A survey instrument was designed to evaluate factors influencing consumer selection of an orthodontist and consumer perception of different forms of media advertising (radio, television, newspaper, magazine, direct mail, and billboard) by orthodontic practices. The surveys were distributed by 8 orthodontic offices in and around the Richmond, Virginia area. Out of 676 surveys, 655 (97%) were returned. Respondents most often cited dentist and patient referrals as how they learned of the orthodontic practices they visited (50%- 57%). However, a caring attitude and good practitioner reputation were cited as the top reasons influencing selection of an orthodontist (53% and 49% respectively). Fourteen percent to 24% of respondents felt that advertising orthodontists would offer a lower quality of care than non-advertising orthodontists. Newspaper, magazine, and direct mail advertisements were viewed more favorably than radio, television and billboard advertisements. Chi-square analyses revealed few statistically significant differences in perception between different income and education groups.

AbstractMEASUREMENT OF FORCES AND MOMENTS IN THREE-DIMENSIONAL ARCHWIRESBy Dwight V. Buelow, D.D.S.A thesis submitted in partial fulfillment of the requirements for the degree of Master of Science at Virginia Commonwealth University.Virginia Commonwealth University, 2003Major Director: Steven J. Lindauer, D.M.D., M.D.Sc.Chairman and Professor, Department of OrthodonticsOrthodontic tooth movement occurs in response to the application of controlled mechanical force systems. The purpose of this study was to improve understanding of those force systems by evaluating differences between the resultants of two-dimensional and three-dimensional orthodontic appliance activations. An in-vitro model was constructed and three force-moment gauges were used to measure the forces and moments produced. Comparisons were made between two-dimensional and three-dimensional v-bend activations. Measurements were made with both edgewise and ribbonwise wire orientations. Locations of v-bends resulting in zero moment at the incisor were found to be closer to the molar than the anticipated 1/3 of the distance from molar to incisor, for both two-dimensional and three-dimensional wires. For two-dimensional wires, this v-bend location was found to be approximately ¼, while for three-dimensional wires it was even closer to the molar. Ribbonwise wires, both two-dimensional and three-dimensional, produced forces and moments of greater magnitude than their edgewise counterparts. Further research is required to explain the differences between anticipated and actual results, and to develop more accurate means of modeling orthodontic force systems.

White spot lesions (WSLs) or decalcifications remain a common complication in orthodontic patients with poor oral hygiene. The purpose of this study was to compare attitudes regarding the development of WSLs among patients, parents, orthodontists and general dentists and improve prevention and treatment protocols through better communication. A survey was developed to evaluate and compare the current opinions of orthodontic patients (n=315), parents (n=279), orthodontists (n=305) and general dentists (n=191) regarding the significance, prevention and treatment of WSLs. All four groups indicated that WSLs did detract from the overall appearance of straight teeth. All four groups indicated that patients were the most responsible for the prevention of WSLs. All four groups indicated that the general dentist should be more responsible for the treatment of WSLs than the orthodontist. General dentists were significantly more likely to indicate that the orthodontist was most responsible for the prevention of WSLs (P <0.005).

The reported prevalence of decalcification in orthodontic patients varies from 2 to 96% mainly due to the lack of a standard examination technique. The aims of this study were: 1) to determine the prevalence of white spot lesions around brackets using visual examination and the DIAGNOdent; 2) to determine which teeth were the most susceptible to decalcification; and 3) to test the accuracy of the DIAGNOdent by comparing to the visual examination. The presence of white spot lesions was determined in two groups of patients who were 6 and 12 months into orthodontic treatment, respectively. The control group consisted of patients who were examined for white spot lesions immediately after having their braces placed on their teeth. The prevalence of white spot lesions was 38%, 46%, and 11% for the 6-month, 12-month, and control groups, respectively. There was a statistically significant correlation (r = 0.71) between the DIAGNOdent measurements and the visual examination.

The purpose of this study was to determine the effect of changes in maxillary incisor position on anterior tooth display (ATD) in adult (n = 21) and adolescent (n = 38) orthodontic patients. The effects of anterior-posterior, vertical, and angular changes of the maxillary central incisor position during orthodontic treatment were evaluated relative to changes in the amount of ATD measured from pretreatment (TI) and posttreatment (T2) lateral cephalometric radiographs of existing patient records.Results showed a significant relationship between starting ATD and ATD change during treatment for both adults (P = ,006) and adolescents (P

The bactericidal efficacy of Listerine®, the essential oil-containing mouthrinse, has long been recognized. The purpose of this study was to determine whether Listerine® mouthrinse, when added to the standard oral hygiene regimen, had an added benefit in reducing plaque and gingivitis development in orthodontic patients over a six-month period. 50 orthodontic patients from the Virginia Commonwealth University Department of Orthodontics were assigned either to the brushing + flossing (N= 25) or brushing + flossing + Listerine® (N = 25) group. At baseline (TI), measurements for the Ramfjord teeth were recorded for the gingival index, plaque index and bleeding index. Subsequent measurements were taken at 3 and 6 months (T2 and T3, respectively). The response profiles for the BI, MGI, and PI over time were significantly different (p<.001) between the two groups. Patients who had Listerine&174; mouthrinse added to their daily oral hygiene regimen exhibited significantly lower BI, MGI, and PI scores at 3 months and 6 months than the patients who only brushed and flossed.

State Medicaid programs were established to care for the poor by eliminating financial barriers and increasing their ability to be treated within the mainstream of the heath care system. The number of children eligible for Medicaid services is increasing, yet the number of Medicaid providers remains low. Health care providers cite failed appointments as being a major problem with Medicaid patients and one of the largest deterrents to participating. The purpose of this study was to determine whether a difference in appointment keeping behavior exists between Medicaid and non-Medicaid orthodontic patients. During a twelve-month period, a tally of appointments was kept for 707 active patients at Virginia Commonwealth University's Department of Orthodontics. Patients were categorized as either Medicaid or non-Medicaid and their appointment keeping behavior was evaluated. The results revealed that a significant difference does exist in the number of failed appointments between the groups (P<0.0001). The Medicaid patients failed 247(15.4%) of 1609 appointments and non-Medicaid patients failed 367(8.3%) of 4438 appointments. Additionally, these data show that although Medicaid patients accounted for only 26.6% of all appointments, they were responsible for about 40% of all appointment failures. The findings from this study support the concern among dental practitioners that Medicaid patients have higher rate of appointment failures than non-Medicaid patients.

The aim of this study was to evaluate how Asians, non-Asians, and orthodontists in America view esthetic soft tissue Asian lip profiles. The null hypothesis was that there was no difference in the perception of lip profile esthetics of Asian patients between Asian laypersons, non-Asians laypersons, and orthodontists. A survey was constructed using the profile photographs of one adult male and one adult female Asian American patient taken from the VCU Orthodontics Clinic records. Using Dolphin Imaging 3D, the original photographs were digitally altered. The lips in each photograph were moved in increments forward and backwards to produce 5 images (-4mm, -2mm, 0mm, 4mm, 8mm). Only the lips were modified. Each evaluator was asked to rank, from 1 to 5, each collection of photographs where 1 was most preferable and 5 was least preferable. There were a total of 10 survey questions. The survey was administered to 111 Asian Americans, 115 Caucasians, and 389 Orthodontists. Results suggested that all three groups were similar in their assessment. A retrusive lip profile for the Asian male was preferred, and a slightly protrusive lip profile for the Asian female was preferred across all groups. Generally, orthodontists preferred slightly more retrusive lips compared to the other two groups. The groups of evaluators that showed statistical differences were Chinese and Filipino laypersons. Cluster analysis also revealed tremendous variation in the results, giving credence to the belief that individual patient preference should be assessed in addition to understanding social norms.

The purpose of this study was to investigate differences in case confidence, treatment management, and Invisalign® expertise between orthodontists and general dentists. A survey was mailed to 1,000 randomly selected orthodontists and general dentists, respectively, who are Invisalign® providers, and results were analyzed. The results indicated that orthodontists treated significantly more Invisalign® cases and received more Invisalign® training than general dentists (P

The purpose of this study was to investigate the social perceptions of subjects with differing lip position and facial convexity in three dimensions. A 3dMD camera (3dMD, Atlanta, GA) was used to capture 3D images of 9 subjects’ faces. The images were altered to have ideal lip position and ideal convexity, ideal lip position and Class II convexity, Class II lip position and ideal convexity, and Class II lip position and Class II convexity. 400 laypersons rated their perceptions of the subjects’ athletic ability, popularity, leadership, and intelligence on a VAS scale. Subjects with ideal lip position relative to the E-line were rated significantly higher for leadership and intelligence. Males with ideal facial convexity were judged to be better leaders and more intelligent than those with Class II convexity. Subjects with ideal lip position were given the highest mean VAS scores for all four social attributes. The perception of differences related to facial convexity was inconsistent.