- Email: [email protected]
Straight wire appliance versus conventional full edgewise
DEPARTMENT OF REVIEWS AND ABSTRACTS Edited by Alex Jacobson, DMD, MS, PhD Birmingham, Ala. All inquiries regarding information on reviews and abstracts should be directed to the respective authors. For ordering books, contact your local bookstore or write directly to the publishers. Articles or books for review in this department should be addressed to Dr. Alex Jacobson, University of Alabama School of Dentistry, University Station/Birmingham, AL 35295
Straight wire appliance versus conventional full edgewise. Erik Reukers. Doctoral dissertation, December 1997 (published in book form). Catholic University of Nijmegen, Illustrated. ISBN 90-9010942-0 This is a prospective clinical study of Class II malocclusions carried out in a university orthodontic clinic with exacting standards, much like recent NIH-funded prospective studies reported in the January 1998 issue of AlOIDO. Carefully done, in excellent English with Dutch summaries, it should be of interest to most orthodontic clinicians around the world. The Nijmegen University book publishing company undoubtedly has copies available and inquires should be directed to them. This fine effort consists of 11 chapters, summaries, appendixes, references, and a list of publications. Chapter 1 is a general introduction, with a history of fixed appliances, followed by a section on edgewise appliances, programmed and nonprogrammed. A review of the literature on the straight wire appliance is given and the research goals and references finish the chapter. Chapter 2 is on the study design and the methods of clinical trial. Because most studies are retrospective, the authors have undertaken prospective studies of fully programmed versus partly programmed appliances. The discussion would serve well for future analyses of appliance variations and responses, removing most of the biases built in with nonrandomized, retrospective assessments. Not even prospective trials do this without proper research design. Chapter 3 assesses the relative merits of assessing crowding by measuring or by visual determination. Arch length discrepancy was determined by both methods, using 10 sets of casts. Both methods are satisfactory, with "eyeballing" taking much less time. Chapter 4 compares full edgewise with straight wire appliances (FPA versus PPA) as far as duration and chairtime are concerned. Time was comparable for both, with extraction cases taking more time with both FPA and PPA. Chapter 5 is a fascinating study of relative root resorption. The aim of this study was to assess in vitro a mathematical computerbased reconstruction of two images not taken with the same recording geometry, i.e., periapical radiographs taken at different angles. This was then applied in vivo. The average amount of root
resorption was 7.8% in this study, which coincides with estimates done with conventional radiographs. Chapter 5 then compared the FPA and PPA appliance results. The loss of tooth length was 8.2% with FPA, versus 7.5 with PPA setups. Seventy-five percent of the patients with FPA showed measurable apical root resorption, versus 55% for partly programed appliance cases. This was not considered clinically significant by the author. Chapter 6 measures the discomfort index for the two appliance groups. The 149 patients in the trial showed no significant difference and were equally satisfied with the results. Chapter 7 discusses the periodontal parameters. A variety of measures showed no significant differences. The FPA claims of being kinder and gentler to the soft tissues could not be confirmed. Chapter 8 compares the two groups using the PAR index. Equally adequate treatment results could be achieved, but the ultimate success depended on the individual orthodontist. As with individual differences among patients, the same variability exists among clinicians. Chapter 9 studies rotational control in extraction cases in fully versus partly programmed appliances. The claim of better control by FPA could not be validated. Chapter 10 uses the Six Keys analysis of Larry Andrews to assess the final result of the two appliance groups. The angulation of the maxillary anterior teeth was better with the FPA, but no interaction could be determined between extraction and type of appliance. It was concluded that equally adequate results could be obtained with either appliance. The final chapter, chapter 11, is a general discussion that points up some of the problems of any study, even prospective ones, dealing with individual variation of patient and operator, even with the common use of a particular appliance. The seven hypotheses postulated in chapter 1 are analyzed as a result of the prospective assessment of FPA and PPA mechanotherapy. The bottom line is that it is possible to treat patients well or poorly with either appliance. The book is recommended particularly for fully or partly programmed orthodontists, who see only one "best" way, as a result of commercial claims, weekend courses, or fancy brochures. T. M. Graber
American Journal of Orthodontics and Dentofaclal Orthopedics/May 1998
593
Straight wire appliance versus conventional full edgewise. Erik Reukers. Doctoral dissertation, December 1997 (published in book form). Catholic University of Nijmegen, Illustrated. ISBN 90-9010942-0 This is a prospective clinical study of Class II malocclusions carried out in a university orthodontic clinic with exacting standards, much like recent NIH-funded prospective studies reported in the January 1998 issue of AlOIDO. Carefully done, in excellent English with Dutch summaries, it should be of interest to most orthodontic clinicians around the world. The Nijmegen University book publishing company undoubtedly has copies available and inquires should be directed to them. This fine effort consists of 11 chapters, summaries, appendixes, references, and a list of publications. Chapter 1 is a general introduction, with a history of fixed appliances, followed by a section on edgewise appliances, programmed and nonprogrammed. A review of the literature on the straight wire appliance is given and the research goals and references finish the chapter. Chapter 2 is on the study design and the methods of clinical trial. Because most studies are retrospective, the authors have undertaken prospective studies of fully programmed versus partly programmed appliances. The discussion would serve well for future analyses of appliance variations and responses, removing most of the biases built in with nonrandomized, retrospective assessments. Not even prospective trials do this without proper research design. Chapter 3 assesses the relative merits of assessing crowding by measuring or by visual determination. Arch length discrepancy was determined by both methods, using 10 sets of casts. Both methods are satisfactory, with "eyeballing" taking much less time. Chapter 4 compares full edgewise with straight wire appliances (FPA versus PPA) as far as duration and chairtime are concerned. Time was comparable for both, with extraction cases taking more time with both FPA and PPA. Chapter 5 is a fascinating study of relative root resorption. The aim of this study was to assess in vitro a mathematical computerbased reconstruction of two images not taken with the same recording geometry, i.e., periapical radiographs taken at different angles. This was then applied in vivo. The average amount of root
resorption was 7.8% in this study, which coincides with estimates done with conventional radiographs. Chapter 5 then compared the FPA and PPA appliance results. The loss of tooth length was 8.2% with FPA, versus 7.5 with PPA setups. Seventy-five percent of the patients with FPA showed measurable apical root resorption, versus 55% for partly programed appliance cases. This was not considered clinically significant by the author. Chapter 6 measures the discomfort index for the two appliance groups. The 149 patients in the trial showed no significant difference and were equally satisfied with the results. Chapter 7 discusses the periodontal parameters. A variety of measures showed no significant differences. The FPA claims of being kinder and gentler to the soft tissues could not be confirmed. Chapter 8 compares the two groups using the PAR index. Equally adequate treatment results could be achieved, but the ultimate success depended on the individual orthodontist. As with individual differences among patients, the same variability exists among clinicians. Chapter 9 studies rotational control in extraction cases in fully versus partly programmed appliances. The claim of better control by FPA could not be validated. Chapter 10 uses the Six Keys analysis of Larry Andrews to assess the final result of the two appliance groups. The angulation of the maxillary anterior teeth was better with the FPA, but no interaction could be determined between extraction and type of appliance. It was concluded that equally adequate results could be obtained with either appliance. The final chapter, chapter 11, is a general discussion that points up some of the problems of any study, even prospective ones, dealing with individual variation of patient and operator, even with the common use of a particular appliance. The seven hypotheses postulated in chapter 1 are analyzed as a result of the prospective assessment of FPA and PPA mechanotherapy. The bottom line is that it is possible to treat patients well or poorly with either appliance. The book is recommended particularly for fully or partly programmed orthodontists, who see only one "best" way, as a result of commercial claims, weekend courses, or fancy brochures. T. M. Graber
American Journal of Orthodontics and Dentofaclal Orthopedics/May 1998
593