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• W4232906723 abstract "“A keener appreciation of biologic interactions in the interpretation of many recurring clinical problems should be a guide to future research.” Truer words could not have been uttered by the young Vanarsdall as he shared his enthusiasm for the specialty with the publication of this “classic article” in 1977. Until this time, treating unerupted teeth meant dealing with many unpredictable problems, ranging from ankylosis to gingival recession and bone loss. Two faculty members at the Pennsylvania School of Dental Medicine noted that little attention was focused on soft tissue management of the problem. After seeing fewer complications when the attached gingiva was placed over the tooth at the time of surgical exposure, this procedure became the norm for the department. After 75 patients were treated this way on a trial basis, the authors brought this descriptive article to life, and it has benefited clinicians ever since. Although “Slick” Vanarsdall might tell you that this surgical technique is a major part of the solution to treatment complications of impacted teeth, subsequent research shows it is not the only way to bring teeth into alignment. Nevertheless, the publication of this article has had an impact on the orthodontic specialty for more than 25 years and deserves to be considered a “classic.” When planning treatment for your next patient, you are pleased that he can probably be treated without complications. A lingually displaced maxillary lateral incisor has motivated the patient to want treatment. “How will you be able to straighten that tooth?” questions the teenager. “It looks like the root is even in the wrong place,” he says as he peers at the records you have collected. You waste little time in assuring him that you use one of the most precise edgewise appliances ever designed, and that, as the teeth are aligned, the lingually positioned root will automatically move into its proper location. But is that really what happens? Not according to this article, which claims that torque in the bracket or archwire, or both, would have to be exaggerated to achieve the desired result. Archwire to bracket-size relationships and stiffness as well as the method of ligation all affect how efficiently you can align this patient's ectopic lateral incisor. I encourage students and inexperienced clinicians to pay close attention to this biomaterials article. It makes it easier to understand why clinicians who depend on a strict straight-wire discipline must carefully consider the materials they use and might even have to bend a few wires. Patient comfort and safety during the removal of fixed appliances have long been concerns of clinicians. This is particularly true when the appliances are ceramic brackets. Although this is an in vitro study, the fact that the researchers compared 2 of the most popular ceramic brackets (Clarity, by 3M/Unitek, and Inspire, by Ormco) make it a must-read. The text makes it very clear exactly how both brackets are to be removed, and the conclusions of the study are most instructive. There was no gross enamel damage to any teeth when the Clarity and Inspire brackets were debonded with the appropriate instruments. When the brackets were removed with pliers, the incidence of partial bracket-base fracture in the Inspire group was 15%. No bracket failure was noted in the Clarity group. “It is advisable,” emphasized the authors, “to use debonding methods designed specifically for each ceramic bracket.”" @default.
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• W4232906723 date "2004-03-01" @default.
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• W4232906723 title "Editor's choice" @default.
• W4232906723 doi "https://doi.org/10.1016/j.ajodo.2004.01.008" @default.
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