A comparison of patients requiring orthognathic treatment who subsequently refused or accepted surgery.

Forty-four patients who required combined orthodontic-surgical procedures were psychologically assessed in relation to stress, self-esteem, introspectiveness, and body satisfaction. Thirty patients accepted the surgical procedures, and 14 refused surgery. These two groups of patients were compared with respect to their psychologic profiles; statistical analysis detected no significant differences.

Radiographic assessment of secondary autogenous alveolar bone grafting in cleft lip and palate patients.

OBJECTIVE: To assess if a 4-point, radiographically based scale could be used between operators to reliably assess the success of secondary alveolar bone grafting. DESIGN: The study was retrospective with the clinicians blind to patient identity. Radiographs were examined twice by two clinicians with 1 week between assessments. SETTING: The research was carried out in a hospital-based orthodontic/oral and maxillofacial unit. PATIENTS: All patients who had secondary alveolar bone grafting in this unit between February 1992 and March 1995 were included in this study. There were 38 patients with a total of 48 grafted sites. INTERVENTIONS: The bone graft site was radiographed following orthodontic expansion prior to grafting. The radiograph was repeated postoperatively at a mean of 4 months after surgery. MAIN OUTCOME MEASURE: The degree of bony fill in the cleft area was assessed using a 4-point scale: Grade 1 > 75% bony fill; Grade 2 50-75% bony fill; Grade 3 < 50% bony fill; Grade 4 no complete bony bridge. RESULTS: Overall, 50% of grafts achieved grade 1, 23% were grade 2, 22% grade 3, and 5% grade 4. Levels of intra- and inter-observer agreement were highly variable (.33 to .72 kappa statistic). CONCLUSIONS: The 4-point scale described could be used to assess the success of autogenous secondary alveolar bone grafting. It showed moderate to substantial intra-observer agreement, and fair-to-moderate inter-observer agreement.

Are cementless acetabular components the cause of excess wear and osteolysis in total hip arthroplasty?

The authors reviewed 175 primary cementless Biologic Ingrowth Anatomic System stem total hip arthroplasties with average followup of 7 years for wear and osteolysis. Group I (24 hips: fixed titanium heads, cemented polyethylene cups) had a wear rate of 0.10 mm per year, and lysis of 0%. Group II (62 hips: fixed titanium heads, cemented metal-backed cups) had a wear rate of 0.13 mm per year, and lysis of 31%. Group III (15 hips: fixed titanium heads, cementless cups) had a wear rate of 0.25 mm per year, and lysis of 87%. Group IV (74 hips: modular cobalt chromium heads, cementless cups) had a wear rate of 0.17 mm per year, and lysis of 24%. Wear rate was associated with younger age and male patients, but not polyethylene thickness. Age, gender, weight, and component stability had no effect on osteolysis rates. Group III had the statistically highest osteolysis rate. Group I had the statistically lowest osteolysis rate. Therefore, features of cementless acetabular cups, such as the screw holes, roughness of the metal shell, and locking mechanism, may cause increased wear and osteolysis.

A posterior open bite.

A case of bilateral posterior open bite, treated using the 'straight wire' appliance, is reported. The diagnostic problems, associated with this type of malocclusion, are discussed.

The correction of dental centre line discrepancies using an edgewise appliance.

This paper deals with dental centre line discrepancies and the treatment mechanics for their correction when using an edgewise appliance.

A cephalometric investigation of overjet changes in fifty severe Class II division I malocclusions.

A retrospective cephalometric study of 50 consecutively completed Class II Division I malocclusion cases was carried out in order to analyse the resultant data for craniofacial features which might act as predictors for successful overjet reduction. All the patients had clinically measured overjets of between 10 mm and 15 mm at the start of treatment. The sample was subsequently divided into two groups depending on whether or not the overjet had been reduced to 4 mm or less at the end of treatment. No firm predictors were found, but the most favourable results were achieved with the Begg appliance.

Neutral protein-degrading enzymes in experimental fracture callus: a preliminary report.

The process of endochondral fracture healing is biochemically similar to growth plate calcification. Recent studies have identified potentially important roles for proteoglycan-degrading enzymes in the growth plate. The purpose of the study described herein was to identify, in healing fractures, neutral enzyme activities capable of degrading proteoglycans and other matrix proteins. Two sets of 60 male Sprague-Dawley rats underwent the production of closed femoral fractures. Calluses were retrieved at timed intervals, and cell and matrix vesicle fractions were prepared for electron microscopy, neutral peptidase, and alkaline phosphatase assays. In another group of 10 animals, fractions were prepared from 14-day calluses and examined for proteoglycanase activity. In the cell fractions, alkaline phosphatase, alanyl-beta-naphthylamidase, aminopeptidase, and endopeptidase activities showed somewhat parallel distributions peaking at approximately 14-17 days. In the matrix vesicle fractions, similar relative distributions were observed for alkaline phosphatase and endopeptidase. However, here the peak activities occurred up to 3 days later than they did in the cell fractions. Significant proteoglycanase activity was confirmed in both cell and matrix vesicle fractions. These findings are consistent with the hypotheses that (a) neutral peptidases, by virtue of their temporal expression in parallel with alkaline phosphatase, may be involved in preparing fracture callus matrix for calcification; and (b) matrix vesicles may convey certain of these enzymes to sites of both matrix degradation and calcification, since the same activities found in cells are found in matrix vesicles a few days later. The possibility that some of these enzymes are involved in growth factor activation remains to be investigated.