Midpalatal suture maturation in adults
Kwak KH, Kim SS, Kim YI, Kim YD. Quantitative evaluation of midpalatal suture maturation via fractal analysis. Korean J Orthod 2016;46:323-30
Nonsurgical rapid maxillary expansion is often contraindicated in adults due to fusion of the midpalatal suture; however, the timing and extent of suture closure are highly variable. The purpose of this study was to evaluate whether fractal analysis (a mathematical procedure) of cone-beam computed tomography data can be used to determine the maturation stage of the palatal suture. The sample consisted of 131 adult patients who had undergone cone-beam computed tomography imaging for diagnostic purposes. The principal investigator used the maturation classification system of Angelieri et al to categorize midpalatal suture closure. A fractal dimension value was also determined for each midpalatal suture with Image J computer software. The results showed a strong negative correlation between the fractal dimension and the suture maturation stage. Additionally, the fractal dimension was a statistically significant predictor of suture fusion. The authors explained that the classification system of Angelieri et al can be a subjective tool because much training is required for proficiency. Fractal analysis is a more objective and highly reliable method of determining suture fusion. There are currently some problems with the technique used in this study. The patient’s bone density is not taken into account; this hinders the accuracy of the results. The fractal dimension calculation method also needs to be refined to prevent extensive errors. Further studies using fractal analysis may develop an objective method for clinicians to determine the midpalatal suture fusion and the feasibility of rapid maxillary expansion in adults.
Reviewed by Erin Riley
Orthodontic bonding with and without primer
Bazargani F, Magnuson A, Löthgren H, Kowalczyk A. Orthodontic bonding with and without primer: a randomized controlled trial. Eur J Orthod 2016;38:503-7
Orthodontists everywhere continue to look for ways to decrease treatment time, increase efficiency, and lower overhead costs. Ensuring adequate bonding of brackets reduces bond failures and thus may decrease the number and length of appointments during treatment. The purposes of this study were to evaluate the incidence of failures of brackets bonded with primer (Transbond MIP) and without primer and to assess whether there is a difference in the numbers of emergency visits. Fifty consecutive patients needing conventional bimaxillary fixed appliances were recruited and enrolled in the study. A cross-mouth design was used in each patient. Two diagonal quadrants (maxillary right and mandibular left, or vice versa) were randomly assigned to the primer group (control) and the contralateral diagonal quadrants to the nonprimer group (experimental). The total failure rates were 5.5% in the nonprimer group and 3.1% in the primer group; this was not statistically significant. The failure rate differences between the groups showed a significant interaction with age. In younger patients (ages, 10-13 years), the failure rate of brackets bonded without primer (12.1%) was significantly higher than that of brackets bonded with primer (4.1%). Among older patients (14-18 years), the difference in failure rates between the nonprimer (2.3%) and the primer (2.6%) groups was not significant. The authors also found that boys are more likely to break brackets than are girls, and that mandibular bond failures are more frequent than maxillary failures. The authors concluded that the failure rates of bonding brackets with or without Transbond MIP primer did not differ significantly in a clinical setting (5.5% vs 3.1%); however, younger patients (10-13 years) may benefit from the use of a primer.
Reviewed by Jeffrey Birg
Orthodontic bonding with and without primer
Bazargani F, Magnuson A, Löthgren H, Kowalczyk A. Orthodontic bonding with and without primer: a randomized controlled trial. Eur J Orthod 2016;38:503-7
Orthodontists everywhere continue to look for ways to decrease treatment time, increase efficiency, and lower overhead costs. Ensuring adequate bonding of brackets reduces bond failures and thus may decrease the number and length of appointments during treatment. The purposes of this study were to evaluate the incidence of failures of brackets bonded with primer (Transbond MIP) and without primer and to assess whether there is a difference in the numbers of emergency visits. Fifty consecutive patients needing conventional bimaxillary fixed appliances were recruited and enrolled in the study. A cross-mouth design was used in each patient. Two diagonal quadrants (maxillary right and mandibular left, or vice versa) were randomly assigned to the primer group (control) and the contralateral diagonal quadrants to the nonprimer group (experimental). The total failure rates were 5.5% in the nonprimer group and 3.1% in the primer group; this was not statistically significant. The failure rate differences between the groups showed a significant interaction with age. In younger patients (ages, 10-13 years), the failure rate of brackets bonded without primer (12.1%) was significantly higher than that of brackets bonded with primer (4.1%). Among older patients (14-18 years), the difference in failure rates between the nonprimer (2.3%) and the primer (2.6%) groups was not significant. The authors also found that boys are more likely to break brackets than are girls, and that mandibular bond failures are more frequent than maxillary failures. The authors concluded that the failure rates of bonding brackets with or without Transbond MIP primer did not differ significantly in a clinical setting (5.5% vs 3.1%); however, younger patients (10-13 years) may benefit from the use of a primer.
Reviewed by Jeffrey Birg
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