J.F. Camilla Tulloch’s research while affiliated with University of North Carolina at Chapel Hill and other places

Early Class III treatment with reverse-pull headgear generally results in maxillary skeletal protraction but is frequently also accompanied by unfavorable dentoalveolar effects. An alternative treatment with intermaxillary elastics from a temporary anchorage device might permit equivalent favorable skeletal changes without the unwanted dentoalveolar effects. Six consecutive patients (3 boys, 3 girls; ages, 10-13 years 3 months) with Class III occlusion and maxillary deficiency were treated by using intermaxillary elastics to titanium miniplates. Cone-beam computed tomography scans taken before and after treatment were used to create 3-dimensional volumetric models that were superimposed on nongrowing structures in the anterior cranial base to determine anatomic changes during treatment. The effect of the intermaxillary elastic forces was throughout the nasomaxillary structures. All 6 patients showed improvements in the skeletal relationship, primarily through maxillary advancement with little effect on the dentoalveolar units or change in mandibular position. The use of intermaxillary forces applied to temporary anchorage devices appears to be a promising treatment method.

The objective of this study was to evaluate a new method for superimposition of 3-dimensional (3D) models of growing subjects. Cone-beam computed tomography scans were taken before and after Class III malocclusion orthopedic treatment with miniplates. Three observers independently constructed 18 3D virtual surface models from cone-beam computed tomography scans of 3 patients. Separate 3D models were constructed for soft-tissue, cranial base, maxillary, and mandibular surfaces. The anterior cranial fossa was used to register the 3D models of before and after treatment (about 1 year of follow-up). Three-dimensional overlays of superimposed models and 3D color-coded displacement maps allowed visual and quantitative assessment of growth and treatment changes. The range of interobserver errors for each anatomic region was 0.4 mm for the zygomatic process of maxilla, chin, condyles, posterior border of the rami, and lower border of the mandible, and 0.5 mm for the anterior maxilla soft-tissue upper lip. Our results suggest that this method is a valid and reproducible assessment of treatment outcomes for growing subjects. This technique can be used to identify maxillary and mandibular positional changes and bone remodeling relative to the anterior cranial fossa.

Einfuhrung: Die temporare skelettale Verankerung ist eine relativ junge kieferorthopadische ­Behandlungsmasnahme. Dabei sind chirurgische Osteosyntheseplatten, die mit intraoralen Attachments versehen sind, eine Alternative zu Minischrauben. In der vorliegenden Studie wurde die Verwendung von modifizierten Osteosyntheseplatten fur die kieferorthopadische Behandlung aus der Sicht von Patienten und von Behandlern untersucht. Methoden: Patienten, bei denen Miniplatten als Teil der kieferorthopadischen Behandlung ein­gesetzt worden waren, wurden anhand von Frage­bogen uber ihre Erfahrungen mit dem ­chirurgischen Eingriff und der nachfolgenden ­kie­fer­orthopadischen Behandlung befragt. Bei ins­ge­samt 97 Patienten waren 200 Miniplatten eingesetzt worden. Die insgesamt 30 Kiefer­ortho­pa­den, die diese Patienten behandelten, wurden ebenfalls mithilfe eines Fragebogens zum Erfolg der Miniplatten und zur Komplexitat im Umgang mit diesen Geraten befragt, sowie um Auskunft gebeten, ob die Behandlungen durch die Miniplatten ver­einfacht worden waren. Ergebnisse: Die Erfolgsrate betrug 92,5 %. Die Mini­platten wurden von den Patienten sehr gut toleriert. Nach einem Jahr berichteten 72 % der Patienten, dass sie das Implantat nicht store und 82 % waren der Ansicht, dass sie den chirurgischen Eingriff als weniger belastend empfunden hatten, als vorher befurchtet und dass sie nur ­geringe oder uberhaupt keine Schmerzen hatten. Das haufigste Problem stellten postoperative Schwellungen dar, die durchschnittlich 5 Tage anhielten. Ebenso kam es anfanglich bei mehr als einem Drittel der Patienten zu Irritationen der Wangenschleimhaut, die sich mit der Zeit verringerten. Die Behandler berichteten, dass die Gerate in der Anwendung einfach waren und die kieferorthopadische Behandlung in grosem Mase vereinfacht hatten. Schlussfolgerung: Modifizierte Osteosyntheseplatten werden von Patienten und Behandlern sehr gut angenommen und stellen ein sicheres und wirksames Hilfsmittel fur komplexe kieferorthopadische Behandlungen dar. Introduction: Temporary skeletal anchorage is a relatively recent addition to orthodontic treatment. Surgical miniplates, modified with intra­oral attachments, provide an alternative to mini­screws for skeletal anchorage. In this study, we wanted to determine patients’ and providers’ perceptions of miniplate use during orthodontic treatment. Methods: Consecutive patients having miniplates placed as part of their treatment completed questionnaires about their experiences during surgery and orthodontic treatment. A total of 200 miniplates were placed for 97 patients. The 30 orthodontists treating these patients also completed questionnaires concerning miniplate success, handling complexity, and whether these devices simplified treatment. Results: The success rate was 92.5 %. The devices were well tolerated by the patients. After a year, 72 % of the patients reported that they did not mind having the implant, and 82 % said that the surgical experience was better than expected, with little or no pain. The most frequent problems were postsurgical swelling, lasting 5 days on aver­age, and cheek irritation experienced initially by more than a third of the patients, but it lessened over time. The clinicians reported that these ­devices were easy to use and greatly simplified orthodontic treatment. Conclusions: Miniplates are well accepted by patients and providers and are a safe and effective adjunct for complex orthodontic treatments.

Skeletal anchorage systems are increasingly used in orthodontics. This article describes the techniques of placement and removal of modified surgical miniplates used for temporary orthodontic anchorage and reports surgeons' perceptions of their use. We enrolled 97 consecutive orthodontic patients having miniplates placed as an adjunct to treatment. A total of 200 miniplates were placed by 9 oral surgeons. Patients and surgeons completed questionnaires after placement and removal surgeries. Fifteen miniplates needed to be removed prematurely. Antibiotics and anti-inflammatories were generally prescribed after placement but not after removal surgery. Most surgeries were performed with the patient under local anesthesia. Placement surgery lasted on average between 15 and 30 minutes per plate and was considered by the surgeons to be very easy to moderately easy. The surgery to remove the miniplates was considered easier and took less time. The patients' chief complaint was swelling, lasting on average 5.3 +/- 2.8 days after placement and 4.5 +/- 2.6 days after removal. Although miniplate placement/removal surgery requires the elevation of a flap, this was considered an easy and relatively short surgical procedure that can typically be performed with the patient under local anesthesia without complications, and it may be considered a safe and effective adjunct for orthodontic treatment.

Temporary skeletal anchorage is a relatively recent addition to orthodontic treatment. Surgical miniplates, modified with intraoral attachments, provide an alternative to miniscrews for skeletal anchorage. In this study, we wanted to determine patients' and providers' perceptions of miniplate use during orthodontic treatment. Consecutive patients having miniplates placed as part of their treatment completed questionnaires about their experiences during surgery and orthodontic treatment. A total of 200 miniplates were placed for 97 patients. The 30 orthodontists treating these patients also completed questionnaires concerning miniplate success, handling complexity, and whether these devices simplified treatment. The success rate was 92.5%. The devices were well tolerated by the patients. After a year, 72% of the patients reported that they did not mind having the implant, and 82% said that the surgical experience was better than expected, with little or no pain. The most frequent problems were postsurgical swelling, lasting 5 days on average, and cheek irritation experienced initially by more than a third of the patients, but it lessened over time. The clinicians reported that these devices were easy to use and greatly simplified orthodontic treatment. Miniplates are well accepted by patients and providers and are a safe and effective adjunct for complex orthodontic treatments.

Our aim was to review the experimental literature to determine what is known about functional and morphological tissue reactions around orthodontically loaded temporary skeletal anchorage devices. The PubMed electronic database and the reference citations in published articles were searched to the end of April 2006. The inclusion criteria were animal studies about orthodontically loaded skeletal anchorage consisting of metallic bone plates or screw implants of 2.2 mm diameter or less. Data on healing time, force application, stability, side effects, and osseointegration were collected by 2 independent readers. Eight articles met the selection criteria. The healing times ranged from 0 to 12 weeks, and the amount of force varied from 25 to 500 g. Implant stability was generally achieved without severe side effects. Direct bone-screw contact was reported to be 10% to 58%, and osseointegration increased with loading time. Nevertheless, no significant difference in bone-screw contact was found between loaded and unloaded screw implants, or between tension and pressure sides of loaded implants. This review highlights some positive experimental findings that apply in clinical practice. However, questions concerning optimal force systems, surgical techniques and placement, and healing times remain. Future research should be well controlled and based on standardized protocols to test specific hypotheses.

Results of the annual American Dental Education Association surveys of dental school seniors show approximately 10 percent of graduates enter federal government services while less than 1 percent enter dental academia. To examine this difference, this study sought the perceptions of senior dental students and junior military dental officers regarding their choice of a military career in order to determine how military recruitment strategies influenced their career decisions. Official documents explaining military recruitment efforts were requested from the military services and summarized. In-depth telephone interviews were conducted to gather perception data from the students and dental officers on successful strategies. By employing several strategies, the military was able to inform potential recruits about the benefits of being a dentist in the military. The opportunity to have the military finance a student's dental education was a successful military recruitment tool. Other enticing factors included guaranteed employment upon graduation, prestige associated with serving in the military, access to postgraduate training, minimal practice management responsibilities, and opportunities to continue learning and improve clinical skills without significant financial implications. It was concluded that dental education can use the same strategies to highlight the benefits of an academic career and offer many similar incentives that may encourage students to consider a career path in dental education.

This paper presents image processing methods for the computation of morphometric changes associated with jaw surgery, precisely locating jaw displacements and quantitatively describing the vectors of displacement. The proposed methods rely on a rigid, normalized mutual-information approach to register one image to another on anatomic structures unaltered by surgery in order to evaluate within-subject changes. After registration, the location and magnitude of changes over time are assessed via graphical overlays and calculation of the Euclidean distances between the surfaces. The resulting 3D graphical display of the magnitude of displacements between two segmentations is color-coded. The direction of displacement is shown by the mean vectors of displacement, within lines that graph connecting points of equal values. (NIDCR DE017727-02 and DE005215-26).

Unlabelled: Recently, there has been a dramatic increase in the use of implantable devices as direct adjuncts to orthodontic treatment. Whereas the use of conventional dental implants has been researched extensively, the body of literature associated with the more recent uses of implantable devices in orthodontics is relatively small. Currently, a limited number of such devices are used to aid in orthodontic treatment. The options include conventional titanium endosseous dental implants, palatal implants, titanium miniscrews (also known as micro- or mini-implants), and mini-bone plates. Integration of dental implants or implantable devices into contemporary orthodontic practice has the following possible advantages: serving as a means of increasing orthodontic anchorage, virtually eliminating patient compliance issues with regard to wearing of appliances, decreasing overall treatment time, and occasionally permitting orthodontic treatments previously thought to be impossible without surgery. Clinical significance: This article is a review of the currently available options for use of implantable devices as sources of temporary skeletal anchorage in orthodontics.

Recently, there has been a dramatic increase in the use of implantable devices as direct adjuncts to orthodontic treatment. Whereas the use of conventional dental implants has been researched extensively, the body of literature associated with the more recent uses of implantable devices in orthodontics is relatively small. Currently, a limited number of such devices are used to aid in orthodontic treatment. The options include conventional titanium endosseous dental implants, palatal implants, titanium miniscrews (also known as micro- or mini-implants), and mini-bone plates. Integration of dental implants or implantable devices into contemporary orthodontic practice has the following possible advantages: serving as a means of increasing orthodontic anchorage, virtually eliminating patient compliance issues with regard to wearing of appliances, decreasing overall treatment time, and occasionally permitting orthodontic treatments previously thought to be impossible without surgery. CLINICAL SIGNIFICANCE: This article is a review of the currently available options for use of implantable devices as sources of temporary skeletal anchorage in orthodontics.