Alveolar cortical plate changes associated with incisor retraction and its influence on the limits of orthodontic tooth movement.

OBJECTIVE: The extent to which the modelling behaviour of the anterior alveolus limits tooth movement remains unclear. Will the labial and lingual cortical plates model as incisors retract, or will they remain unchanged, therefore limiting the extent of possible tooth movement? SETTING AND SAMPLE POPULATION: Pre- and post-treatment lateral cephalometric radiographs of 29 bimaxillary protrusive patients of South Korean descent were examined. Treatment consisted of two premolar extractions in one or both arches with en masse retraction of the incisors using miniscrew anchorage. MATERIALS AND METHODS: Pre- and post-treatment measurements of both tooth and cortical plate position were made at various increments along the length of the root and then compared using paired t tests. RESULTS: Despite the use of miniscrew anchorage, the incisors were retracted by controlled tipping. The labial cortical plates in both arches modelled to follow tooth movement. Following retraction of the incisors in the maxilla, the incisor root approached the lingual cortical plate, which remained unchanged. In the mandible, the lingual cortical plate position was unchanged except at the level closest to the cementoenamel junction. CONCLUSIONS: The maxillary and mandibular lingual cortical plates did not model to follow the incisor movement while the labial cortical plates did. These findings suggest that lingual cortical plates may act as limitations to planned orthodontic tooth movement.

Bimaxillary transverse constriction in adults: Short-term follow-up of non-surgical arch expansion.

OBJECTIVE: Concurrent maxillary and mandibular expansion is a treatment option for patients with maxillary and mandibular transverse constriction. These patients do not present with crossbite but require expansion due to narrow arches and associated crowding, dark buccal corridors and decreased anterior arch contour. The objective of the study is to first establish Bimaxillary Transverse Constriction as an under-recognized malocclusion and second to evaluate whether in adults the maxillary and mandibular arches can be successfully and safely expanded. SETTING AND SAMPLE POPULATION: Pre- and post-treatment study models and lateral cephalograms of 31 adults with Bimaxillary Transverse Constriction expanded non-surgically were analysed. Thirty adult orthodontic patients who did not require expansion served as a control. Expanders were turned no more frequently than every other day in the maxilla and every third day in the mandible. MATERIALS AND METHODS: Measurements in both arches made on OrthoCAD models were transarch widths, molar and premolar axial angulation, clinical crown height of posterior teeth and cuspids, and mandibular divergence. Retrospective comparison of the 2 groups used independent Student's t tests for mean differences between groups. RESULTS: At pre-treatment, the expansion group demonstrated significant transverse constriction compared with the control. Increased widths were achieved in the expansion group (4 mm in the maxilla and 2.5 mm in the mandible), while the control group was unchanged. The mandibular plane was unchanged. There was no buccal attachment loss. CONCLUSION: Non-surgical expansion in the maxilla and mandible is a viable treatment option for adult patients with Bimaxillary Transverse Constriction.

ROC surface assessment of the ANB angle and Wits appraisal's diagnostic performance with a statistically derived 'gold standard': does normalizing measurements have any merit?

OBJECTIVE: To assess the ANB angle's and Wits appraisal's diagnostic performance using an extended version of Receiver Operating Curve (ROC) analysis, which renders ROC surfaces. These were calculated for both the conventional and normalized cephalometric tests (calculated by exchanging the patient's reference landmarks with those of the Procrustes superimposed sample mean shape).The required 'gold standard' was derived statistically, by applying generalized Procrustes superimposition (GPS) and principal component analysis (PCA) to the digitized landmarks, and ordering patients based upon their PC2 scores. METHODS: Digitized landmarks of 200 lateral cephalograms (107 males, mean age: 12.8 years, SD: 2.2, 93 females, mean age: 13.2 years, SD: 1.7) were subjected to GPS and PCA. Upon calculating the conventional and normalized ANB and Wits values, ROC surfaces were constructed by varying not just the cephalometric test's cut-off value within each ROC curve, but also the gold standard cut-off value over different ROC curves in 220 steps between -2 and 2 standard deviations along PC2. The volume under the resulting ROC surfaces (VUS) served as a measure of overall diagnostic performance. The statistical significance of the volume differences was determined using permutation tests (1000 rounds, with replacement). RESULTS: The diagnostic performance of the conventional ANB and Wits was remarkably similar for both Class I/II (81.1 and 80.75% VUS, respectively, P > 0.05). Normalizing the measurements improved all VUS highly significantly (91 and 87.2 per cent, respectively, P < 0.001). CONCLUSION: The conventional ANB and Wits do not differ in their diagnostic performance. Normalizing the measurements does seem to have some merit.

Stability of open bite correction with sagittal split osteotomy and closing rotation of the mandible.

PURPOSE: To determine the long-term stability of bilateral sagittal split osteotomies with counterclockwise (closing) rotation of the mandible combined with rigid internal fixation in the correction of anterior open bite deformities. MATERIALS AND METHODS: A total of 28 patients who had completed orthodontic therapy and had at least 1 year of postoperative follow-up were evaluated using cephalometric analysis for dental and skeletal changes. We evaluated 7 angular and 6 linear measurements cephalometrically at 3 points for each patient: immediately preoperatively, immediately postoperatively, and after a minimum of 1 year of postoperative follow-up. RESULTS: Of the 28 patients, 12 exhibited some degree of opening rotation (range 1% to 64%, mean 16%), and 16 showed no open rotation or continued to experience bite closure. However, all patients had a positive overbite at 1 year of follow-up, indicating that even though skeletal relapse was observed postoperatively, dental compensation resulted in the maintenance of the occlusal relationships. CONCLUSIONS: Bilateral sagittal split osteotomies and closing rotation of the mandible using rigid fixation is a relatively stable procedure and a viable surgical treatment option for the correction of anterior open bite in instances in which maxillary osteotomies are not indicated to improve or enhance facial esthetics.

Rapid palatal expansion for spontaneous Class II correction.

INTRODUCTION: Palatal expanders have been advocated for spontaneous correction of some Class II malocclusions. However, little research has been done to determine whether correction or improvement actually occurs with expansion. Past research has not shown whether an anterior functional shift is achieved in patients who have Class II improvement. The objective of this study was to determine whether maxillary expansion causes spontaneous correction or improvement of a Class II malocclusion. METHODS: This was a retrospective study of subjects from an orthodontic office in which models are mounted (articulator) in centric occlusion and maximum intercuspation before and after treatment. The sample included Class II patients (n = 13; mean age, 10 years 3 months) who, during the preceding 2 years, had been treated with expansion alone. Study models made before and after expansion were measured to compare the centric occlusion to the maximum intersuspation position. Condyle position indicator paper was also used to determine whether there was a functional shift after expansion. RESULTS: The only measurements with statistically significant changes from pretreatment to postexpansion were the maxillary intermolar widths. Seven of the 13 patients showed Class II improvement, but none had an anterior functional shift after expansion. CONCLUSIONS: Maxillary expansion does not predictably improve Class II dental relationships.

How well does Invisalign work? A prospective clinical study evaluating the efficacy of tooth movement with Invisalign.

INTRODUCTION: The purpose of this prospective clinical study was to evaluate the efficacy of tooth movement with removable polyurethane aligners (Invisalign, Align Technology, Santa Clara, Calif). METHODS: The study sample included 37 patients treated with Anterior Invisalign. Four hundred one anterior teeth (198 maxillary and 203 mandibular) were measured on the virtual Treat models. The virtual model of the predicted tooth position was superimposed over the virtual model of the achieved tooth position, created from the posttreatment impression, and the 2 models were superimposed over their stationary posterior teeth by using ToothMeasure, Invisalign's proprietary superimposition software. The amount of tooth movement predicted was compared with the amount achieved after treatment. The types of movements studied were expansion, constriction, intrusion, extrusion, mesiodistal tip, labiolingual tip, and rotation. RESULTS: The mean accuracy of tooth movement with Invisalign was 41%. The most accurate movement was lingual constriction (47.1%), and the least accurate movement was extrusion (29.6%)- specifically, extrusion of the maxillary (18.3%) and mandibular (24.5%) central incisors, followed by mesiodistal tipping of the mandibular canines (26.9%). The accuracy of canine rotation was significantly lower than that of all other teeth, with the exception of the maxillary lateral incisors. At rotational movements greater than 15 degrees, the accuracy of rotation for the maxillary canines fell significantly. Lingual crown tip was significantly more accurate than labial crown tip, particularly for the maxillary incisors. There was no statistical difference in accuracy between maxillary and mandibular teeth of the same tooth type for any movements studied. CONCLUSIONS: We still have much to learn regarding the biomechanics and efficacy of the Invisalign system. A better understanding of Invisalign's ability to move teeth might help the clinician select suitable patients for treatment, guide the proper sequencing of movement, and reduce the need for case refinement.

Outcome of one-visit and two-visit endodontic treatment of necrotic teeth with apical periodontitis: a randomized controlled trial with one-year evaluation.

The choice of one-visit versus two-visit root canal therapy for necrotic teeth with apical periodontitis is a source of current debate. The primary objective of this randomized controlled clinical trial was to compare radiographic evidence of periapical healing after root canal therapy completed in one visit or two visits with an interim calcium hydroxide/chlorhexidine paste dressing. Ninety-seven patients met the inclusion criteria and consented to participate in this study. Patients were randomly assigned to either the one-visit or two-visit group, and root canal therapy was performed with a standardized protocol. Patients in the two-visit group received an intracanal dressing of calcium hydroxide/chlorhexidine paste. Sixty-three patients, 33 in the one-visit group and 30 in the two-visit group, were evaluated at 12 months. The primary outcome measure was change in apical bone density by using the periapical index (PAI). Secondary outcome measures were proportion of teeth healed or improved in each group. Both groups exhibited equally favorable periapical healing at 12 months, with no statistically significant differences between groups.

Bond strength analysis of custom base variables in indirect bonding techniques.

INTRODUCTION: Various methods are used to prepare the cured composite-adhesive interface for orthodontic indirect bonding. The intent of this study was to determine the effect on the shear bond strength of the following variables: use of a filled flowable composite resin as an adhesive, light air-abrasion of the cured composite bracket pad, and wetting the cured composite bracket pad with an unfilled resin. METHODS: The sample of 240 brackets was divided into 2 groups of 120 each. The first group was further divided into 4 groups of 30 each. Brackets were bonded to bovine incisors with a filled flowable composite resin (Filtek, 3M ESPE, St Paul Minn), but the bracket pads were prepared differently in the 4 groups: unfilled resin was applied (Orthosolo, Ormco, Glendora, Calif), the surface was air abraded, the surface was air abraded followed by application of an unfilled resin (Orthosolo), and a control group. A matching sample of 120 brackets was bonded without the flowable composite as an adhesive. The different bracket pad preparations were chosen to represent the various techniques clinicians use in indirect bonding. The shear bond strength was measured on a universal testing machine. RESULTS: Two-way ANOVA analysis showed significant differences in the shear bond strength among the different surface preparations, but not between the use and nonuse of flowable composite. The Scheffé test showed that the mean shear bond strength of the air-abraded surface was significantly higher than all other surface preparations. CONCLUSIONS: Air abrading orthodontic bracket-pad composite surfaces in indirect bonding increased the shear bond strength, whereas the use of flowable composite did not affect bond strengths.

Preferences for vertical position of the maxillary lateral incisors.

AIM: To evaluate the preferences for vertical position of the maxillary lateral incisors among orthodontists, general dentists, and laypeople. METHODS: The study group consisted of 120 judges, 40 in each of 3 study groups. Judges were asked to give their preference for maxillary lateral incisor position while viewing an animation of an idealized smile. Perceptometrics software animated the photograph and collated responses. Each judge participated in 2 similar experiments, 1 to determine what he/she found to be the most pleasing position and another to define that position's range of acceptability. The processed data were analyzed with ANOVA (analysis of variance) and post-hoc Scheffé tests to determine mean differences among the 3 study groups. RESULTS: The most pleasing protocol revealed no significant difference (P >.05) in the mean preferences of the 3 groups. The average preference was 0.6 mm above the incisal plane. No subjects chose a level incisal plane as being most pleasing. Orthodontists and general dentists had a smaller range of acceptability than laypeople. The means for lower and upper limits of acceptability for all subjects were 0.3 mm and 1.0 mm, respectively, above the incisal plane. CONCLUSIONS: The judges in this study preferred that the maxillary lateral incisor to be set about 0.5 mm above the incisal plane, slightly offset from the incisal plane, and not level. The lateral incisors were best perceived when they were offset slightly from the incisal plane, and there was an acceptable range within which the lateral incisors may be placed.

Quantitative measures of gingival recession and the influence of gender, race, and attrition.

BACKGROUND: Gingival recession in dentitions with otherwise healthy periodontium is a common occurrence in adults. Recession is clinically measured using a periodontal probe to the nearest millimeter. The aim of this study is to establish quantitative measures of recession, the clinical crown height, and a new measure the gingival margin-papillae measurement. The latter is seen as the shortest apico-coronal distance measured from the depth of the gingival margin to a line connecting the tips of the two adjacent papillae. METHODS: Measurements on all teeth up to and including the first molar were performed on pretreatment study models of 120 adult Caucasian and African-American subjects divided into four groups of 30 by gender and race. RESULTS: Both the clinical crown height and the gingival margin-papillae measurements gave a true positive result for changes associated with gingival recession. Tooth wear shortens the clinical crown, and therefore, the measure of clinical crown height can give a false negative result when gingival recession is present. However, the gingival margin-papillae measurement was not affected by tooth wear and gave a true positive result for gingival recession. Tooth wear (attrition) was not associated with an increase in gingival recession. These measures are also useful in detecting recession prior to cemental exposure. Measures for recession and tooth wear were different for the four demographic groups studied. CONCLUSIONS: These measures can be used as quantitative standards in both clinical dentistry, research, and epidemiological studies.

Extracellular matrix-mediated tissue remodeling following axial movement of teeth.

Tooth eruption is a multifactorial process involving movement of existing tissues and formation of new tissues coordinated by a complex set of genetic events. We have used the model of the unopposed rodent molar to study morphological and genetic mechanisms involved in axial movement of teeth. Following extraction of opposing upper molars, lower molars supererupted by 0.13 mm. Labeled tissue sections revealed significant amounts of new bone and cementum apposition at the root apex of the unopposed side following supereruption for 12 days. Newly apposited cementum and alveolar bone layers were approximately 3-fold thicker in the experimental vs the control group, whereas periodontal ligament width was maintained. Tartrate-resistant acid phosphatase staining indicated bone resorption at the mesial alveolar walls of unopposed molars and provided in tandem with new bone formation at the distal alveolar walls an explanation for the distal drift of molars in this model. Microarray analysis and semiquantitative RT-PCR demonstrated a significant increase in collagen I, integrin beta5, and SPARC gene expression as revealed by comparison between the unopposed molar group and the control group. Immunohistochemical verification revealed increased levels of integrin beta5 and SPARC labeling in the periodontal ligament of the unopposed molar. Together our findings suggest that posteruptive axial movement of teeth was accomplished by significant formation of new root cementum and alveolar bone at the root apex in tandem with upregulation of collagen I, integrin beta5, and SPARC gene expression.

Antimicrobial effect of triclosan and triclosan with Gantrez on five common endodontic pathogens.

Microbial control of the root canal system is one of the key objectives of root canal therapy. Triclosan is a widely accepted broad spectrum antimicrobial agent proven to be effective against many gram-positive and gram-negative bacteria. Triclosan acts by blocking bacterial fatty acid biosynthesis. The addition of Gantrez copolymer has been shown to enhance the antimicrobial activity of triclosan. The purpose of this study was to determine the minimum inhibitory and bactericidal concentrations of triclosan and triclosan with Gantrez against Prevotella intermedia, Fusobacterium nucleatum, Actinomyces naeslundii, Porphyromonas gingivalis, and Enterococcus faecalis. The minimum inhibitory concentration (MIC) of both test solutions was determined for each of the 5 microorganisms by using microtiter serial dilutions. Samples were streaked on 5% sheep blood agar plates and placed in an anaerobic incubator to determine the minimum bactericidal concentration (MBC). The MBC of triclosan ranged from 12-94 microg/mL. The MBC of triclosan with Gantrez ranged from <0.3-10.4 microg/mL. The addition of Gantrez enhanced the bactericidal activity of triclosan. Both triclosan and triclosan with Gantrez demonstrated bactericidal activity against the 5 specific endodontic pathogens.

Relationship between index of complexity, outcome and need, dental aesthetic index, peer assessment rating index, and American Board of Orthodontics objective grading system.

INTRODUCTION: The objectives of this study were to examine the relationships among 4 indexes that are used to score orthodontic treatment need and outcome, and to determine whether 1 index could replace the other 3. The index of complexity, outcome, and need (ICON), the dental aesthetic index (DAI), the peer assessment rating (PAR) index, and the American Board of Orthodontics objective grading system (ABO-OGS) were studied. The use of the ICON is desirable because it is faster to use than separate indexes for assessing different treatment facets. METHODS: One hundred pretreatment and posttreatment study models were randomly selected from an accredited graduate orthodontic clinic at University of Illinois at Chicago, Chicago, Ill. The sample was assessed by using the PAR index, the DAI, the ABO-OGS, and the ICON. The data were analyzed descriptively and the relationships evaluated by using the Spearman rank order correlation coefficient. RESULTS: The study showed a significant correlation between the DAI and the ICON with respect to treatment need (r = .5523, P <.001). The PAR index and the ABO-OGS had significant correlations with the ICON for treatment outcome (pretreatment PAR vs ICON, r = .6840, P <.001; posttreatment PAR vs ICON, r = .3466, P <.001; ABO-OGS vs ICON, r = .2654, P <.01). CONCLUSIONS: The ICON can be used in place of the PAR and the ABO-OGS for assessing treatment outcome and in place of the DAI for assessing treatment need.

Assessing the American Board of Orthodontics objective grading system: digital vs plaster dental casts.

INTRODUCTION: The purposes of this study were to determine whether the American Board of Orthodontics objective grading system (ABO OGS) can be assessed accurately from digital dental casts and whether there are statistical differences between digital and plaster dental casts in scoring the ABO OGS. METHODS: Thirty posttreatment plaster dental casts were selected and scanned by OrthoCAD (Cadent, Carlstadt, NJ) to produce 30 corresponding digital dental casts. The plaster and digital casts were compared by using the criteria of the ABO OGS. Because the data were ordinal, a nonparametic statistical analysis was used. RESULTS: The Wilcoxon test for paired samples showed significant differences between the plaster and digital casts for occlusal contacts, occlusal relationships, and total scores (P <.05). No significant differences were found for alignment, marginal ridges, overjet, and interproximal contacts. Buccolingual inclination was not included in this study because of inability to perform proper measurements with the OrthoCAD program. Mean differences of points deducted ranged from .03 point for marginal ridges to 5.07 points for the total score. The variable with the most points deducted related to occlusal relationships, and the fewest points were deducted for interproximal contacts. CONCLUSIONS: Based on this study, the current OrthoCAD program (version 2.2) was not adequate for scoring all parameters as required by the ABO OGS.

Use of an Electronic Patient Record system to evaluate restorative treatment following root canal therapy.

Electronic Patient Record (EPR) systems are rapidly gaining acceptance as an important tool for managing patient information. The purpose of this project was to evaluate the use of an EPR system for assessment of quality of care in an academic dental institution. The primary outcome of interest was the timeliness and completeness of restorative care following completion of nonsurgical root canal therapy. An initial query of the EPR database was performed using the following inclusion criteria: root canal treatment performed in the postgraduate endodontics clinic between September 2002 and June 2004, patient age > or =18 years old, and posterior tooth (premolars and molars). A total of 925 patients with 1,014 endodontically treated teeth met the inclusion criteria. A random sample of 30 percent of the treated teeth (302 teeth on 281 patients) was selected for detailed review. This sample of 302 teeth was then screened to determine if any restorative treatment had been performed between September 2002 and November 2005. Forty-eight percent (n=146) of the 302 teeth did not receive any form of permanent restoration over the time period studied. Twenty-five percent (n=75) of the teeth received a buildup only, and 27 percent (n=82) received the recommended treatment, a full occlusal coverage restoration. This study documents the use of an EPR system to objectively and efficiently assess one aspect of quality of care in a dental school environment.

Magnetic strength and corrosion of rare earth magnets.

INTRODUCTION: Rare earth magnets have been used in orthodontics, but their corrosion tendency in the oral cavity limits long-term clinical application. The aim of this project was to evaluate several; magnet coatings and their effects on magnetic flux density. METHODS: A total of 60 neodymium-iron-boron magnets divided into 6 equal groups--polytetrafluoroethylene-coated (PTFE), parylene-coated, and noncoated--were subjected to 4 weeks of aging in saline solution, ball milling, and corrosion testing. RESULTS: A significant decrease in magnet flux density was recorded after applying a protective layer of parylene, whereas a slight decrease was found after applying a protective layer of PTFE. After 4 weeks of aging, the coated magnets were superior to the noncoated magnets in retaining magnetism. The corrosion-behavior test showed no significant difference between the 2 types of coated magnets, and considerable amounts of iron-leached ions were seen in all groups. CONCLUSIONS: Throughout the processes of coating, soaking, ball milling, and corrosion testing, PTFE was a better coating material than parylene for preserving magnet flux density. However, corrosion testing showed significant metal leaching in all groups.

Orthodontic treatment--improvement and standards using the peer assessment rating index.

This article is aimed at assessing the orthodontic treatment outcome in an accredited graduate orthodontic clinic in the United States, using the original Peer Assessment Rating (PAR) Index. A sample of 100 pre- and posttreatment study models was randomly selected from the clinic model storage. One investigator assessed all the components of the PAR Index. Descriptive statistics and Scheffe test were used to analyze the data. The mean weighted PAR point reduction was 22.11, and mean percentage reduction was 86.20. "Greatly improved" conditions were seen in 50% of patients while 47% accounted for the "improved category." Only 3% belonged to the "worse or no different" group. Statistically significant differences were observed between the three improvement groups for weighted pre- and posttreatment PAR scores, reduction, and percentage reduction. The results indicated an excellent improvement of the patients, with patients being treated to a high standard and a great proportion of patients with a clear need for treatment.

Orthodontic treatment need in an accredited graduate orthodontic center in north america: a pilot study.

AIM: To assess the objective orthodontic treatment needs of patients treated in an accredited Orthodontic Clinic in North America using a retrospective cross sectional study and the Dental Aesthetic Index (DAI). METHODS AND MATERIALS: One hundred pre- and post-treatment study models were randomly selected from the model storage facility of the clinic. Only the pre-treatment study models were assessed using the DAI. The pre-treatment and post-treatment ages for each case were noted as recorded on the corresponding study models. The range for the pre-treatment age was 10 to 52 years, and from 12 years, 4 months to 54 years for the post-treatment age range. The duration of treatment for each case was calculated by subtracting the pre-treatment age from the post-treatment age (range of treatment duration, 9 to 125 months). Descriptive statistics as well as chi-square statistics were employed to analyze the data. RESULTS: Fifteen cases had normal or minor malocclusions with no treatment or slight need for treatment. Definite malocclusions with treatment highly desirable accounted for 22 cases and severe malocclusion with treatment highly desirable was found in 16 cases. Forty-seven cases had handicapping malocclusion with treatment considered mandatory. While a statistically significant association (p<0.05) was found between duration of treatment and severity levels of malocclusion (DAI scores), the association between pre-treatment age and DAI scores was not significant (p > 0.05). CONCLUSIONS: Eighty-five percent of the study sample needed orthodontic treatment with different malocclusion severity levels, while 47% of the cases qualified for publicly subsidized treatment due to handicapping malocclusions. The association between duration of treatment and DAI score groups (malocclusion severity levels) was found statistically significant. It could be helpful for more clinic-based (demand populations) studies on treatment needs be undertaken across the globe using the DAI, at least for the purposes of comparison.

Prognostic factors associated with the success rates of posterior orthodontic miniscrew implants: A subgroup meta-analysis.

OBJECTIVE: To systematically review previous studies and to assess, via a subgroup meta-analysis, the combined odds ratio (OR) of prognostic factors affecting the success of miniscrew implants (MIs) inserted into the buccal posterior region. METHODS: Three electronic searches that were limited to articles on clinical human studies using MIs that were published in English prior to March 2015 were conducted. The outcome measure was the success of MIs. Patient factors included age, sex, and jaw of insertion (maxilla vs. mandible), while the MI factors included length and diameter. A meta-analysis was performed on 17 individual studies. The quality of each study was assessed for non-randomized studies and quantified using the Newcastle-Ottawa Scale. The meta-analysis outcome was a combined OR. Subgroup and sensitivity analyses based on the study design, study quality, and sample size of miniscrews implanted were performed. RESULTS: Significantly higher success rates were revealed for MIs inserted in the maxilla, for patients ≥ 20 years of age, and for long MIs (≥ 8 mm) and MIs with a large diameter (> 1.4 mm). All subgroups acquired homogeneity, and the combined OR of the prospective studies (OR, 3.67; 95% confidence interval [CI], 2.10-6.44) was significantly higher in the maxilla than that in the retrospective studies (OR, 2.10; 95% CI, 1.60-2.74). CONCLUSIONS: When a treatment plan is made, these risk factors, i.e. jaw of insertion, age, MI length, and MI diameter, should be taken into account, while sex is not critical to the success of MIs.

The effect of human immunodeficiency virus on endodontic treatment outcome.

The purpose of this retrospective study was to compare periradicular healing between HIV positive and negative patients 1 yr after endodontic treatment of necrotic teeth with chronic apical periodontitis. The preoperative radiographs of 33 patients diagnosed with HIV and 33 medically healthy patients were scored by three endodontists using the Periapical Index (PAI) Scoring Method. Follow-up radiographs were taken 12 months after endodontic treatment and also scored with the PAI. The degree of healing, as determined by the mean PAI change, was compared between the two groups. There were no statistically significant differences between the two with respect to the degree of periradicular healing. In addition, the three evaluators were found to have very high inter-examiner agreement. The results indicate that clinicians do not have to alter their expectations for healing and resolution of periradicular lesions based solely on the HIV status of their patients.