2013 AAO Annual Session Charley Schultz Resident Scholar Award
The Charley Schultz Resident Scholar Award program will be held on Saturday, May 4 in the
Pennsylvania Convention Center Room 108 from 1:00pm-2:00pm. Clinicians will be at their posterboards
during this time to answer questions about their research.
*- Denotes financial interest or visual enhancement
Basic Science Research
Dental Pulp-Derived Stem Cell (DPSC) Viability May Correlate with Patient Demographics
Charles Hill
University of Nevada - Las Vegas
This study examined whether four patient demographic factors - age, gender, ethnicity, and tooth type positively or negatively influenced the viability and survival of dental-pulp derived stem cells (DPSCs).
Pulp tissue was removed from extracted teeth, cultured in the laboratory, and surviving stem cells lines
were analyzed to determine whether any of the four demographic factors were predictive of viability.
These analyses demonstrated that only patient age and tooth type were found to have a positive
influence on the survival of DPSCs, with stem cell lines from premolars extracted from younger patients
ages 19-25 having the highest rates of survival. The results of this study may aid in creating evidence
based recommendations for patients who are considering undertaking the potentially costly process of
having their tissues stored for future use.
SBS
Stephanie Mai
University of Montreal
A literature-based clinical protocol is lacking for indirect bonding of metal to porcelain with autopolymerizing resin. Goal: compare bond strength of various surface treatments. 90 leucite discs (6
groups) were prepared with 6 mechanical (+/-bur) and chemical (hydrofluoric acid, silane, primer)
combinations. Metal brackets with custom composite base were bonded to dics with Sondhi A+B, then
thermocycled and shear tested. Statistics were done on ranks. All 6 groups had clinically acceptable bond
strength for orthodontic tooth movement. Unless treated with acid only, ceramic fracture is expected.
Effect of Corticision and Force Magnitude on Tooth Movement
Christopher Murphy
University of Connecticut
Obj: To evaluate effects of two distinct forces & corticision on the rate of tooth movement and alveolar
changes in rats. Methods: 52 male rats divided into 4 groups: light, heavy, light +corticision & heavy +
corticision. 10g or 100g of force applied from the max left first molar to the max incisors. Corticision done
when appliances placed & one week afterward. Tooth movement measured with feeler gauges at days
4, 7, 11 & 14 and with u-ct at day 14. Alveolar changes studied with u-ct. TRAP stain used to quantify
osteoclasts.Results: Greater tooth movement found in the heavy force groups with (P = 0.001) & without
corticision (P=0.007) at 4 days vs the light force group. At 7 days the heavy force group + corticision had
greater tooth movement vs the light force group (P=0.005). u-ct analysis found no differences.
Conclusions: Heavy forces & heavy forces + corticision enhanced tooth movement during the first week
vs light force. No differences found during the second week.
Determination of the Transformation Temperature Ranges (TTR) of Orthodontic Nickel-Titanium
Archwires
Noor Obaisi
University of Illinois - Chicago
Background: No standard exists for testing Nickel-Titanium (Ni-Ti) archwires (AWs). Many studies use
Differential Scanning Calorimetry (DSC) to test the Transformation Temperature Range (TTR), but the
Bend and Free Recovery Test (BFR) may be more clinically applicable. Objective: To compare the TTR
values of thermoelastic Ni-Tis between: 1) BFR and DSC, 2) two wire sizes, 3) two brands, and 4) tested
values vs. manufacturer-listed values. Methods: Eighty Ni-Ti AWs were tested using BFR or DSC and
further divided based on manufacturer and wire size. TTR was recorded and analyzed using Student ttests (α≤0.05). Results: Statistically significant mean differences were observed: 1) between BFR and
DSC, 2) between wires size for all BFR-tested groups, 3) between brands, 4) between all tested and
manufacturer-listed values. Conclusions: BFR and DSC provide comparable TTRs. BFR is more
economical and clinically relevant for TTR testing, enabling testing on as-received Ni-Ti AWs.
Orthodontic Tooth Movement is Reduced by a Bisphosphonate Derivative of Enoxacin
Edgardo Toro
University of Florida
Background: The antibiotic enoxacin decreases osteoclast formation and activity. A bisphosphonatelinked derivative of enoxacin (BENX) targets bone and may have similar anti-resorptive activity.
Purpose:1) to test whether BENX inhibits osteoclastic activity as enoxacin, and 2) to test whether BENX
can reduce orthodontic tooth movement (OTM) in rats. Research Design: Osteoclasts treated with BENX
were quantified for tartrate-resistant acid phosphatase (TRAP) activity. Western blot analysis was done to
determine the levels of osteoclast marker proteins. A simplified lever system was used to study the effect
of BENX in OTM. Results: BENX reduced the number of TRAP+ cells with an IC50 of 10 µM. BENX
altered the proteolytic activation of TRAP5b. Rats treated with BENX showed significant reduction in OTM
compared to those treated with alendronate. Conclusion: The novel mechanistic characteristics of BENX
suggest that it could be a potent therapeutic agent to control anchorage and retention.
Clinical Research
Perception of Profile Appearance as Judged by Peers Using 3D Video Imaging
Lisa Babb
Virginia Commonwealth University
Consideration of soft-tissue profile esthetics is an integral part of orthodontic diagnosis and treatment
planning. The purpose of this study was to determine whether soft-tissue profile appearance influences
the perception of a college-aged individual's athleticism, popularity, leadership skills and intelligence
when evaluated in 3 dimensions. Images of 8 dental students were captured using a 3D camera. Each
was altered to create 1 image with an ideal profile, 1 retrognathic and 1 prognathic. Three surveys were
constructed with either the ideal, retrognathic, or prognathic video of the 8 models in each. The videos
were rated by 284 evaluators indicating their perception of each model’s athleticism, popularity,
leadership skills, and intelligence. The models with ideal soft-tissue profiles rated higher than the same
models with nonideal profiles in the categories of athleticism, leadership skills and intelligence. There was
no significant difference in popularity.
Basal and Dental Arch Changes of Class I, II Malocclusions
Mohamed Bamashmous
Boston University
Super-elastic wire material, pre-adjusted appliance systems, and preformed arch wires are used more.
Mismatched pre to post-treatment arch form and dimensions has higher relapse. Our aim is to investigate
the basal and dental arch changes of the Angle Class I and II malocclusions in skeletal class I patients
during treatment. Subjects (70) with angle class I, and II malocclusion treated by Boston University
residents. Models were scanned with 3D scanner. FA and WALA points were identified to represent the
dental and basal arch dimension respectively. Comparing pre to post-treatment in subjects with class I
malocclusion there was statistically significant difference in (IC), and (IM) using both the FA and WALA
points (P<0.05). For class II subjects there was statistically significant difference in (IC) using the WALA
point (P<0.02). Arch dimensions are not maintained during treatment of class I subjects. Careful attention
is needed to maintain arch dimensions for more stable occlusion.
Validation of an Alumni-Centered Practice-Based Research Network
Matthew Brown
Texas A&M University - Baylor College of Dentistry
Purpose: To validate an alumni-centered practice-based research network (PBRN) by evaluating the
prevalence and predisposing etiology of white spot lesions (WSL). Research Design: An initial survey was
used to recruit practicing orthodontic alumni of TAMU-BCD. Eligible and willing alumni were asked to
submit records, complete surveys, and the ADA Caries Risk Assessment for 10 consecutively finished
cases. Results: The initial survey response rate was 49.1% (57/116), 89.5% of whom were willing to
participate, due to being asked by a fellow alumnus. Twenty orthodontists, providing 181 treated cases,
participated in the PBRN. During treatment, 28% of the patients developed WSL. Multiple significant risk
ratios were identified (2.3-3.5X). All participants said that they would or might participate in future
projects. Conclusions: An alumni-centered PBRN is a valid, effective, and efficient means of obtaining
information about treatments being provided in practice-based settings.
Cephalometric Evaluation of Dental Class II Correction Using the Xbow Appliance
Randeep Chana
University of Manitoba
OBJECTIVE: To assess the magnitude of the dental movements in subjects with different facial patterns
following Class II correction with the Xbow appliance. METHODS: A retrospective review of 134 subjects
with Class II malocclusions were categorized into three growth types based on pre-treatment
cephalometric variables (MPA, Y-axis, LFH). RESULTS and CONCLUSIONS: Dental changes induced by
the Xbow appliance included; proclination of the L1 (L1-MP 7.3-12.3o±1.0o p<0.05), protrusion of the L1
(L1-APo 2.1-3.8mm±0.3mm p<0.05), mesial movement of the mandibular first molar (5.5-6.9mm±0.7mm
p<0.05) and retrusion of the U1 (2.4-3.5mm±0.4mm p<0.05). No significant association between the
amount of tooth movement and dolichocephaly was found. There was a trend towards proclination of the
lower incisor in the brachycephalic group. Retroclination of the maxillary incisor (U1-PP 0.2-0.5o±0.9o
p>0.05) and distal movement of the maxillary molar (0.4-0.7mm±0.3mm p>0.05) were not significantly
influenced.
The Role of Light Emitting Diode (LED) Phototherapy on Orthodontic Tooth Movement (OTM)
Sean Chung
University of Toronto
Objective: This study investigated LED phototherapy as an alternative to lasers in accelerating the rate of
OTM in the clinical setting (Faculty of Dentistry, University of Toronto).Methods: During space closure of
bilaterally symmetric premolar extraction sites, LED phototherapy was applied to one side of the dental
arch (20 min/d; 4-12 weeks). Extraction spaces were measured on dental casts taken before (T0), during
(T1) and later in space closure (T2). LED usage was recorded by the patient and the device. The rates of
space closure in controls and LED-treated sides were compared.Results: All patients were compliant with
LED usage. Preliminary results suggest no significant differences with the application of LED
phototherapy. Conclusions: Preliminary results suggest that extra-orally delivered LED phototherapy does
not significantly alter the rate of OTM. Further studies are needed to determine if variations in the LED
phototherapy prescription can influence the rate of OTM.
Pathology Observed on Cone Beam Computed Tomographic Scans: A Comparison of Prevalence and
Type of Incidental Findings for Child
James Cobb
Tri-Service Orthodontic Residency Program
Background: The use of CBCT raises the likelihood of incidental findings outside of the primary area of
interest. Purpose: This study compared the prevalence, type, and percent of referral for incidental findings
observed on CBCTs between child/adolescent and adult patients. Research Design: 267 CBCT scans
from child/adolescents and 254 from adults (≥19 yo) were evaluated by one radiologist. Findings were
placed into seven categories for comparison. All findings were also analyzed by need for referral to a
healthcare provider. Results: 97.3% of all scans had at least one incidental finding. Adults were more
likely to incur at least one finding (p<0.001) in every category studied, except the airway category. Adults
were more likely (p=0.0001) to have findings that required referral. Referrals for dental, osseous
structures, and other findings were more prevalent in adults. Conclusions: The high prevalence of findings
in this study supports routine review of CBCT scans by a radiologist.
Accuracy of Magnetic Resonance Imaging in Orthodontics: Cephalometric Measurements Using MRI
Compared to Traditional Radiographs
Grant Collins
Mayo Clinic
In light of the current controversy regarding radiation exposure in orthodontic patients, MRI was evaluated
as an alternative to traditional orthodontic radiographs. In our two-part study, we found MRI to be more
accurate than the radiographs with linear measurements, as well as similar to lateral cephalographs with
ABO tracing and analysis. MRI is a safe non-ionizing radiation alternative to traditional orthodontic
radiographs for both linear measurements and ABO tracing and analysis.
Diagnostic Accuracy of Impression-Free Digital Models
Benjamin Cozad
University of Texas - Houston
BACKGROUND: Chair-side scanners offer digital dental models without the need for dental impressions.
PURPOSE: This study sought to evaluate the accuracy of three-dimensional (3D) digital models acquired
from a chair-side intraoral scanner compared to manual and cone-beam CT (CBCT) measurements.
RESEARCH DESIGN: Sixty dry skulls were scanned using a Cadent iTero® scanner and a Carestream®
9300 CBCT. Measurements were carried out on dry skulls using calipers and on scans using computers.
Intraclass correlation analysis coefficients (ICCs) were calculated to test the accuracy of digital platforms
compared to manual skull measurements. RESULTS: Measurements from iTero® models showed a near
perfect agreement (ICCs: 0.91-0.99) with caliper measurements. CBCT measurements had a moderate to
high level of agreement (ICCs:0.65-0.99). CONCLUSIONS: Direct digital acquisition of the dental arches
with the tested chair-side scanner provided to be one-to-one and was superior to CBCT measurements.
Prevalence of Sleep Apnea in Pediatric Dental Population: Confirmed via PSQ and Correlated with
Cephalometric Characteristics
Bahram Elaahi
Stony Brook School of Dental Medicine
Background: Many sleep related breathing disorders remain undiagnosed in the pediatric population. A
previously developed Pediatric Sleep Questionnaire can be used to screen patients in a dental clinic.
Objectives: To assess the prevalence of sleep apnea in the dental school clinic setting via PSQ and to
assess how a limited 2D airway analysis correlates with the questionnaire results in identifying the at risk
patients. Methods: Parents completed PSQ (n=301) and cephalometric airway analyses were done on
patients seen in the Orthodontic clinic. Results of the airway analyses were used to compare patients
detected as being prone to sleep apnea versus those who were not susceptible based on the PSQ.
Results: 25% of patients were classified as being at risk for SRBD. Snoring and obesity were significantly
related to risk of SRBD. No gender differences were found. Conclusion: High percentage of pediatric
patients who suffer from SRBD supports the use of SRBD screening in the dental clinic.
The Effect of Pulsed Low-Level Laser Therapy on Orthodontic Tooth Movement
Monica Gawlik
Montefiore Medical Center
Purpose: To determine the effect of pulsed Low-level laser therapy (LLLT) on the rate of tooth movement
in humans.Research Design: Eleven patients requiring extraction of maxillary first premolars and bilateral
canine retraction with NiTi coils were recruited. In this split-mouth randomized clinical trial, one side of the
mouth was irradiated. A 810 nm gallium aluminum arsenide diode laser with power output of 0.2 W and
frequency of 2 Hz was applied to the tooth for 80 seconds once a week for 7 weeks. Tooth movement
was measured weekly on progress models. Results: The difference in rate of tooth movement between
sides was greatest after initial activation of the NiTi coils. The rate decreased significantly over time in
both treatment and control groups. There was no statistically significant difference in the rate observed
between groups at any timepoint. Conclusions: Pulsed LLLT does not increase the rate of canine
retraction relative to no laser therapy at all of the timepoints tested.
Correlation Analysis of 3D Condylar Anatomy and Skeletal-Facial Characteristics in Growing Patients
Nika Grigaitis
University of Michigan
Background: Growth prediction from 2D radiographs is unreliable. Unique measurements taken from 3D
radiographs may correlate with adult morphology and provide orthodontists with a means of predicting
growth patterns in children. Purpose: Identify unique cephalometric measurements and anatomical
indicators of facial form using CBCT. Research Design: We measured condylar height, width, volume,
inter-condylar angle, FMA, ANB, MP-SN, Ar-Go-Me, GoGn-SN, LAFH from pretreatment CBCT scans of
57 growing subjects. Relationships between condylar anatomy and facial form were determined by
Pearson correlation coefficients. Results: Significant correlations exist between condylar anatomy and
facial form, condylar volume and LAFH (r>0.447, p<0.001), condylar volume and ANB (r<-0.350, p<0.01).
Conclusions: 3D condylar morphology measurements from growing patients may be reliable indicators of
facial patterning and may be useful guides for orthodontic diagnosis and treatment planning.
Epidemiology of Early Orthodontic Treatment Need in Philadelphia Schoolchildren Using the IPION
Zane Haider
Temple University
Background: The Index for Preventive and Interceptive Orthodontic Needs (IPION), (Coetzee), identifies
the need for treatment in the mixed dentition. No published studies utilizing this index exist for a United
States population. Purpose: The purpose of this study is to utilize the IPION to quantify the proportion of
Philadelphia children that would benefit from early orthodontic treatment. Research Design: IRB approval
was obtained from Temple University. Children between 6 and 9 in two pediatric dental practices were
scored chair-side. Sample size calculation analysis was performed on the first 43 subjects. Results: 55%
of children have definite treatment need, 20% have moderate treatment need, and 25% have no
treatment need. Descriptive statistics on the proportion of children that demonstrate specific
malocclusions will be available in April. Conclusions: Thus far in the study, a significant proportion of
Philadelphia children between 6 and 9 need early orthodontic intervention.
Three-Dimensional Treatment Outcomes in Class II Patients Treated Using Herbst: Pilot Study
Megan LeCornu
University of North Carolina
Objectives: Analyze 3-D skeletal changes in class II patients treated with the Herbst appliance and
compare to treated class II controls. Methods: 7 consecutive Herbst and 7 controls, had CBCTs taken
pre-treatment (T1¬) and post- treatment (T2). 3-D models were generated from CBCTs, registered on
anterior cranial bases and analyzed using color map and point-to-point measurements. Results: Herbst
patients demonstrated anterior translation of glenoid fossa and condyles (1.56mm +0.66 and
1.36mm+0.98 respectively), while posterior displacement predominated in controls (-1.41mm +0.65 and 1.24mm+0.49 respectively). Anterior projection of B point, and a restraining effect on A point was
observed in Herbst patients (2.62mm +1.08 vs 1.48mm +0.79, and 1.47mm + 0.52 vs -1.67mm +0.67
respectively). Conclusions: Orthopedic response is variable. Anterior displacement of condyles and
glenoid fossa may result in more anterior mandibular projection when compared to treated class II
controls.
Clinical Use of a Chairside Oral Scanner: Accuracy, Speed, and Patient Acceptance
Shawn McCarthy
University of Minnesota
Background: Understanding the accuracy, speed, and patient acceptance of chairside oral scanners
(COS) is critical for accepting this technology in orthodontics. Purpose: To evaluate the relative accuracy,
speed, and patient acceptance of the 3M Lava COS. Research Design: Thirty patients had full-arch
models made from COS scans and alginate impressions. The time for each procedure was recorded and
patient preference was assessed using a questionnaire. Model pairs were superimposed and
discrepancies were tested for statistical significance. Results: Models made from COS scans and
impressions did not differ significantly. The chair time for impressions was significantly less than that for
COS scans; total time, including processing, did not differ significantly. 73% of patients preferred
impressions, 27% preferred the COS. Conclusions: Despite the high accuracy of COS scans, alginate
impressions are the preferred model acquisition method with respect to chair time and patient
acceptance.
An Exploratory Approach for Mapping the Surface of the Human Skull in Three Dimensions
Ryan McComb
University of California – Los Angeles
Objectives: The goals of this project are to accurately map the skull surface in three dimensions; to find
the average of multiple skull surfaces; and to develop protocol for superimposing sample skulls on the
average skull model. Methods: 67 NewTom 3G CBCT scans met inclusion criteria. Following surface
segmentation, topology of each skull was corrected. Shapes were refined to a sphere and then
registered using a spherical patch mapping approach. Finally, an average was created using procrustes
alignment. Results: An average skull model was generated from the 67 scans. Color-coded displacement
maps were generated to demonstrate clinical applicability of this protocol. Conclusions: The results
suggest that it is possible to average shapes of highly varying topology such as the human skull. The
most immediate application of this technology will be rapid and detailed diagnostic imaging analysis for
orthodontic and surgical treatment planning, particularly in complex cases.
Rapid Maxillary Expansion in Cleft Patients: A Comparison Between Four Expanders
Carolina Morsani Mordente
Pontifícia Universidade Católica de Minas Gerais
This study compared the dentoskeletal and upper airway effects of 4 rapid maxillary expanders in cleft
patients (CP) using Cone-Beam Tomography (CBT). Forty complete unilateral CP were divided into 4
groups: (I) Hyrax, (II) Fan-type, and Inverted Mini-Hyrax soldered to molar bands (III) iMini-M and first
premolar bands (IV) iMini-P. Pre and post maxillary expansion (ME) (for bone graft planning) CBTs were
analyzed with Dolphin and ITK-SNAP softwares. All groups showed significant anterior ME. Group IV
restricted posterior ME, group II showed the greatest anterior teeth inclination and group III the largest
inter-apex expansion. Group I and III showed the greatest posterior ME. All groups increased the cleft
volume, nasal cavity width/volume, but no significant changes were found in oropharynx volume.
Conclusion: When anteroposterior ME is required in CP, either Hyrax or iMini-M might be used. However,
when a greater anterior than posterior ME is needed, iMini-P should be the choice.
Cone Beam Computed Tomography Evaluation After Palatal Expansion and Orthodontics
Bar Nguyen
University of Oklahoma
Background: RPE is accepted as an effective method in correction of different types of malocclusions. An
understanding of the effects of RPE to the buccal plate is critical. Purpose: The purpose of this study was
to evaluate dentoalveolar changes, using CBCT, to the maxillary first premolars and permanent first
molars from initial to more than 6 months in retention following orthodontics where a Hyrax expander was
used in two groups; rapid and slow expansion. Research Design: CBCTs on 14 patients were evaluated
at 3 time points: pretreatment, 3 months after palatal expansion, and in retention after orthodontics.
Results: Greater tipping and crest height recession were observed at the first premolars. There was
significant recovery of buccal plate thickness for both teeth following RPE and orthodontics. Conclusions:
One can expect significant recovery after active treatment following rapid palatal expansion. There were
no clinical differences between the rapid and slow expansion groups.
Post-Orthodontic Retention Trends Among Orthodontists in the US: AAO Member Survey
Nahal Niknam
Roseman University of Health Sciences
Increase in the number of esthetically oriented adults seeking orthodontics and also a rise in retreatments
has brought attention to retention. The purpose of this study is to identify the retention protocols that are
being prescribed in the U.S. and to recognize factors that play a role. A survey was emailed to 2197
randomly selected AAO active members using the AAO Partners in Research. 58% chose initial
presentation of the teeth as the main determinant of retention. Despite the low cost and ease of
fabrication, there appears to be only a moderate increase in vacuum-formed retainers. Hawley still
remains the preferred choice for the vast majority; especially in the upper arch. Only 5% used fixed
retainers on the upper arch compared to 42% on the lower. At least half of the participants considered
vacuum -formed retainers in TMD patients. On post-insertion retention protocol, 67% had at least 3
retention checks with 70% having their first retainer check only a month after insertion.
Clinical Experience in Cleft Care of Orthodontic Residents in Nigeria
Chikaodi Oguchi
University of Lagos
OBJECTIVE: To access the clinical experience and beliefs in cleft care of orthodontic residents in Nigeria.
METHOD: In August 2012, a total of 34-20 item questionnaires were sent to orthodontic residents in
Nigeria. RESULTS: 33 were returned (97%) from 5 institutions. The largest percentage 42.4% of
respondents was from LUTH. 54.5% were male, 45.5% female. All (100%) believed that orthodontic
residents should be involved in the management of patients with cleft lip ± palate deformity. 75.8% had
some experience, while 51.5% had attended a workshop/seminar related to management of patients with
cleft deformities. Majority of the residents(63.6%) had performed some form of postnatal counseling.
However for most other procedures a higher percentage had no experience. CONCLUSIONS: All
residents believed that orthodontic residents should be involved in the management of patients with cleft
lip ± palate deformity. However majority had limited experience in clinical management of these patients.
Assessing the Quality of Life Impact of Orthodontic Treatment
Jerek Petrous
University of Detroit Mercy
Objectives: The aim of this study is to determine the post-orthodontic changes that occur in the quality of
life of Medicaid eligible and private pay patients with a severe malocclusion. Methods: These changes
were assessed through a survey both parents and children answered pre and post-treatment. The
Psychosocial Impact of Dental Aesthetics Questionnaire was included in the pre and post-treatment
surveys in addition to demographic, oral health and perception of malocclusion questions. Results: 71
parents and children completed this survey. Paired t-tests were used to compare pre and post-treatment
differences and revealed that there were significant improvements (p-value=0.000) in the dental
confidence, social impact, psychological impact, and esthetic concern components of PIDAQ.
Conclusions: Orthodontic treatment improved the quality of life of patients. Medicaid patients reported
significantly more improvement in their dental self confidence in comparison to private pay patients.
Report of Demographic Factors Associated with Orthodontic Services in an Underserved Population
Rishi Popat
Harvard School of Dental Medicine
Objective: Orthodontic care remains an unattainable service among the underserved population. This
study assessed community health center (CHC) patients’ attitudes towards orthodontic treatment.
Materials & Methods: CHC patients were interviewed. Participants’ perception of dental esthetics was
determined using the IOTN scale. Results: 108 subjects were included in the study. Mean age was 25.2
+ 14.3 years & 90% identified themselves as Hispanic. 51.9%, 22.2%, & 23.1% were found to have Class
I, Class II, Class III right molar class, respectively; while 50.9, 19.4, & 25.9 had a Class I, II, or III left
molar class. Of the 26.9% with a crossbite, 7.4% had an anterior crossbite, while 14.8% had a posterior
crossbite & 4.6% had both. Overall, 59.3% stated that they needed braces, with 77.8% stating financial
constraints, & 25.0% identifying geographic constraints. Conclusion: This novel study identified
orthodontic needs & barriers to care for low-income CHC patients.
Facial Profile Esthetic Preferences in Puerto Ricans Seeking Orthodontic Treatment
Sebastian Rodriguez-Guerra
University of Puerto Rico
The purpose of this study was to evaluate the influence of facial convexity and lip protrusion on the
perception of facial attractiveness. A questioner with 14 profile images(7male/7female)representing
different degrees of profile convexities and lip protrusion was administered to 209 Puerto Ricans.
Attractiveness scores were obtained from the visual assessment of these digitally altered images. Median
scores were calculated and non-parametric median tests were employed for comparison between
different participants’ personal profile, age groups and genders. Both female and male concave profiles
were scored as the least attractive. Subjects in our study scored straight to slightly convex male and
female profiles as most attractive. Overall, participants’ personal profile, age and gender did not have
significant (p>.05)influence on the perception of attractiveness of the profile patterns presented.Our study
suggests that male and female straight profiles were perceived as most attractive.
Comparison of BMI, AHI and Apolipoprotein E allele e4 Alleles Among Sleep Apnea Patients with
Different Angle Classifications
Jason Roedig
University of Kentucky
This study examined possible associations between APOE-e4 and OSA in Class-II (CII) pts compared to
non-CII pts.Associations between OSA, APOE e4 and BMI were studied.OSA pts with an AHI > 15 were
classified into Angle Classes by oral exam and photos.DNA via saliva was collected.Two APOE-e4 SNPs
were genotyped.Chi-square analysis was used (p<0.05).ANOVA was used to compare BMI and AHI.76
Caucasian OSA pts were recruited,25 CII(mean BMI 30.7,AHI 33.6)and 51 non-CII(mean BMI 37.4,AHI
44.2).70 pts were obese,6 were normal BMI and CII.Neither SNP was associated with OSA among the
Angle Classes.CII OSA pts had significantly lower BMI 30.7 than CI 37.2 or CIII 37.8 pts (p<.001).AHI for
was CII 33.6, CIII 39.5 and CI 46.0.There was no significant difference among the 3 groups.There was a
significant (p=.05) difference between CII and CI for AHI.Patients who have OSA and CII have a lower
BMI,or are not obese,suggesting that CII is a contributing factor to OSA with or without increased BMI.
Incisal Posturing for Sibilant Articulation in Untreated Orthodontic Patients
Jeff Shao
University of Texas Health Science Center - San Antonio
Background: The main position Pound referred to during speech is the forward speaking position that is
used when pronouncing the letter “s”. Purpose: Determine if mandibular posturing for sibilant articulation
is correlated with pre-treatment anterior horizontal overjet and vertical overbite values. Compare results
with theoretically derived methods. Research Design: This is a case series involving thirty subjects with
Class I molar relationship and oral anatomy unaltered by extraction. A computerized jaw-tracking device
will record the movement of the mandible in relation to the maxilla throughout speech production utilizing
a magnet. Results: Mandibular posturing for sibilant articulation is correlated with pre-treatment anterior
horizontal overjet and vertical overbite values. Conclusion: Anterior teeth for sibilant competency is a
guide for placement of anterior teeth in dentures, veneer fabrication and orthodontically moving teeth to a
phonetically ideal and functional area.
Three-Dimensional Soft and Hard Tissue Change in the Treatment of Bimaxillary Protrusion
R. Christian Solem
University of California, San Francisco
The three-dimensional (3D) relationship between soft and hard tissue movement in the treatment of
bimaxillary dentoalveolar protrusion in an Asian female population (n=23, mean age=24) was
investigated. 3D movements were quantified using cranial fossa registration of longitudinal cone beam
CTs, and visualized using color mapping. Soft tissue changes correlated with initial resting lip posture.
Lower lip retraction was accompanied by significant redistribution of soft tissue at the pogonion. Upper lip
retraction was concentrated between the nasolabial folds and commissures, and correlated with vertical
and A-P movement (p=0.03) of the upper incisor. Lower lip retraction correlated with lower incisor A-P
movement (p=0.02). Soft tissue adaptation resulting from anterior dental retraction correlated with
regional facial muscle activity near the nasolabial fold, mentolabial sulcus, and pogonion. Significant
retraction (2–4 mm) of soft tissue occurred outside of the mid-sagittal region.
Antegonial Notching and the Pattern of Vertical Facial Growth
Maggie Wang
University of Washington
Introduction: The study evaluated whether panoramic radiographs can adequately estimate antegonial
notch depth and compared development of the notch with vertical growth. Methods: Longitudinal
cephalograms were collected for 43 open bite, 61 Pierre Robin sequence, 13 idiopathic condylar
resorption, 104 controls, and 55 pairs of panoramic and cephalometric radiographs. Notch depth and
vertical facial dimensions were measured. Results: Correlation between the 2 methods in measuring
notch depth cannot be validated. Except for the ICR group, notch depth did not change during growth, nor
did it predict vertical growth. The ICR group was unique in having greater notch depth even at T1,
showing poor growth of posterior facial height, and increase in mandibular plane angle. Conclusions:
Panoramic radiograph is not a good estimator for notch depth. Except in ICR, notch depth is established
early and maintained throughout growth, so is not a good predictor of vertical facial growth.
The Effect of Facial Attractiveness on Orthodontic Treatment Outcome
Desy Wilson
Oregon Health & Science University
This study explored the influence of patient facial attractiveness on treatment outcome in orthodontics,
which has yet to be investigated, while associations have been demonstrated in other healthcare fields.
Associations were also explored between facial attractiveness and case complexity, compliance, hygiene,
orthodontist satisfaction with treatment outcome, and treatment length. Records from 45 Class I
orthodontic patients treated by 45 different orthodontists (surveyed) were assessed for treatment outcome
using the Objective Grading System (OGS) and for facial attractiveness using a Kiekens Visual
Attractiveness Scale (VAS). Bivariate correlations and step-wise multiple regression analysis was used.
VAS scores were significantly associated only with OGS scores. In regression analysis, adding pretreatment VAS scores significantly improved prediction of OGS scores. These findings suggest that
orthodontic treatment outcome is significantly influenced by patient facial attractiveness.