Indiana University-Purdue University Indianapolis (IUPUI) / The study evaluated the effects of a mandibular repositioning appliance (MRA) in patients with obstructive sleep apnea. The MRA was designed to hold the mandible anteriorly in an attempt to maintain a patent airway. Eleven subjects completed a full-night polysomnogram wherein their normal sleep was recorded half the night without the appliance (control) and the other half with the appliance (test). The sequencing of test and control halves was randomly assigned to avoid bias. After seven subjects were tested with the MRA, the MRA was modified for four additional patients by placing anterior vertical elastics (MRA*) to minimize the opening of the mandible. The skeletal and soft tissue changes with both appliances were analyzed using lateral cephalometric radiographs. The MRA was found to have no significant effect on the obstructive sleep apnea patients as a group. Individual response to the appliance varied from noticeably worse to marked improvement. Subject #2A exhibited the reduction of a moderate-to-severe apnea (Apnea-hypopnea index 55.92) to a clinically acceptable level (Apnea-hypopnea index 9.57) with appliance wear. The treatment was considered successful. Significant cephalometric changes with appliance wear were increased lower facial height, a superiorly positioned hyoid bone relative to the mandibular plane, and a decreased posterior airway space. No cephalometric measurement could accurately predict the outcome of the treatment, and posterior airway space, commonly measured in sleep research, was not reliable. The mandibular repositioning appliance was effective in treating a small percentage of individuals with obstructive sleep apnea. A polysomnogram was needed to quantitatively measure the effectiveness of treatment. Under no circumstance should a subjective evaluation by the patient or the clinician be used to assess treatment results. Further investigation is required to evaluate the long-term effectiveness of this treatment. Periodic follow-up sleep studies are required for any patient treated with this appliance until more long term studies are completed.

Indiana University-Purdue University Indianapolis (IUPUI) / Direct bonding of orthodontic brackets often results in decalcification of tooth structure surrounding bracket sites. Glass ionomer cements, while typically leaching fluoride over time, often exhibit a significantly lower bond strength. Fluoride-containing resins generally release high concentrations of fluoride for a short time, then cease to release any significant amount. The purpose of this study was to evaluate the tensile bond strength, fluoride release, hardness, solubility, and sorption of a newly formulated fluoride containing resin. The experimental resins were prepared with 5% and 7.5% fluoride (F-) monomer, and were compared to a fluoride-free control adhesive (Rely-a-Bond Phase II™, Reliance Orthodontics Inc ., Itasca, Ill .). To evaluate tensile bond strength, orthodontic brackets were bonded to bovine teeth and debonded using an lnstron machine. Fluoride release was tested using resin disks stored in deionized water. The fluoride content of the water was determined with an ion-specific electrode. Hardness, solubility, and sorption were tested using disks made of each material. Comparison of experimental and control resins by ANOVA followed by General Linear Models multiple comparisons revealed the control to show a statistically significant difference (p<.0001) for tensile bond strength. Experimental Control 5%F- 7.5%F- Peak Stress (MPa) 4.48±0.65 3.83±0.76 5.31±0.97. Fluoride continued to be released from the experimental resins (5% and 7.5% F-) at 18 days. The control was significantly harder than either of the experimental resins at 1 hour, 24 hours, 1 week, and 1 month (p<.0001). The 5% F- resin exhibited slight solubility (0.10 percent), while the 7.5%F- resin and the control exhibited very little solubility (0.01 percent). Phase II™ exhibited significantly lower sorption at 21 days (0.60 percent, p<.001) than either the 5%F- resin (1.69 percent) or the 7.5%F- resin (1.63 percent). These results indicate that while the experimental resin had lower bond strength, lower hardness, and higher sorption than the control, measurable fluoride was released from the experimental resins for up to 18 days. Further testing is indicated to determine the clinical acceptability of this adhesive.

Indiana University-Purdue University Indianapolis (IUPUI) / Many factors may affect orthodontic bond strength study results. An important variant to consider is the bonding surface contour. Contour alters the proximity of adherent surfaces, the surface area available for adhesion, and the stress distribution. It was the purpose of this study to determine if bracket base or enamel contour affect in vitro bond strengths. Orthos Mini-Diamond (ORMCO Corp.) .0 018" slot central incisor brackets with flattened or unaltered curved bases were bonded (System 1 + self cure resin cement by ORMCO, Corp.) to unaltered and flattened bovine central incisors. Bond strengths were determined by debonding on a Bionix 858 (MTS System Corp.) testing machine. The results showed that unaltered bracket bases bonded on unaltered enamel surfaces (the closest approximation to a clinical situation) had the significantly (p< 0.0002) lowest tensile bond strength among the three combinations. The adhesive remnant index evaluation demonstrated that unaltered bracket base/ unaltered enamel surface (Group II) had significantly higher ARI (less adhesive remaining on enamel) than any of the other groups. A negative correlation between ARI scores and mean bond strength was found. There was not a significant difference between flattened bracket base / flattened enamel surface (Group I) and unaltered bracket base/ flattened enamel surface. The results suggest that the surface convexity and texture of enamel are important variables that can affect bond strength tests results. Standardization of testing protocols and control of the different variables that can affect bond strength are important factors in the testing of orthodontic brackets.

No description available.

published_or_final_version / Dentistry / Master / Master of Dental Surgery

Mini-implantes ortodônticos são acessórios de ancoragem esquelética. O objetivo deste estudo foi descrever a cicatrização óssea inicial ao redor dos mini-implantes, esterilizados pelos pesquisadores, submetidos ou não à aplicação de carga imediata. Foram inseridos 144 mini-implantes autoperfurantes (TOMAS®, Dentaurum, Germany) nas tíbias de dezoito coelhos brancos. Carga imediata (50 cN) foi aplicada sobre 50% dos mini-implantes. Quatro coelhos foram sacrificados em cada tempo pós-cirúrgico: dias 15, 21, 30 e 60, e dois no dia 0, constituindo grupo controle. Radiografias digitais foram obtidas para mensuração da espessura da cortical óssea (ECO), contíguo aos mini-implantes e equidistante deles. Nas imagens digitais das lâminas histológicas, realizou-se análise histológica e histomorfométrica. Quantidade de osso (QO), contato osso-implante (BIC) e ECO foram analisados pelos testes t-pareado, ANOVA e coeficiente de correlação de Pearson. Aos 0 e 15 dias haviam áreas de fraturas da borda da cortical. Após 30 dias houve deposição de osso imaturo, que se apresentou maduro aos 60 dias. QO foi maior com carga aos 15 dias (p = 0,034); e aumentou ao longo da cicatrização, nos grupos com (p =0,004) e sem carga (p<0,001). Carga não afetou BIC; os valores aumentaram no decorrer do tempo, nos grupos com (p<0,001) e sem carga (p=0,001). ECO aumentou em todas as regiões (p<0,001). ECO próximo aos miniimplantes foi maior que no ponto médio, exceto aos 15 dias sem carga (p = 0.077). Concluiu-se que carga imediata leve não comprometeu a cicatrização óssea ao redor dos mini-implantes. Ósseointegração e o aumento da espessura da cortical óssea foram tempo-dependentes. / Mini-implants are attachments for orthodontic anchorage. This study aimed to describe the initial bone healing around mini-implants sterilized by the researchers, submitted or not to application of immediate loading. Were inserted 144 self-drilling mini-implants(TOMAS®, Dentaurum, Germany) in the tibia of eighteen white rabbits. Immediate loading (50 cN) was applied to 50% of mini-implants. The animals were sacrificed at each time post-surgery: day 15, 21, 30 and 60, and two on day 0, being the control group. Digital radiographs were obtained to measure the thickness of cortical bone (ECO), adjacent to mini-implants and equidistant from them. In digital pictures from histological slides histology and histomorphometry was analyzed. Amount of bone (QO), bone-implant contact (BIC) and ECO were analyzed by paired t-test, ANOVA and coefficient of Pearson correlation. At 0 and 15 days had shear areas. After 30 days there was deposition of immature bone, which appeared mature at 60 days. QO load was greater at 15 days (p = 0.034), and increased over healing in load (p = 0.004) and unloaded groups (p <0.001). Load affected BIC, the values increased over time in groups with load (p <0.001) and unloaded (p = 0.001). ECO increased in all regions (p <0.001). ECO near the mini-implants was greater than at midpoint, except for 15 days without load (p = 0,077). It was concluded that light immediate loading did not affect bone healing around the mini-implants. Osseointegration and increased cortical bone thickness were time-dependent.

Thesis (M.S.)--West Virginia University, 2007. / Title from document title page. Document formatted into pages; contains ix, 117 p. : ill. (some col.). Vita. Includes abstract. Includes bibliographical references (p. 60-68).

Thesis (M.S.)--West Virginia University, 2001. / Title from document title page. Document formatted into pages; contains vii, 73 p. : ill. Vita. Includes abstract. Includes bibliographical references (p. 64-69).

Thesis (M.S.)--West Virginia University, 2002. / Title from document title page. Document formatted into pages; contains vii, 101 p. : ill. (some col.). Vita. Includes abstract. Includes bibliographical references (p. 57-63).

Thesis (M.S.)--University of Alabama at Birmingham, 2008. / Title from first page of PDF file (viewed May 30, 2008). Includes bibliographical references.