CONTENTS

Editor’s Choice

David L. Turpin, Editor-in-Chief

The impact of orthodontic applianceson sleep qualityAkbar Rawji, Larry Parker, Prativa Deb, Donald Woodside,Bryan Tompson, and Colin M. Shapiro

This article deals with a forgotten area of patientcompliance: how do our appliances affect sleep qual-ity? When discussing with a patient the importance ofwearing headgear or a functional appliance 12 to 14hours a day, including all night, what do you say aboutpossible sleep interferences? Sleep quality is importantfor several reasons. First, complaints about sleep qual-ity are common: 15% to 35% of adults complain offrequent sleep quality disturbances. Second, poor sleepquality can be an important symptom of many sleep andmedical disorders. The question of concern in this studyis worth repeating: will using an orthodontic applianceat night affect sleep quality?

Scientific knowledge about the physiology of sleephas advanced greatly in recent years, thanks in large partto a combination of tests called polysomnography. A sleepspecialist can assess human sleep continuously, withoutinterrupting it. As a result, this prospective study of asmall sample of patients determined that there was nosignificant impact of orthodontic appliances on sleepquality between extraoral and intraoral appliances. Afterreading this article, you will certainly be better prepared toanswer questions about these appliances. And the knowl-edge might even help you sleep better.

External apical root resorption inpatients treated with conventional andself-ligating bracketsNikolaos Pandis, Maria Nasika, Argy Polychronopoulou,and Theodore Eliades

The popularity of self-ligating brackets has grownexponentially in certain parts of the world, and an impres-sive list of appliance claims usually accompanies theirpromotion. These investigators did an excellent job ofcovering most known limitations and shortcomings of

Am J Orthod Dentofacial Orthop 2008;134:10A0889-5406/$34.00Copyright © 2008 by the American Association of Orthodontists.

doi:10.1016/j.ajodo.2008.09.008

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clinical studies that seek to measure external apical rootresorption (EARR). To date, few studies have comparedthe incidence of EARR in patients treated with self-ligating systems and conventional straight-wire appliances.

To carry out this prospective study, the records of 96patients (average age, 13.2 years) were examined beforeand after active orthodontic treatment. They were dividedinto 2 equal groups; 1 group was bonded with a 0.022-inslot, conventional edgewise appliance (Microarch, GAC,Bohemia, NY), and the other received a passive self-ligating appliance of the same slot size (Damon 2, Ormco,Glendora, Calif). The same clinician, who had receivedtraining in both appliance systems, performed all stages oftreatment. EARR of the maxillary incisors was assessedfor each patient. The results showed no statisticallysignificant difference in EARR between the 2 groups;although the researchers noted a trend for more EARR inthe self-ligating group, the difference was not statisticallysignificant (P � 0.06).

Gingival recession in young adults:Occurrence, severity, and relationshipto past orthodontic treatment and oralpiercingShimshon Slutzkey and Liran Levin

Several factors play a role in the development of gin-gival recession. Among the primary etiologic factors arerecessions secondary to periodontal diseases and mechan-ical trauma, age, bone dehiscence, and smoking. Data sug-gest that gingival recession is universal. It is estimated thathalf of adults in the United States have gingival recession.We still lack data for other adult populations and need toassess the relationship between potential risk factors.

The subjects for this research were 303 healthy adults(ages, 18-22 years) who arrived for routine dental exam-ination at the Israel Defense Force Dental Center in 2005.Gingival recession was found in 14.6% of them. Withinthe limitations of this study, the authors concluded thatgingival recession is not uncommon among young adultsand is related to oral piercing (tongue and lip) and priororthodontic treatment. You might wonder what youshould do with this information. Patients who desire treat-ment and are about to pierce their tongue or lips should be

advised of these findings.