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Biomedical subjects

J F Camilla Tulloch

Publications and source records attributed to J F Camilla Tulloch.

8 recordsLinked to original sources

Implantable devices as orthodontic anchorage: a review of current treatment modalities.

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.

Alveolar Process↗

Bond strengths and adhesive remnant index of self-etching adhesives used to bond brackets to instrumented and uninstrumented enamel.

PURPOSE: This study evaluated bond strengths of orthodontic brackets to instrumented and uninstrumented enamel using self-etching adhesive systems when compared to a total-etch adhesive system. The adhesive remnant index (ARI) was also determined after debonding. METHODS: 140 bovine incisors were included in acrylic resin, and divided randomly in two groups: instrumented vs. uninstrumented enamel. For the instrumented enamel, specimens had their facial enamel ground flat to 600-grit. In each group, specimens were subdivided into four experimental subgroups according to the adhesive technique used: Transbond Plus, Adper Prompt L-Pop, iBond, and Adper Single Bond, applied following manufacturers' instructions. Orthodontic brackets were bonded to the treated instrumented or uninstrumented enamel with Transbond XT light-cured resin-based composite cement, and the bond strength was tested in shear mode after 7 days. One group where no etch and no adhesive were used served as a control. ARI scores were determined after debonding. RESULTS: There was no statistically significant difference in mean bond strengths between instrumented and uninstrumented enamel for any of the adhesive systems (P > or = 0.05). No significant differences were observed for bond strengths among the adhesives tested (P = 0.308), and all experimental groups resulted in mean bond strengths significantly higher than the controls (P < 0.05). Statistically significant differences were identified when ARI scores were compared, with less adhesive remnants being observed for iBond (uninstrumented enamel) and the control groups (P < 0.05).

Acid Etching, Dental↗

Outcomes in a 2-phase randomized clinical trial of early Class II treatment.

In a 2-phased, parallel, randomized trial of early (preadolescent) versus later (adolescent) treatment for children with severe (>7 mm overjet) Class II malocclusions who initially were developmentally at least a year before their peak pubertal growth, favorable growth changes were observed in about 75% of those receiving early treatment with either a headgear or a functional appliance. After a second phase of fixed appliance treatment for both the previously treated children and the untreated controls, however, early treatment had little effect on the subsequent treatment outcomes measured as skeletal change, alignment, and occlusion of the teeth, or length and complexity of treatment. The differences created between the treated children and untreated control group by phase 1 treatment before adolescence disappeared when both groups received comprehensive fixed appliance treatment during adolescence. This suggests that 2-phase treatment started before adolescence in the mixed dentition might be no more clinically effective than 1-phase treatment started during adolescence in the early permanent dentition. Early treatment also appears to be less efficient, in that it produced no reduction in the average time a child is in fixed appliances during a second stage of treatment, and it did not decrease the proportion of complex treatments involving extractions or orthognathic surgery.

Adolescent↗

External apical root resorption in Class II malocclusion: a retrospective review of 1- versus 2-phase treatment.

External apical root resorption (EARR) is an imperfectly understood problem of orthodontic treatment. The records of 138 children with Class II malocclusion (overjet > 7 mm) participating in a randomized clinical trial of early orthodontic treatment were reviewed. The patients were treated in either 1 phase with fixed appliances only (n = 49) or 2 phases with headgear (n = 49) or bionator (n = 40) followed by fixed appliances. The 3 groups were similar in age, sex, and malocclusion severity at enrollment. The records examined included anamnestic data, clinical examination records, panoramic radiographs before and after fixed appliance therapy, and posttreatment periapical radiographs. All radiographs were reviewed and scored independently by 2 examiners for maxillary incisor root development, morphology, and EARR. Of the 532 incisors scored, 11% of central and 14% of lateral incisors demonstrated moderate to severe (>2 mm) EARR. The proportion of incisors with moderate to severe EARR was slightly greater in the 1-phase treatment group. There was no difference in the incidence of EARR between teeth that had had trauma and those that had not, and there was only a slight increase in frequency of root resorption in teeth with unusual root morphology. Significant associations exist among EARR, the magnitude of overjet reduction, and the time spent wearing fixed appliances. However, not all incisors in a child respond in the same way, so other variables must play a role in determining the root response to orthodontic forces.

Child↗

Incisor trauma and early treatment for Class II Division 1 malocclusion.

This study investigated incisor trauma in children with overjets greater than or equal to 7 mm who were enrolled in a clinical trial of 2-phase early orthodontic treatment for Class II malocclusion. In phase 1, children were randomly assigned to treatment in the mixed dentition with either modified bionator or combination headgear or to a group in which treatment was delayed until the permanent dentition. All children received comprehensive treatment during phase 2 if necessary. At the start of the trial, 29.1% of the patients had already had some incisor trauma. This was not significantly related to dental developmental age. During the trial, there was an increase in trauma in all 3 groups, but the magnitude of this increase was not significantly greater in the group for which treatment was delayed until the permanent dentition. This might suggest that orthodontic intervention aimed at reducing trauma should begin very soon after the eruption of the maxillary incisors. However, the injuries tended to be minor, and the expected cost of treatment related to incisor trauma was small compared with the expected additional cost of a 2-phase orthodontic intervention.

Activator Appliances↗