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Research in orthodontics: State of the art
GUEST
EDITORIAL
Research in orthodontics: State of the art
0 rthodontists
can gain valuable information applicable in their daily practice and get a purview of the state of the art of orthodontic research, dentistry in general, and cognate subjects from over 1,500 abstracts of papers that were presented at the 1981 general sessions of the International Association of Dental Research held at Chicago in March 1981.* The following are some examples. With the significant increase in the use of orthognathic surgery in recent years, the role of the orthodontist as a participant has received much discussion. Ewan and Gay of the University of Connecticut reported on adaptive changes in masticatory function and occlusal intercuspation following orthognathic surgery. Patients who were originally retrognathic showed a slight postoperative decrease in vertical interarch opening during mastication, whereas those originally prognathic showed an increase in vertical interarch opening. Flanary (University of Texas) and Alexander (University of Virginia) reported on behavioral reactions of patients after orthognathic surgery. Postoperative pain was not a significant factor, but the lack of pronounced postsurgical changes in facial appearance was a predominant complaint. Surgeons and orthodontists are advised to discuss and provide patients with preoperative written estimates on the degree of improvement in facial appearance they may hope to achieve. Hohl and co-workers (University of Washington, Seattle) discussed psychological and functional changes following long-term orthognathic treatment. Patients experienced delayed psychological disturbance despite recognizable physical and functional improvement. Patient preparation and psychological postoperative counseling was advised. The technique of remineralization of “white spots” in enamel was discussed in a number of presentations. Arakawa and associates reported on remineralization with 30% phosphoric acid and 0.2% sodium fluoride. After one month in the oral environment the enamel showed remineralization. Hartz of Beme, Switzerland, found that application of 100% sodium fluoride decreased the tendency to demineralize. Sadowsky and associates (University of Alabama) reported on enamel uptake of fluoride from fluoride-containing orthodontic cements. The greater the fluoride uptake from the cement used the greater the enamel resistance to demineralization. J. Weiss and co-workers spoke on unerupted third molar extraction as evaluated by orthodontists, oral surgeons, periodontists, and general practitioners. The oral surgeons most frequently favored extractions based on a diagnosis *Journal
334
of Dental
Research.
Special
Issue,
March,
1981. 734 Fifteenth
St., Washington,
0002-9416/81/090334+02$00.20/0
0
D.C.
20005.
1981 The C.V.
Mosby Co.
Volume 80 Number 3
Guest editorial
335
of impaction. A direct relationship was found to exist between the decision to extract and the degree of surgical orientation of the practitioner. Orthodontists were least inclined to extract and were more apt to consider the stage of potential growth and development of the patient. Rugh (University of Texas) reported on electromyographic analysis of craniomandibular relation in Class I and Class III malocclusion. Significant differences were observed in the contour patterns of muscle activity required to position the jaw, at various locations and on a horizontal plane. Rizzo (National Institute of Dental Research, Bethesda, Maryland) spoke on funding from federal and nonfederal sources. He stated that dental research has evolved primarily as a result of government funding. As we see it, dental research, not unlike scientific research in general, has received valuable financial aid from government sources and will be hurt by curbing of appropriations. Although The National Institute of Dental Research has suffered comparatively little, under the budget proposed by the Reagan administration funding for dentistry, as for all health research, will not be increased in keeping with the rate of inflation. The leveling off of federal support does, therefore, present serious problems. U.S. dentists engaged in research even before the formal profession of dentistry was founded in 1840 and research progressed in step with the other sciences long before government funding became a factor. At present, dental research, if it is not to lag, will have to depend on support from foundations and individuals. It has been proposed that manufacturers and distributors of scientific health equipment and materials could be induced to take up the slack in government appropriations. However, the American Public Health Association advises that commercially funded research should be done under the auspices of professionals and performed in a professional environment. J. A. Salzmann
EDITORIAL
Research in orthodontics: State of the art
0 rthodontists
can gain valuable information applicable in their daily practice and get a purview of the state of the art of orthodontic research, dentistry in general, and cognate subjects from over 1,500 abstracts of papers that were presented at the 1981 general sessions of the International Association of Dental Research held at Chicago in March 1981.* The following are some examples. With the significant increase in the use of orthognathic surgery in recent years, the role of the orthodontist as a participant has received much discussion. Ewan and Gay of the University of Connecticut reported on adaptive changes in masticatory function and occlusal intercuspation following orthognathic surgery. Patients who were originally retrognathic showed a slight postoperative decrease in vertical interarch opening during mastication, whereas those originally prognathic showed an increase in vertical interarch opening. Flanary (University of Texas) and Alexander (University of Virginia) reported on behavioral reactions of patients after orthognathic surgery. Postoperative pain was not a significant factor, but the lack of pronounced postsurgical changes in facial appearance was a predominant complaint. Surgeons and orthodontists are advised to discuss and provide patients with preoperative written estimates on the degree of improvement in facial appearance they may hope to achieve. Hohl and co-workers (University of Washington, Seattle) discussed psychological and functional changes following long-term orthognathic treatment. Patients experienced delayed psychological disturbance despite recognizable physical and functional improvement. Patient preparation and psychological postoperative counseling was advised. The technique of remineralization of “white spots” in enamel was discussed in a number of presentations. Arakawa and associates reported on remineralization with 30% phosphoric acid and 0.2% sodium fluoride. After one month in the oral environment the enamel showed remineralization. Hartz of Beme, Switzerland, found that application of 100% sodium fluoride decreased the tendency to demineralize. Sadowsky and associates (University of Alabama) reported on enamel uptake of fluoride from fluoride-containing orthodontic cements. The greater the fluoride uptake from the cement used the greater the enamel resistance to demineralization. J. Weiss and co-workers spoke on unerupted third molar extraction as evaluated by orthodontists, oral surgeons, periodontists, and general practitioners. The oral surgeons most frequently favored extractions based on a diagnosis *Journal
334
of Dental
Research.
Special
Issue,
March,
1981. 734 Fifteenth
St., Washington,
0002-9416/81/090334+02$00.20/0
0
D.C.
20005.
1981 The C.V.
Mosby Co.
Volume 80 Number 3
Guest editorial
335
of impaction. A direct relationship was found to exist between the decision to extract and the degree of surgical orientation of the practitioner. Orthodontists were least inclined to extract and were more apt to consider the stage of potential growth and development of the patient. Rugh (University of Texas) reported on electromyographic analysis of craniomandibular relation in Class I and Class III malocclusion. Significant differences were observed in the contour patterns of muscle activity required to position the jaw, at various locations and on a horizontal plane. Rizzo (National Institute of Dental Research, Bethesda, Maryland) spoke on funding from federal and nonfederal sources. He stated that dental research has evolved primarily as a result of government funding. As we see it, dental research, not unlike scientific research in general, has received valuable financial aid from government sources and will be hurt by curbing of appropriations. Although The National Institute of Dental Research has suffered comparatively little, under the budget proposed by the Reagan administration funding for dentistry, as for all health research, will not be increased in keeping with the rate of inflation. The leveling off of federal support does, therefore, present serious problems. U.S. dentists engaged in research even before the formal profession of dentistry was founded in 1840 and research progressed in step with the other sciences long before government funding became a factor. At present, dental research, if it is not to lag, will have to depend on support from foundations and individuals. It has been proposed that manufacturers and distributors of scientific health equipment and materials could be induced to take up the slack in government appropriations. However, the American Public Health Association advises that commercially funded research should be done under the auspices of professionals and performed in a professional environment. J. A. Salzmann