Orthodontic extractions and the Internet: Quality of online information available to the public
Urvi Patel and Martyn T. Cobourne. Am J Orthod Dentofacial Orthop 2011;139:e103-e109
Introduction: The aim of this study was to evaluate the quality of information available on the Internet for a person interested in orthodontic extractions. Methods: The term “orthodontic extractions” was entered into the search engines of both Google and Yahoo, and the first 50 Web links for each were pooled and examined. Exclusion criteria consisted of repetitions, sites requiring registration or login, and those accessing scientific articles. Sites fulfilling the criteria for inclusion were examined by using the LIDA instrument, a validated method of evaluating health care Web sites, based on accessibility, usability, and reliability. The readability of each site was further assessed by using the Flesch reading ease score. Results: Of the 100 Web sites identified, 21 were suitable for inclusion and scoring. Overall, the mean total LIDA score was 93 of a possible 144 (65%) (range, 71-116 or 49%-81%). No Web site scored above an arbitrary gold standard of 90%; however, most (20 of 21) scored above 50%. With the LIDA instrument, average accessibility was 70%, average usability was 72%, and average reliability was 41%. The average Flesch reading ease score was 58.3. Conclusions: Overall, the quality of information available on the Internet with regard to orthodontic extractions is variable. Although readability is generally good, reliability is a cause for concern, and patients should interpret many of these sites with caution. The top-rated Web sites in a search engine are not necessarily those of the highest quality.
Duration of treatment and occlusal outcome using Damon3 self-ligated and conventional orthodontic bracket systems in extraction patients: A prospective randomized clinical trial
Andrew T. DiBiase, Inas H. Nasr, Paul Scott, and Martyn T. Cobourne. Am J Orthod Dentofacial Orthop 2011;139:e111-e116
Introduction: This was a prospective randomized clinical trial comparing the effect of bracket type on the duration of orthodontic treatment and the occlusal outcome as measured by the peer assessment rating (PAR). Methods: A multi-center randomized clinical trial was carried out in 2 orthodontic clinics. Sixty-two subjects (32 male, 30 female; mean age, 16.27 years) with a mean pretreatment PAR score of 39.40, mandibular irregularity from 5 to 12 mm, and prescribed extractions including mandibular first premolars were randomly allocated to treatment with either the Damon3 self-ligated or the Synthesis conventional ligated preadjusted bracket systems (both, Ormco, Glendora, Calif). An identical archwire sequence was used in both groups excluding the finishing archwires: 0.014-in, 0.014 × 0.025-in, and 0.018 × 0.025-in copper-nickel-titanium aligning archwires, followed by 0.019 × 0.025-in stainless steel working archwires. Data collected at the start of treatment and after appliance removal included dental study casts, total duration of treatment, number of visits, number of emergency visits and breakages during treatment, and number of failed appointments. Results: Sixty-two patients were recruited at the start of treatment, and the records of 48 patients were analyzed after appliance removal. Accounting for pretreatment and in-treatment covariates, bracket type had no effect on overall treatment duration, number of visits, or overall percentage of reduction in PAR scores. Time spent in space closure had an effect on treatment duration, and the pretreatment PAR score influenced only the reduction in PAR as a result of treatment. Conclusions: Use of the Damon3 bracket does not reduce overall treatment time or total number of visits, or result in a better occlusal outcome when compared with conventional ligated brackets in the treatment of extraction patients with crowding.
Duration of treatment and occlusal outcome using Damon3 self-ligated and conventional orthodontic bracket systems in extraction patients: A prospective randomized clinical trial
Andrew T. DiBiase, Inas H. Nasr, Paul Scott, and Martyn T. Cobourne. Am J Orthod Dentofacial Orthop 2011;139:e111-e116
Introduction: This was a prospective randomized clinical trial comparing the effect of bracket type on the duration of orthodontic treatment and the occlusal outcome as measured by the peer assessment rating (PAR). Methods: A multi-center randomized clinical trial was carried out in 2 orthodontic clinics. Sixty-two subjects (32 male, 30 female; mean age, 16.27 years) with a mean pretreatment PAR score of 39.40, mandibular irregularity from 5 to 12 mm, and prescribed extractions including mandibular first premolars were randomly allocated to treatment with either the Damon3 self-ligated or the Synthesis conventional ligated preadjusted bracket systems (both, Ormco, Glendora, Calif). An identical archwire sequence was used in both groups excluding the finishing archwires: 0.014-in, 0.014 × 0.025-in, and 0.018 × 0.025-in copper-nickel-titanium aligning archwires, followed by 0.019 × 0.025-in stainless steel working archwires. Data collected at the start of treatment and after appliance removal included dental study casts, total duration of treatment, number of visits, number of emergency visits and breakages during treatment, and number of failed appointments. Results: Sixty-two patients were recruited at the start of treatment, and the records of 48 patients were analyzed after appliance removal. Accounting for pretreatment and in-treatment covariates, bracket type had no effect on overall treatment duration, number of visits, or overall percentage of reduction in PAR scores. Time spent in space closure had an effect on treatment duration, and the pretreatment PAR score influenced only the reduction in PAR as a result of treatment. Conclusions: Use of the Damon3 bracket does not reduce overall treatment time or total number of visits, or result in a better occlusal outcome when compared with conventional ligated brackets in the treatment of extraction patients with crowding.
Effect of bone thickness on alveolar bone-height measurements from cone-beam computed tomography images
Zongyang Sun, Tharon Smith, Sahira Kortam, Do-Gyoon Kim, Boon Ching Tee, and Henry Fields. Am J Orthod Dentofacial Orthop 2011;139:e117-e127
Introduction: Cone-beam computed tomography (CBCT) has been used to assess alveolar bone changes after rapid palatal expansion. The purpose of this study was to investigate the accuracy of alveolar bone-height measurements from CBCT images with varied bone thicknesses and imaging resolutions. Methods: Eleven maxillary specimens from 6-month-old pigs were measured for alveolar bone height (distance between drilled reference holes and alveolar crests) at 6 locations with a digital caliper, followed by CBCT scanning at 0.4-mm and 0.25-mm voxel sizes. Buccal alveolar bone of these locations was then reduced approximately by 0.5 to 1.5 mm, followed by CBCT rescanning with the same voxel sizes. The CBCT images were measured by using 3-dimensional software to determine alveolar bone height and thickness in buccolingual slices by independent, blinded raters. The specimens were subsequently cut into buccolingual sections at reference-hole levels, and direct bone height and thickness were measured from these sections. Intrarater and interrater repeatability and the differences between CBCT and direct measurements were assessed. Results: Excellent intrarater (intraclass correlations, r = 0.89-0.98) and good interrater (r = 0.64-0.90) repeatability values were found for alveolar bone-height measurements from the CBCT images. Before alveolar bone reduction, the thickness was much greater than the CBCT voxel size (0.4 mm), and bone-height measurements from the CBCT images were 0.5 to 1 mm more than the direct measurements (paired t tests, P <0.017 at most locations). After bone reduction, the thickness at the subcrest 1-mm level was near or below the CBCT voxel size (0.4 mm), and bone-height measurements from the CBCT images were 0.9 to 1.2 mm less than the direct measurements (paired t tests, P <0.017 at most locations). These measurement inaccuracies were substantially improved by decreasing the CBCT voxel size to 0.25 mm. Conclusions: Alveolar bone-height measurements from conventional clinical 0.4-mm voxel size CBCT images might overestimate alveolar bone-height loss associated with rapid palatal expansion.
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