5, 1.0, 1.5, and 2.0 mm for only the 0.014-inch superelastic wire. The wires were pulled for 3.0 mm at a speed of 0.1 mm per second. Unpaired t tests were used to compare the mean differences of the measurements between the two bracket systems with both wires. No significant difference in the kinetic frictional force between the two bracket systems and the two wires were found for the 0.014-inch superelastic wire at 0-mm deflection. Both bracket systems demonstrate low friction, which is beneficial for effective orthodontic tooth movement with light forces.
    World journal of orthodontics 01/2009; 10(3):220-3.
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    ABSTRACT: To investigate the relationship between mechanomyogram (MMG), electromyogram (EMG) and bite force during isometric contraction of the human masseter muscle. Data were obtained from 16 healthy Japanese males (Mean age: 25.6 +/- 2.3 years). The measuring device for MMG consisted of an amorphous sensor and a small magnet. The bite force, MMG and EMG signals were recorded simultaneously during isometric contraction of the masseter muscle. The subjects were instructed to perform 0, 5, 10, 20, 30, 40, 50, and 60% maximal voluntary contractions (MVC) for 20 seconds. The average rectified value (ARV) for MMG and EMG were calculated from 1 to 5 second samples. The median frequency of the power spectrum (MFPS) for MMG and EMG were determined with the use of a fast Fourier transformation algorithm. The mean ARV for MMG increased up to 20% MVC and then gradually decreased at the higher force levels. The mean ARV for EMG increased with bite force in a monotonic fashion. The mean MFPS for MMG clearly increased up to 10% MVC and then gradually increased. On the other hand, the mean MFPS for EMG clearly increased up to 10% MVC, but then gradually decreased with bite force. These findings suggest that the MMG analysis combined with the EMG may be a more useful method for evaluating the status of the masseter muscle.
    Australian orthodontic journal 12/2008; 24(2):116-20. · 0.27 Impact Factor
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    ABSTRACT: A consensus on the contemporary perception of beauty might have been developed between different countries because of increased worldwide access to variations in pleasing facial profiles. The objectives of this study were to determine, assess, and compare the ranges of values of the most-favored facial profiles rated by young Korean and Japanese adults. Average profiles were constructed from the profiles of 30 Japanese men and women with normal occlusions. A series of 13 profiles each was developed for men and women. In the series, the average profile was located in the center (number 7), and the lips were protruded or retruded in 1-mm increments from the average profile. Forty-six Korean dental students and 52 Japanese dental students were asked to rate the top 3 most-favored profiles. Both the Korean and the Japanese dental students tended to select a slightly more retruded lip profile compared with the averages for men and women, and the tendency to prefer a more retruded lip position was evident for the women. These findings suggest that young Korean and Japanese adults prefer a retruded profile, even though their profiles have historically been characterized by more convex facial features.
    American journal of orthodontics and dentofacial orthopedics: official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics 11/2008; 134(4):490-5. DOI:10.1016/j.ajodo.2006.09.070 · 1.44 Impact Factor
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    ABSTRACT: To determine whether there is an association between temporomandibular joint (TMJ) osteoarthritis/osteoarthrosis (OA) and immune system factors in a Japanese sample. The records of 41 subjects (7 men, aged 22.0 +/- 3.8 years; 34 women, aged 24.8 +/- 6.3 years) and 41 pair-matched controls (7 men, aged 22.1 +/- 2.3 years; 34 women, aged 24.8 +/- 6.4 years) based on age and gender were reviewed. Information on medical history included local or systemic diseases, details on medication type and use, and the presence of allergies and asthma. Dental history questions referred to details regarding past oral injuries. The validity of the hypothesis, defining allergies and asthma as risk factors in OA, was tested by using a logistic regression analysis. The incidence of allergy was significantly higher in the TMJ OA (P = .008), with a mean odds ratio of 4.125 and a 95% confidence interval of 1.446-11.769. These results suggest that allergy may be a risk factor in association with TMJ OA in this Japanese sample.
    The Angle Orthodontist 10/2008; 78(5):793-8. DOI:10.2319/091407-438 · 1.28 Impact Factor
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    ABSTRACT: To test whether there is a relationship between head and cervical posture and dentofacial morphology in patients with temporomandibular joint osteoarthritis/osteoarthrosis (OA). The subjects consisted of 34 Japanese females with TMJ OA (aged 24.7 +/- 6.1 years). Six craniocervical angular measurements were constructed for head posture. Two angular and 6 linear measurements were constructed for the skeletal relationship, while 1 angular and 6 linear measurements were constructed for the dental relationship. Pearson correlation coefficients were calculated between head posture and dentofacial variables. In the skeletal relationship, increased craniocervical angulations were significantly associated with a more posterior position of the maxilla, a decreased Frankfort to mandibular plane angle, decreased mandibular length, and a decreased lower facial height. In the dental relationship, increased craniocervical angulations were significantly associated with more posterior positions of the anterior teeth to the basal bone and decreased alveolar height of the anterior-posterior teeth. The hypothesis was rejected. These results suggest that an association may exist between head and cervical posture and dentofacial morphology in patients with TMJ OA.
    World journal of orthodontics 02/2008; 9(4):329-36.
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    ABSTRACT: The purpose of this study was to test the hypothesis that there is a relationship between the temporomandibular joint (TMJ) osteoarthritis/osteoarthrosis (OA), head posture and dentofacial morphology. Case-control study. The subjects consisted of 34 Japanese females with TMJ OA (aged 24.7 +/- 6.1 years) and a control group of 25 healthy Japanese females (aged 23.6 +/- 1.3 years). Six cranio-cervical angular measurements were constructed for head posture analysis. Nine angular and three linear measurements were constructed for the skeletal hard tissue analysis. Five angular and one linear measurements were constructed for the dental hard tissue analysis. Unpaired t-tests were used to compare the mean differences of head posture measurements and dentofacial cephalometric measurements between the TMJ OA and the control group. The TMJ OA group had significantly larger cranio-cervical angles (p < 0.05) and had more posteriorly rotated mandibles (p < 0.0001) than those in the control group. They also had a significantly shorter posterior facial height (p < 0.0001). The TMJ OA group had more retroclined lower incisors (p < 0.05). These results suggest that an association may exist between TMJ OA, head posture and dentofacial morphology.
    Orthodontics and Craniofacial Research 02/2008; 11(1):8-16. DOI:10.1111/j.1601-6343.2008.00406.x · 1.29 Impact Factor
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    ABSTRACT: The aims of this study were to determine Japanese cephalometric norms in the antero-posterior and vertical dimension, and to test the hypothesis that there are racial differences in cephalometric measurements between Japanese and Caucasian norms. Radiographs were obtained from 25 healthy Japanese males (aged 25.1 +/- 2.7 years) and 24 healthy Japanese females (aged 23.6 +/- 1.3 years). Inclusion criteria were an ANB angle between 2 and 5 degrees, a normal occlusion with minor or no crowding, all teeth present except third molars, no previous orthodontic treatment, and no prosthetic replacement of teeth. Two angular and five linear measurements were constructed for the skeletal hard tissue analysis, one angular and six linear measurements for the dental hard tissue analysis, and two angular and seven linear measurements for the soft tissue analysis. The mean and standard deviations for the hard and soft tissue measurements were determined for each gender. Unpaired t-tests were used to determine the mean differences for each cephalometric measurement between the Japanese and the Caucasians. In the antero-posterior dimension, the Japanese subjects had a significantly more retruded chin position (P < 0.001), typically protruding mandibular incisors, and protruded lip positions compared with the Caucasian norms. In the vertical dimension, the Japanese had a significantly steeper mandibular plane (P < 0.01). The Japanese females had a significantly larger lower face height and increased dental height (P < 0.001). The results of this study suggest that these cephalometric measurements might be helpful to formulate treatment plans for Japanese patients.
    The European Journal of Orthodontics 10/2007; 29(5):493-9. DOI:10.1093/ejo/cjm059 · 1.39 Impact Factor
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    ABSTRACT: To compare the lip positions found in two ancient Buddha statues with the lip positions in contemporary Japanese adults. The facial profiles of Yakushi-ji temple Sho Kannon (male) and Chugu-ji temple Bodhisattva (female), generally considered to be two of the most beautiful Buddha statues in existence, were compared with the facial profiles of 30 Japanese dental students. Profiles of the statues were measured on photographs and profiles of the adults on cephalometric radiographs. The adults comprised 15 men between 22 and 26 years of age (Mean age: 23.8+/-1.3 years) and 15 women between 22 to 25 years of age (Mean age: 22.9+/-1.0 years). The Buddha statues had retrusive lips compared with the lip positions in contemporary Japanese adults. Flat profiles may be favoured by Japanese adults who, typically, have protrusive lips.
    Australian orthodontic journal 12/2006; 22(2):161-5. · 0.27 Impact Factor
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    ABSTRACT: The purpose of this study was to assess the range of the top three most-favored facial profiles for each sex from a series of varying lower facial vertical proportion, and to evaluate clinically acceptable facial profiles for Japanese adults. Silhouettes of average male and female profiles were constructed from the profiles of 30 Japanese males and females with normal occlusions. Lower facial vertical proportions were increased or decreased by intervals of 5% of Sn–Me′ for each sex from the average profile. Forty-one orthodontists and 50 dental students were asked to select the 3 most-favored, well-balanced profiles for each sex. They were also asked to indicate whether they would seek surgical orthodontic treatment for each of the shorter or longer lower facial profiles if those images represented their own profile. For male profiles, both the orthodontists and dental students chose the average profile as the most-favored. For female profiles, the dental students chose a slightly shorter lower facial as the most-favored profile while the orthodontists chose the average profile. The dental students chose shorter lower facial profiles as more acceptable than longer lower facial profiles for females (p
    Orthodontic Waves 12/2006; 65(4):161-165. DOI:10.1016/j.odw.2006.11.002
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    ABSTRACT: The purposes of this study were to evaluate the upper and lower lip changes after orthodontic treatment of bimaxillary protrusion in adult Japanese. We also intended to predict the upper and lower lip positions from the changes of the maxillary and mandibular incisor positions in both the horizontal and vertical planes. Pre-treatment and post-treatment cephalograms of 38 patients (6 males and 32 females, aged 24.2 ± 2.9 and 22.8 ± 4.1 years, respectively) who had four first premolars extracted, were taken with lips in their voluntary relaxed position, traced and compared between them. Stepwise multiple regression analysis revealed that a 1 mm retraction and a 1 mm intrusion of the maxillary incisor cervical point would produce a 0.22 mm retraction of the upper lip, a 1 mm retraction of the mandibular incisor tip would produce 0.76 mm retraction of the lower lip, and a 1 mm mandibular incisor tip retraction would produce a 0.50 mm retraction of Stomion. Moreover, a 1 mm maxillary incisor tip intrusion would produce a 0.56 mm upward movement of the upper lip and a 1.00 mm upward movement of the lower lip. The predictability of this study may be beneficial for orthodontists in planning and discussing treatment plans and options with patients.
    Orthodontic Waves 12/2006; 65(4):141-147. DOI:10.1016/j.odw.2006.09.001
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    ABSTRACT: The temporomandibular joint (TMJ) is the principal adaptive center for determining the intermaxillary relationship in all three planes of space. The joint diseases, such as TMJ osteoarthritis/osteoarthrosis (OA) might associate with dentofacial morphologic changes. The purpose of this study was to investigate the relationship between TMJ OA and dentofacial morphology in Japanese females and compare findings to a normal control group. The subjects consisted of 24 Japanese females with TMJ OA (aged 22.5 ± 4.4 years) and a control group of 24 asymptomatic Japanese females (aged 23.6 ± 1.3 years). Linear and angular cephalometric measurements were noted to evaluate the skeletal, dental and soft tissue relationships of the two groups. Unpaired t-tests were used to compare the mean differences of each cephalometric measurement between the TMJ OA and the control group. The subjects with TMJ OA had a more significant posteriorly rotated mandible as well as a smaller mandible compared with the subjects in the control group. They also had more protrusive lower incisors, upper lips and lower lips. These results suggest that there might exist association between TMJ OA and dentofacial morphology in Japanese females.
    Orthodontic Waves 10/2006; DOI:10.1016/j.odw.2006.06.001
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    ABSTRACT: The purpose of this study was to examine the validation of mechanomyogram (MMG) for assessing the masseter muscle fatigue. Data were obtained from 16 healthy Japanese males (aged 25.6 ± 2.3 years). The measuring device for the MMG consisted of an amorphous sensor and a small magnet. The bite-force, the MMG, and the electromyogram (EMG) signals were recorded simultaneously. The subjects were instructed to perform 0%, 5%, 10%, and 20% maximal voluntary contraction (MVC) for 20 s as the pre-fatigue trials. A recovery period of 5 min was allowed after each pre-fatigue trial. As the fatigue task, the subjects were instructed to sustain 40% level of MVC until they feel intolerable discomfort. The subjects were asked to perform 0%, 5%, 10%, and 20% MVC for 20 s as the post-fatigue trials. No recovery period was allowed after each post-fatigue trial. The mean values of the average rectified value for EMG of the post-fatigue trials were significantly higher than those of the pre-fatigue trials at 10% (p < 0.05) and 20% MVC (p < 0.05). The mean values of the electromechanical efficiencies of the post-fatigue trials were significantly lower than those of the pre-fatigue trials at 10% (p < 0.01) and 20% MVC (p < 0.05). These findings suggest that the MMG analysis combined with the EMG may be a more useful method for evaluating the masseter muscle status.
    Orthodontic Waves 03/2006; DOI:10.1016/j.odw.2005.12.002
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    ABSTRACT: The objective of this study was to determine whether there is an association between excessive root resorption and immune system factors in a sample of Japanese orthodontic patients. The records of 60 orthodontic patients (18 males, age 17.7 +/- 5.7 years; 42 females, age 16.4 +/- 6.0 years) and 60 pair-matched controls (18 males, age 15.9 +/- 4.5 years; 42 females, age 18.5 +/- 5.2 years) based on age, sex, treatment duration, and the type of malocclusion were reviewed retrospectively. The validity of our hypothesis was tested using the logistic regression analysis. The pretreatment records revealed that the incidence of allergy and root morphology abnormality was significantly higher in the root resorption group (P = .030 and .001), with a mean odds ratio of 2.794 and 6.317 and 95% confidence interval of 1.107-7.053 and 2.043-19.537, respectively. The incidence of asthma also tended to be higher in the root resorption group. From these results, we concluded that allergy, root morphology abnormality, and asthma may be high-risk factors for the development of excessive root resorption during orthodontic tooth movement in Japanese patients.
    The Angle Orthodontist 02/2006; 76(1):103-8. DOI:10.1043/0003-3219(2006)076[0103:RRAISF]2.0.CO;2 · 1.28 Impact Factor

Publication Stats

255 Citations
27.13 Total Impact Points

Institutions

  • 2006–2011
    • Jacksonville University
      Jacksonville, Florida, United States
  • 2005–2009
    • Kyushu University
      • Faculty of Dental Science
      Hukuoka, Fukuoka, Japan
  • 2008
    • Jacksonville State University
      Джексонвилл, Alabama, United States
  • 2001–2004
    • Oklahoma City University
      Oklahoma City, Oklahoma, United States
  • 2002
    • University of Oklahoma
      • College of Dentistry
      Norman, Oklahoma, United States