CONTENTS

Editor’s choice

David L. Turpin, Editor-in-Chief

Orthodontists’ opinions of factorsaffecting patients’ choice of orthodonticpractices

Tamer M. Bedair, Sarah Thompson, Charu Gupta,

F. Michael Beck, and Allen R. Firestone

Why do you think people choose to visit your of-fice for an orthodontic consultation? How is that all-important decision made? Knowing the answer iscritical to making appropriate decisions regardingwhether to remodel the office, move to anotherarea, hire more staff, or keep everything just as itis. The purpose of this study was to determine ortho-dontists’ perceptions about the relative importance ofvarious practice characteristics to the parents of pro-spective adolescent patients and to prospective adultpatients.

Researchers at Ohio State University wrote a simplebut insightful report, one that should be of interest tomost practicing orthodontists, especially in tougheconomic times. They dealt with the topic seriouslybecause every practitioner needs to know what factorsgo into how a patient or parent decides who will provideorthodontic treatment.

My first question after reading the article was whydid they not ask prospective parents or patients insteadof sampling orthodontists. Yes, the professionals’ opin-ions might be illuminating, but the decisions were beingmade by patients, so why not simply ask them? Whenconfronted with this question, the lead author quicklyindicated that my suggestion will be the next study bya lucky Ohio State resident. The conclusions of thisstudy are short, sensible, and not especially surprising.Orthodontists thought that the personal characteristicsof the doctor and the staff were the most importantfactors affecting a potential patient’s decision whenchoosing a practice.

Am J Orthod Dentofacial Orthop 2010;138:11A-12A

0889-5406/$36.00

Copyright � 2010 by the American Association of Orthodontists.

doi:10.1016/j.ajodo.2010.05.008

Comparison of the mandibular dentaland basal arch forms in adults andchildren with Class I and Class IImalocclusions

Deepak Gupta, R. Matthew Miner, Kazuhito Arai, and

Leslie A. Will

Comparison of dental and apical basearch forms in Class II Division 1 andClass I malocclusions

Randy L. Ball, R. Matthew Miner, Leslie A. Will, and

Kazuhito Arai

When I was practicing, my clinical assistantwould ask why I spent time altering the shape ofnearly every archwire placed in a patient’s mouth.After all, they could be purchased in various shapesand sizes for more convenient use without furtherbending. That got me thinking, and I now realizethat recent research from Harvard has made it easierto understand why most good clinicians bend a newarchwire to match the original arch form before plac-ing it in the patient’s mouth. In a 2008 article, theauthors used a unique methodology to evaluate man-dibular arch forms in subjects with Class I occlusion(Ronay V, Miner RM, Will LA, Arai K. Mandibulararch form: the relationship between dental and basalanatomy. Am J Orthod Dentofacial Orthop2008;134:430-8).

In this issue, Gupta et al and Ball et al used the samemethodology to compare mandibular arch forms in sub-jects with Class I and Class II Division 1 malocclusions.Gupta et al looked at arches in adults and children, withthe same inclusion criteria for both Class I and Class IIpatients. In the past, researchers hesitated to group thesepatients together because we assumed that the relation-ship between basal bone and dental arches could changewith growth and maturation. However, this new re-search shows that the relationship remains stable. Ballet al reported that arch forms are highly individual,and that a general arch form cannot be used for all ClassII Division 1 patients.

With advances in technology based on digital modelsand cone-beam computed tomography, individualized

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12A Editor’s choice American Journal of Orthodontics and Dentofacial Orthopedics

July 2010

arch forms are available from several vendors. Ortho-CAD’s virtual setups permit customizing the archform for each patient from the pretreatment model.Ormco’s Insigna and SureSmile produce archwirescustomized for each patient.

Stability of anterior open-bite treatmentwith occlusal adjustment

Guilherme Janson, Marcus Vinicius Crepaldi, Karina Maria

Salvatore Freitas, Marcos Roberto de Freitas, and

Waldyr Janson

Patients with open-bite malocclusion in the perma-nent dentition can be difficult to treat and often have sig-nificant relapse after orthodontic correction. But what doyou do when an adult patient with mild relapse returns 4years later and complains about the return of an openbite? Do you propose the fixed appliance approachagain, schedule a surgical consultation, or look for analternative approach, such as occlusal equilibration?

This report presents long-term data for a study ini-tially consisting of 20 patients who had mild relapseover 4 years after treatment for closure of anterioropen bite. All patients were retreated with occlusaladjustment until a positive overbite was established.

At the time, these researchers planned to follow thepatients in the long term to evaluate the success of thisapproach. Over 3 years later, 17 of these same patientsreturned for additional posttreatment evaluation. Tosummarize, the sample in this investigation included pa-tients who were previously evaluated for the use of oc-clusal adjustment to retreat relapsed open bite. Initialselection of the sample included 20 open-bite subjectswith clinically significant relapse of the anterior openbite and who were willing to have their malocclusionretreated. Although only 17 of the original 20 couldbe located, this sample can be considered satisfactorybecause of the unusual procedure used to correct theopen bite. What did these Brazilian clinicians seewhen they examined the same patients in the long term?

There was ‘‘clinically significant’’ stability in66.7% of the patients treated with occlusal adjustment,and dentinal sensitivity remained within the normalrange in the long term. There was a statistically signif-icant relapse of anterior open bite in the entire sample.Growth seemed to have contributed to a significantamount of the relapse. For now, we can only look for-ward to additional studies with larger samples. Ofcourse, if a patient wants more treatment, you stillhave the original 3 treatment options and some hopefor additional stability.