• Accelerated Orthodontic Tooth Movement in Adult Patients by Micro-perforations of Cortical Bone

      Mahmoudi, Tina; Schneider, Monica, D.D.S., M.S. (2016)
      Introduction: The objective of this study was to determine whether micro-osteoperforation of the cortical bone produces accelerated tooth movement during space closure in adult patients. Methods: Ten healthy adult patients, ages 18 to 44 years old with a malocclusion requiring maxillary first premolar extractions participated in this split-mouth study. Temporary Anchorage Devices (TADs) were placed bilaterally for anchorage control in the maxilla. Micro-osteoperforations were performed unilaterally apical to the extractions site and maxillary canines were distalized using sliding mechanics. Canine retraction rate was measured using: (1) Cone Beam Computed Tomography (CBCT) and (2) Digital models taken before canine distalization at the initiation of the study (T0) and three months later (T2). Results: Each of the research subjects showed varied amount of canine retraction into the extraction space. For the two measurements performed on the initial and final CBCTs, the mean of all patient measurements on the experimental side was 0.44mm less than control for "TAD-U3D" and 0.30mm greater than control for "U5M-U3D". For the four measurements performed on the initial and final digital models, the mean of all patient measurements on the experimental side was 0.14mm greater than control for "U3 Cusp Tip- U5 Cusp Tip", 0.24mm less than control for "U5M-U3D", 0.24mm greater than control for "U2 Midpoint- U3 Cusp Tip", and 0.18mm greater than control for "U6 MP Cusp Tip- U3 Cusp Tip". Statistical analysis showed that the amount of canine retraction on the experimental side was not significant when compared with the control side for any of the six measured variables (P>0.05). Conclusion: Our results indicate that 50% of subjects showed faster canine retraction rate on the experimental side when compared to control, however, this difference was not statistically significant. Further studies are necessary to evaluate the effects of micro-osteoperforations on the rate of tooth movement in the orthodontic treatment of adult patients.
    • Accelerated Orthodontic Tooth Movement in Adult Patients by Subsequent Micro-osteoperforations of Maxillary Cortical Bone

      Laraway, Robert Dane; Schneider, Monica, D.D.S., M.S.; 0000-0001-6539-7123 (2018)
      Objective: Determine if orthodontic tooth movement during space closure is accelerated after subsequent micro-osteoperforations (MOPs). Methods: Five adults requiring maxillary 1st premolar extractions participated. MOPs were performed unilaterally in the extraction site at the beginning of the study and four weeks later. Canines were retracted bilaterally and space closure was measured after two months. Results: Overall, the canine retraction rate was 0.34mm greater on the MOP side compared to the control side but showed statistically insignificant differences. When compared to our initial study, which only had one MOP application, canine retraction was 0.24mm greater but, again, was statistically insignificant. Conclusion: The results of this study show that the experimental side had greater retraction of than the control side. However, the difference was not statistically significant. More studies are needed to study the extent and duration of effects of MOPs on tooth movement in humans.
    • Alveolar Bone Height Changes in Patients Treated with Conventional and Damon Brackets

      Akinwande, Akinwale Banji; Schneider, Monica, D.D.S., M.S. (2019)
      Objective: To compare the distance between the cementoenamel junction (CEJ) and marginal alveolar bone (MAB) on the buccal root surfaces of the maxilla and mandible after orthodontic treatment using Conventional bracket system (CS) and Damon bracket system (DS). Methods: The sample included 30 patients, 14- 46 years of age (13 treated with CB and 17 with DB) with moderate to severe crowding treated nonextraction. We compared pre and post-alignment cone beam computed tomography (CBCT) images to measure the bone height (BH) changes of 24 buccal surfaces for each subject. Results: Even though we found great variability in BH levels, there was a statistically significant difference (Paired t-test: p value ≤ 0.05) between pre and post- alignment CBCT images of teeth in both Conventional and Damon groups. There was no statistically significant difference (independent t-test: p value ≤ 0.05) in BH changes when comparing the 2 bracket systems. Conclusion: The bone height levels changed after orthodontic treatment with both Conventional and Damon bracket systems, but there appears to be no significant difference in alveolar bone height changes between the two brackets in this study.
    • Dental and Skeletal Changes seen on CBCT with Damon Self-ligating Bracket System vs. Conventional Bracket System

      Silagi, Dana; Schneider, Monica, D.D.S., M.S.; 0000-0003-4863-4523 (2017)
      Introduction: This research investigated changes in arch width and arch length through a CBCT analysis of patients treated with either Damon or Conventional brackets. Methods: Pre-treatment and post-alignment CBCT files were collected for borderline extraction patients treated through non-extraction therapy (17 Damon, 13 Conventional). Measurements were made for the canine, premolars, and first molars to evaluate dental arch width (inter-occlusal dimension: IOD, inter-apical dimension: IAD), skeletal arch width (inter-buccal/lingual alveolar crests: IBACD, ILACD), angulation, and arch length changes. Results: IOD increased for all teeth, with similar overall expansion in both groups. Damon cases showed tipping of all teeth except the mandibular canine. The arch length increased for both treatment modalities in both jaws. IBACD decreased for teeth, which translated. Conclusion: The claim that moderate to severe crowding can be resolved through translation of the posterior dentition without AP expansion of the dental arch was not supported by this study.
    • The Pretreatment Profile Photo: Do We Need Our Patients to Smile?

      DePascale, Michael Thomas; Schneider, Monica, D.D.S., M.S. (2017)
      Objective: To determine whether a smiling profile photo should be taken on each patient on initial exam. Materials and Methods: 27 patient photographs were taken from the orthodontics clinic at the University of Maryland to be evaluated. A smiling and repose profile photograph for each patient was reproduced 4 times to make 4 different randomizations. A book of visual analog scales was given to 59 randomly selected laypeople to rate each photo. Results: Ten of 14 patients who showed a significant difference between the smiling and repose profile photos had a lower smiling photo score. There is no difference based on rater, gender. Conclusions: The smiling profile photograph may be an important tool in performing a thorough orthodontic diagnosis and treatment plan. Laypeople can detect the differences in smiling and repose profiles of the same patient and patients should be made aware of their own discrepancy by the orthodontist.
    • Radiographic Evaluation of the Craniofacial Skeletal Structures in Pediatric Patients with Neurofibromatosis Type 1

      Friedman, Laura; Schneider, Monica, D.D.S., M.S. (2014)
      Introduction: Neurofibromatosis Type I (NF1), also known as von Recklinghausen disease, is an autosomal dominant disorder that affects one in every 3000 births. There is no gender or race predilection seen in NF1 patients. Common clinical features include neurofibromas, cafe-au-lait spots, axillary and inguinal freckling, optic glioma, Lisch nodules and some form of bone lesions. NF1 causes a mutation in the gene that produces neurofibromin protein, which thus increases the activation of the Ras protein. This leads to rapid, radical growth of cells in the skin, skeletal and neural tissues. The craniofacial morphology of NF1 adult patients has been studied, however there have been few studies done on pediatric NF1 patients. The purpose of this study was to analyze and compare craniofacial regions, including the morphology of the cranial base and the sphenoid bone, using cephalometric radiographs of NF1 pediatric patients and age and gender matched healthy controls. Methods: A total of 28 pediatric NF1 patients and their age and gender matched healthy controls were used in this study. Cephalometric radiographs of the NF1 group were obtained from the NIH, and the cephalometric radiographs of their matched healthy controls were collected from The University of Maryland Dental School, orthodontic department. Sixteen cephalometric linear and angular measurements that reflected the cranial base, vertical heights, maxilla and mandible were measured to the nearest tenth of a millimeter or degree utilizing Dolphin Software. The groups were analyzed based on the total sample, pre-pubertal and post-pubertal status, and gender. Results: The results showed that there were very few statistically significant differences found between the NF1 pediatric group and their matched healthy controls. The NF1 pediatric patients in the total group, pre-pubertal and post-pubertal groups were all found to have larger cranial base flexure angles compared to their matched healthy controls. It was also found that male NF1 patients had larger measurements compared to their female NF1 patients, which was also seen in the healthy control group. Conclusion: In conclusion, there were very few statistically significant differences found between the NF1 pediatric group and their matched controls. These differences are unlikely to have an effect on the orthodontic and orthopedic treatments performed on NF1 pediatric patients by their clinicians. Therefore, pediatric NF1 patients should be offered the same type of orthodontic and orthopedic treatment options as their matched healthy controls.
    • The effect of delayed curing time of a self-etch primer on shear bond strength of the orthodontic bracket

      Lee, Hyun San; Schneider, Monica, D.D.S., M.S. (2020)
      This study investigated if a delay in curing time of a self-etching primer (SEP) affects the shear bond strength (SBS) of orthodontic brackets and the Adhesive Remnant Index (ARI) score. In 2-Step group, the conventional two-step technique was used for enamel conditioning. In groups Delay0, Delay1, and Delay5, a SEP was used with various delays in curing time (0, 1, and 5 minutes). Stainless steel brackets were bonded to the specimens using composite resin adhesive and were tested for SBS. Then ARI scores were measured under naked eye, 2.5x, and 10x magnifications. The results showed no significant difference in mean SBS and the ARI scores between the SEP technique and the two-step technique. The findings also implied a delay up to 5 minutes in SEP curing time do not affect the SBS and ARI scores. Finally, there was no difference in the ARI scores measured under three levels of magnification.