Volume 15, No.5 - November 1999

Original Articles

Brackets, epitopes and flash memory cards: a futuristic view of clinical orthodontics
Milton R. Sims
Australian Orthodontic Journal 15(5):260-8

Bone induction using autogenous bone mixed with demineralised bone matrices
A. Bakr M. Rabie, Ricky W. K.Wong, Urban Hägg
Australian Orthodontic Journal 15(5):269-75

Smoking patterns in adolescent orthodontic patients and school children
Anthony R. Collett, Jenny C. Mather, Michael Phillips
Australian Orthodontic Journal 15(5):276-83

Longidutinal cephalometric changes in the maxilla, mandible and maxillary-mandibular relationship between 10 and 14 years of age
Sahsene Aydemir, Ismail Çeylan, Ü. Barçin Eröz
Australian Orthodontic Journal 15(5):284-8

The community and orthodontic care
Part II: Community-perceived importance of correcting various dentofacial anomalies
Part III: Community perception of the importance of orthodontic treatment
Rhonda Coyne, Michael Woods, Richard Abrams
Australian Orthodontic Journal 15(5): 289-301
Australian Orthodontic Journal 15(4):246-50

Case Reports

Orthodontic management of a patient with Epidermolysis Bullosa
Felix Goldschmied
Australian Orthodontic Journal 15(5): 302-7

A comparison of autotransplantation and orthodontics in a case exhibiting two ectopic upper cuspids
Paul M. Schneider
Australian Orthodontic Journal 15(5): 308-12

Begg Appliance management of a moderately crowded Angle Class II division 2 malocclusion
H.C.W. Ho, C.W. Dreyer
Australian Orthodontic Journal 15(5): 313-19

An extended three-stage treatment to correct a severe skeletal and dental discrepancy
Grahame J. Moore
Australian Orthodontic Journal 15(5): 320-49

Brackets, epitopes and flash memory cards: a futuristic view of clinical orthodontics
Milton R. Sims

Orthodontics continues to be a profession anchored in traditional technology using appliances that cause inflammatory periodontal ligament (PDL) responses. Existing concepts of biological tooth movement based largely on histological tissue observations and the application of physical principles require major reassessment. In the next millennium, the genome revolution and knowledge of protein production and control could lead to the genetic correction of dentofacial anomalies and pain-free, biomolecular methods of malocclusion correction and long-term stability. A fundamental change is likely to be the abolition of bracket systems and their replacement with preprogrammed microchips driven by computers, and the control of PDL blood vessels and cells by pharmacological targeting. Future survival of the profession will depend on a radically different specialist who will be educated with a postgraduate curriculum based on molecular biology and computer engineering.

Received for publication: January 1999
Accepted: July 1999
Aust Orthod J 1999; 15(5): 260-8

Bone induction using autogenous bone mixed with demineralised bone matrices
A. Bakr M. Rabie, Ricky W. K. Wong, Urban Hägg

The aim of the present study was to examine the healing of endochondral (EC) autogenous bone grafts in the presence of demineralised bone matrix prepared from intramembranous bone (DBMIM), or prepared from endochondral bone (DBMEC) using quantitative analysis. Thirty bone defects were created on the parietal bone of fifteen New Zealand White rabbits. In the experimental groups, five defects were grafted with EC bone, five defects were grafted with EC bone mixed with DMBIM (EC-DBMIM) and six defects were grafted with EC bone mixed with DBMEC (EC-DBMEC). In the control groups, ten defects were left empty (passive control) and four defects were grafted with rabbit skin collagen (positive control). They were all sacrificed at day fourteen post grafting, and the defects were prepared for histological analysis. Serial sections were cut across the whole defect. Quantitative analysis was performed on 152 sections of the experimental groups by image analysis. Four hundred and fourteen per cent more new bone was formed in defects grafted with composite EC-DBMIM than those grafted with EC bone alone (p<0.001). Eighty-five per cent more new bone was formed in defects grafted with composite EC-DBMEC than those grafted with EC bone alone (p<0.001). No bone was formed in either passive or positive controls. In conclusion, DBM, especially DBMIM, have extremely high esteoinductive properties and greatly enhance the integration of EC bone grafts with defects created in IM bone.

Received for publication: November 1998
Accepted: July 1999
Aust Orthod J 1999; 15(5): 269-75

Smoking patterns in adolescent orthodontic patients and school children
Anthony R. Collett, Jenny C. Mather, Michael Phillips

Smoking is known to be widely practised by young adults and teenagers, a fact that is of immediate importance to the orthodontic profession as it is now well accepted that smokers have poorer periodontal health than non-smokers. The aim of the present study was to determine the level of smoking in teenage orthodontic patients and compare it with that in the general teenage population and, further, to examine how these smoking habits are influenced by the subjects’ attitudes. Patients were surveyed as to their smoking habits and attitudes. All were between 10 and 18 years of age and undergoing active fixed-appliance therapy. The same survey was distributed to a local primary (elementary) school and local secondary (high) schools. Of the 729 school respondents, 29 per cent were classified as smokers; of the 333 respondents in the orthodontic group, 11 per cent were classified as smokers. Although the level of smoking amongst orthodontic patients appears to be lower than that for the general adolescent population, significant numbers of patients smoke on a regular basis, and a small proportion of these is under 13 years of age. Because they have contact over a number of years with their adolescent patients, orthodontists are in a favourable position to reinforce non-smoking behaviour.

Received for publication: December 1998
Accepted: June 1999
Aust Orthod J 1999; 15(5): 276-83

Longitudinal cephalometric changes in the maxilla, mandible and maxillary-mandibular relationship between 10 and 14 years of age
Sahsene Aydemir, Ismail Çeylan, Ü. Barçin Eröz

In the present study, longitudinal growth changes in the maxilla, mandible, and maxillary-mandibular relationship occurring between the ages of 10 and 14 years were evaluated in 19 female and 15 male subjects. All subjects had a clinically-acceptable occlusion, a normal growth pattern, and none had undergone orthodontic treatment. Serial cephalometric radiographs were taken at the ages of 10, 11, 12, and 14 years. The effects of age and sex on the sagittal growth of the jaws were studied by means of variance analysis. The results show that A-Ptm, B-Ptm, Pg-Ptm, A’-Ptm, and S-N-Pg measurements were affected by age, and the measurements A-Ptm, A’-Ptm, Wits and ANB by sex. Duncan’s multiple range test was applied to those measurements where F values were found to be statistically significant. As a result, it was observed that the greatest growth changes occurred between 12 and 14 years old.

Received for publication: March 1997
Accepted: January 1999
Aust Orthod J 1999; 15(5): 284-8

The community and orthodontic care
Part II: Community-perceived importance of correcting various dentofacial anomalies
Part III: Community perception of the importance of orthodontic treatment
Rhonda Coyne, Michael Woods, Richard Abrams

Part II: A professionally-managed telephone survey was undertaken to assess the community-perceived importance of correcting various dentofacial anomalies. The sample included 505 respondents, aged eighteen and over, from metropolitan and non-metropolitan households across the state of Victoria. The sample distribution had a 95 per cent confidence limit with a 5 per cent margin of error and closely matched the known population distributions for age, sex and geographical location. This article forms part two of a series. It was found that the correction of functional problems such as "difficulty chewing or speaking" was considered to be very important, regardless of age, sex or geographical area. The correction of other factors such as "top teeth which stick out in front", "bottom teeth which stick out in front" or "crooked or crowded front teeth" was also considered to be important. "Spaced front teeth" was the factor considered least important for correction within all groups. It is interesting to note that, for all factors, correction seemed to be considered more important by females and non-metropolitan respondents than by males and metropolitan respondents, respectively. In contrast to previous studies in which it has been suggested that patients seek treatment mainly for reasons of aesthetics, the results of this study have shown a definite community recognition of the importance of functional problems as well.

Part III: A professionally-managed telephone survey was undertaken to assess the community’s perceptions of the importance of having "straight teeth and a nice smile", to assess if a Medicare (the Australian government health benefit scheme) rebate should be provided for orthodontic treatment, and to assess whether respondents had any private health insurance that would help cover the cost of orthodontic treatment. The sample included 505 respondents, aged eighteen and over, from metropolitan and non-metropolitan households across the state of Victoria. The sample distribution had a 95 per cent confidence limit with a 5 per cent margin of error and closely matched the known population distributions for age, sex and geographical location.
It was found that a very large percentage of respondents considered the need for "straight teeth and a nice smile" to be very important. This finding is supported by the many studies showing the importance of facial attractiveness to the lives of all people, young and old. Only a small percentage of respondents indicated that they had any private dental health insurance that would help cover the cost of orthodontic treatment, and over 70 per cent indicated that the government should provide some Medicare rebate for orthodontic treatment. Efforts should be made to inform those responsible for the planning of orthodontic services in both the public and private sectors of the importance of the community’s perceptions of aesthetics, and the large amount of published work that reinforces the impact of facial attractiveness of people’s lives.

Received for publication: July 1999
Accepted: October 1999
Aust Orthod J 1999; 15(5): Part II; 289-95; Part III; 296-301

Case report: Orthodontic management of a patient with Epidermolysis Bullosa
Felix Goldschmied

This case report received the Harry Barrer Award for the Best of Show by an International Affiliate Member, from the North American Society for the Study of Orthodontics, in October 1996.

A male patient with a dental malocclusion presented with Epidermolysis Bullosa, a group of genetically determined diseases characterised by abnormal fragility of the skin and mucosa. Described is the management of the patient utilising Begg Light Wire fixed-appliance orthodontic treatment.

Received for publication: September 1999
Accepted: October 1999
Aust Orthod J 1999; 15(5): 302-7

Case report: A comparison of autotransplanation and orthodontics in a case exhibiting two ectopic upper cuspids
Paul M. Schneider

This case report was one of the winners of the Australasian Edgewise Study Group awards for 1997.

Bilateral severely ectopic maxillary cuspids were treated differently on each side. On one side the ectopic cuspid was moved into position orthodontically, and on the other, the ectopic cuspid was positioned by autotransplantation. The orthodontic positioning took a long time and the tooth exhibited root resorption. Treatment time for the autotransplantation positioning was far quicker, and there was no resorption nor were there any other side effects.
Received for publication: August 1999

Accepted: September 1999
Aust Orthod J 1999; 15(5): 308-12

Case report: Begg appliance management of a moderately crowded Angle Class II division 2 malocclusion
H. C.W. Ho, C. W. Dreyer

A case is presented that shows Begg appliance management of an Angle Class II division 2 malocclusion. The judicious use of anchorage bends and Class II elastics enabled the successful treatment of the poor posterior and anterior relationships, at the same time addressing the chief complaint of crooked front teeth.
Received for publication: January 1999

Accepted: January 1999
Aust Orthod J 1999; 15(5): 313-19

Case report: An extended three-stage treatment to correct a severe skeletal and dental discrepancy
Grahame J. Moore

This case report was one of the winners of the Australasian Edgewise Study Group awards for 1997.

A report of a case of extended treatment of a patient with severe mandibular retrognathism and an Angle Class I division 1 malocclusion. Initial fixed appliance treatment reduced incisor protrusion. A second phase utilising a Teuscher appliance achieved improved facial and dental relations through excellent mandibular growth. A third phase of fixed Edgewise treatment finalised dental relations.

Received for publication: July 1999
Accepted: September 1999
Aust Orthod J 1999; 15(5): 320-4