ABO certification in the age of evidence and enhancement

Opening and closure forces of sliding mechanisms of different self-ligating brackets

Self-ligating brackets engage the wire by means of a slide mechanism. Forces that have to be applied to open and close the sliding mechanism of brackets are still unknown.

OBJECTIVE

The aim of this study was to measure and compare the opening and closure forces of different self-ligating brackets.

MATERIAL AND METHODS

Three different stainless steel self-ligating brackets (Carriere LX, Ortho Organizers; F1000, Leone; Damon Q, Ormco) were tested. For each different bracket, 20 maxillary right central incisors and 20 mandibular right central incisors were used. Opening and closure forces were measured using an Instron Universal Testing Machine. Statistical analysis was performed and ANOVA and Tukey tests were carried out.

RESULTS

Opening forces were registered between 1.1 N and 5.6 N, whereas closure forces were recorded between 1.57 N and 4.87 N. Significant differences were detected among the different brackets and between the two prescriptions tested.

CONCLUSION

The knowledge of different opening and closure forces of self-ligating brackets can help the orthodontist in the clinical management of these devices.

Quality of orthodontic treatment performed by orthodontists and general dentists

OBJECTIVE

To perform a blind comparative evaluation of the quality of orthodontic treatment provided by orthodontists and general dentists.

MATERIALS AND METHODS

Sixty cases of orthodontic treatment were evaluated-30 treated by specialists in orthodontics and 30 treated by general dentists with no specialization course. Orthodontists were selected randomly by lots, in a population of 1596 professionals, and recordings were performed based on the guideline established by the Objective Grading System proposed by the American Board of Orthodontics. Each participant was asked to present a case considered representative of the best outcome among the cases treated, regardless of the type or initial severity of the malocclusion. Statistical analysis involved the chi-square, Wilcoxon, and Mann-Whitney tests. The level of significance was set at P  =  .05 for the statistical tests.

RESULTS

The results showed that 29 orthodontists (96.7%) presented cases considered satisfactory and would be approved on the qualification exam, whereas only 15 dentists (50%) had cases considered satisfactory. Moreover, treatment time was significantly shorter among the orthodontists (P  =  .022), and the posttreatment comparison revealed that orthodontists achieved better outcomes considering all the variables studied.

CONCLUSIONS

Orthodontists spend less time on treatment and achieve better quality outcomes than cases treated by general dentists who have not undergone a specialization course in orthodontics.

Future practice plans of orthodontic residents in the United States

INTRODUCTION

The purpose of this study was to investigate the future clinical practice plans of orthodontic residents in the United States.

METHODS

All program chairs and directors of the 65 US orthodontic residency programs were contacted by e-mail and telephone and asked for permission to e-mail their residents and invite them to take part in an anonymous 57-item questionnaire online. A total of 335 e-mails from 37 programs were obtained, and the survey was sent in May 2007. Basic statistics including chi-square comparative analyses were performed by sex, age, and year of program.

RESULTS

A total of 63.04% of orthodontic residents plan to use self-ligating brackets; 84.06% plan to use Invisalign (Align Technology, Santa Clara, Calif); 92.03% plan to use temporary anchorage devices, and 72.26% plan on placing them themselves; 28.26% plan to use cone-beam computerized tomography; 92.75% plan to use a digital imaging program; 45.65% plan to use indirect bonding; and 10.87% plan to use lingual orthodontics. A total of 70.07% plan to use 2-phase treatment, and 61.59% said they will use functional appliances. A total of 81.16% plan to become certified by the American Board of Orthodontics, but only 18.12% thought certification should be mandatory for licensure; 36.50% indicated that a master of science degree should be required in their program, and 77.94% believe that a 24- to 30-month program adequately prepares them for future orthodontic practice.

CONCLUSIONS

Newer orthodontic technologies such as self-ligating brackets, temporary anchorage devices, and Invisalign as well as functional appliances are expected to grow in popularity in the United States because of projected future use by orthodontic residents. Two-phase orthodontic treatment with functional appliance mechanics will continue to be used. Most orthodontic residents will become certified by the American Board of Orthodontics but do not believe it should be necessary for licensure. Orthodontic residents in the United States believe that a 2-year program adequately prepares them for private practice.

Self-ligating brackets: present and future

Recently, there has been a resurgence in the use of self-ligating (SL) brackets, which were introduced in the early 20th century. From a synthesis of both in-vitro and in-vivo evidence-based literature, we present general concepts, principles, and axioms. The references to "active" and "passive" SL brackets are explained and juxtaposed in relation to their perceived advantages and disadvantages. We also present new concepts in regard to the future of SL brackets: combination bracket system, hybrid system, and selective use of SL brackets.

Orthodontic treatment of patients using bisphosphonates: A report of 2 cases

The pharmacologic agent bisphosphonate has recently received much attention in the dental literature. Bisphosphonates in oral or intravenous forms are used to treat various diseases such as certain cancers, bone- and calcium-related disorders, osteoporosis, and osteopenia. Bisphosphonates inhibit bone turnover and result in increased bone-mineral density. The most serious dental side effect of bisphosphonate treatment (particularly when it is administered intravenously) is, paradoxically, osteonecrosis of the mandible or the maxilla represented by exposed nonhealing bone. Other related complications include decreased bone healing and inhibition of orthodontic tooth movement. This article reports the orthodontic treatment of 2 patients who were taking bisphosphonates.