Latest Medical Journal Articles

• Prevalence of Obesity and Trends in the Distribution of Body Mass Index Among US Adults, 1999-2010 [Original Contribution]
  New England Journal of Medicine - Recent
  

  Context Between 1980 and 1999, the prevalence of adult obesity (body mass index [BMI] ≥30) increased in the United States and the distribution of BMI changed. More recent data suggested a slowing or leveling off of these trends.

  Objective To estimate the prevalence of adult obesity from the 2009-2010 National Health and Nutrition Examination Survey (NHANES) and compare adult obesity and the distribution of BMI with data from 1999-2008.

  Design, Setting, and Participants NHANES includes measured heights and weights for 5926 adult men and women from a nationally representative sample of the civilian noninstitutionalized US population in 2009-2010 and for 22 847 men and women in 1999-2008.

  Main Outcome Measures The prevalence of obesity and mean BMI.

  Results In 2009-2010 the age-adjusted mean BMI was 28.7 (95% CI, 28.3-29.1) for men and also 28.7 (95% CI, 28.4-29.0) for women. Median BMI was 27.8 (interquartile range [IQR], 24.7-31.7) for men and 27.3 (IQR, 23.3-32.7) for women. The age-adjusted prevalence of obesity was 35.5% (95% CI, 31.9%-39.2%) among adult men and 35.8% (95% CI, 34.0%-37.7%) among adult women. Over the 12-year period from 1999 through 2010, obesity showed no significant increase among women overall (age- and race-adjusted annual change in odds ratio [AOR], 1.01; 95% CI, 1.00-1.03; P = .07), but increases were statistically significant for non-Hispanic black women (P = .04) and Mexican American women (P = .046). For men, there was a significant linear trend (AOR, 1.04; 95% CI, 1.02-1.06; P < .001) over the 12-year period. For both men and women, the most recent 2 years (2009-2010) did not differ significantly (P = .08 for men and P = .24 for women) from the previous 6 years (2003-2008). Trends in BMI were similar to obesity trends.

  Conclusion In 2009-2010, the prevalence of obesity was 35.5% among adult men and 35.8% among adult women, with no significant change compared with 2003-2008.

• Prevalence of Obesity and Trends in the Distribution of Body Mass Index Among US Adults, 1999-2010 [Original Contribution]
  New England Journal of Medicine - Current
  

  Context Between 1980 and 1999, the prevalence of adult obesity (body mass index [BMI] ≥30) increased in the United States and the distribution of BMI changed. More recent data suggested a slowing or leveling off of these trends.

  Objective To estimate the prevalence of adult obesity from the 2009-2010 National Health and Nutrition Examination Survey (NHANES) and compare adult obesity and the distribution of BMI with data from 1999-2008.

  Design, Setting, and Participants NHANES includes measured heights and weights for 5926 adult men and women from a nationally representative sample of the civilian noninstitutionalized US population in 2009-2010 and for 22 847 men and women in 1999-2008.

  Main Outcome Measures The prevalence of obesity and mean BMI.

  Results In 2009-2010 the age-adjusted mean BMI was 28.7 (95% CI, 28.3-29.1) for men and also 28.7 (95% CI, 28.4-29.0) for women. Median BMI was 27.8 (interquartile range [IQR], 24.7-31.7) for men and 27.3 (IQR, 23.3-32.7) for women. The age-adjusted prevalence of obesity was 35.5% (95% CI, 31.9%-39.2%) among adult men and 35.8% (95% CI, 34.0%-37.7%) among adult women. Over the 12-year period from 1999 through 2010, obesity showed no significant increase among women overall (age- and race-adjusted annual change in odds ratio [AOR], 1.01; 95% CI, 1.00-1.03; P = .07), but increases were statistically significant for non-Hispanic black women (P = .04) and Mexican American women (P = .046). For men, there was a significant linear trend (AOR, 1.04; 95% CI, 1.02-1.06; P < .001) over the 12-year period. For both men and women, the most recent 2 years (2009-2010) did not differ significantly (P = .08 for men and P = .24 for women) from the previous 6 years (2003-2008). Trends in BMI were similar to obesity trends.

  Conclusion In 2009-2010, the prevalence of obesity was 35.5% among adult men and 35.8% among adult women, with no significant change compared with 2003-2008.

• Treating the Triad: Teeth, Muscles and TMJs (2011)
  European Journal of Orthodontics - current issue
  
• Lingual and esthetic orthodontics (2011)
  European Journal of Orthodontics - current issue
  
• Biomechanics in orthodontics principles and practice (2010)
  European Journal of Orthodontics - current issue
  
• A comparative in vitro study of frictional resistance between lingual brackets and stainless steel archwires
  European Journal of Orthodontics - current issue
  

  Friction between archwires and labial brackets has received considerable attention; however, information on the frictional behaviour of commercially available lingual brackets is limited. The aim of this study was to investigate the frictional resistance resulting from a combination of lingual orthodontic brackets (7th Generation, STb, Magic, and In-Ovation L) and stainless steel archwires at 0, 5, and 10 degrees of second-order angulation. Each bracket type (n = 30) was tested with three different sizes of archwires. Static and kinetic frictional forces were evaluated with a universal testing machine. Statistical analysis of the data was performed with non-parametric Kruskal–Wallis and Dunn's multiple comparison tests.

  All tested brackets showed higher frictional forces as the wire size and second-order angulation increased. The lowest friction was found with In-Ovation L brackets and 0.016 inch archwires at 0 degrees angulation, and the greatest friction with a combination of STb brackets and 0.017 x 0.025 inch archwires at 10 degrees angulation. For all combinations, Magic and In-Ovation L brackets showed lower frictional resistance when compared with 7th Generation and STb brackets. The slot width (occluso-gingival dimension) of the brackets, measured using the optics of a microhardness machine, showed that all brackets were oversized and that Magic brackets had the largest slot width. Surface roughness of the brackets investigated using atomic force microscopy and scanning electron microscopy, demonstrated that the 7th Generation brackets had the greatest surface roughness.

• Metal ion release from fixed orthodontic appliances--an in vivo study
  European Journal of Orthodontics - current issue
  

  The aim of this study was to test the hypothesis that there is no difference in salivary metal ion content between subjects with fixed orthodontic appliances and their same-gender sister or brother without any orthodontic appliance.

  This retrospective study was carried out on 28 subjects (16 females and 12 males) who had undergone fixed orthodontic therapy for a duration of 12–18 months. In order to limit the effects of dietary and hygiene habits on salivary metal ion concentration, a same-gender brother or sister (total of 28 subjects) was selected as a control. Approximately 5 ml of saliva was collected from each subject, and the samples were analysed using an atomic absorption spectrophotometer. The detection limit of the method for sample solutions was 1 ng/ml. Since some variables were not normally distributed, non-parametric tests (Mann–Whitney U and Wilcoxon W ) were used for statistical analysis.

  The mean salivary nickel (Ni) content in subjects with and without a fixed orthodontic appliance was 18.5 ± 13.1 and 11.9 ± 11.4 ng/ml, respectively. A statistically significant difference (P < 0.035) was found between the two groups. The mean salivary chromium (Cr) ion level recorded was 2.6 ± 1.6 ng/ml in the study group and 2.2 ± 1.6 ng/ml in the control group. The difference, however, was statistically insignificant. Within the limits of this in vivo study, it can be concluded that the presence of fixed orthodontic appliances leads to an increased concentration of metal ions in salivary secretions.

• Influence of Pre-Orthodontic Trainer treatment on the perioral and masticatory muscles in patients with Class II division 1 malocclusion
  European Journal of Orthodontics - current issue
  

  The aim of this follow-up study was to evaluate the effects of Pre-Orthodontic Trainer (POT) appliance on the anterior temporal, mental, orbicularis oris, and masseter muscles through electromyography (EMG) evaluations in subjects with Class II division 1 malocclusion and incompetent lips. Twenty patients (mean age: 9.8 ± 2.2 years) with a Class II division 1 malocclusion were treated with POT (Myofunctional Research Co., Queensland, Australia). A group of 15 subjects (mean age: 9.2 ± 0.9 years) with untreated Class II division 1 malocclusions was used as a control. EMG recordings of treatment group were taken at the beginning and at the end of the POT therapy (mean treatment period: 7.43 ± 1.06 months). Follow-up records of the control group were taken after 8 months of the first records. Recordings were taken during different oral functions: clenching, sucking, and swallowing. Statistical analyses were undertaken with Wilcoxon and Mann–Whitney U-tests. During the POT treatment, activity of anterior temporal, mental, and masseter muscles was decreased and orbicularis oris activity was increased during clenching and these differences were found statistically significant when compared to control. Orbicularis oris activity during sucking was increased in the treatment group (P < 0.05). In the control group, significant changes were determined for anterior temporal (P < 0.05) and masseter (P < 0.01) muscle at clenching and orbicularis oris (P < 0.05) muscle at swallowing during observation period. Present findings indicated that treatment with POT appliance showed a positive influence on the masticatory and perioral musculature.

• Orthodontic anchoring techniques and its influence on pain, discomfort, and jaw function--a randomized controlled trial
  European Journal of Orthodontics - current issue
  

  The aim of this trial was to evaluate and compare perceived pain, discomfort, and jaw function impairment between orthodontic treatments combined with skeletal anchorage and treatment using conventional anchorage with headgear or transpalatal bar. A total of 120 adolescent patients in order to start orthodontic treatment were consecutively recruited and randomized into three groups with different anchorage. Group A underwent installation of a skeletal anchorage (Onplant or Orthosystem implant), group B received headgear, and group C a transpalatal bar. Questionnaires were used to assess pain intensity, discomfort, analgesic consumption, and jaw function impairment from baseline to the end of treatment. Pain scores overall peaked on day 2 and were almost back to baseline on day 7. The site with the highest pain scores during treatment was incisors in contact but with no differences between groups. Pain intensity from molars was significantly less in the skeletal anchorage group A compared to the transpalatal bar group C the first 4 days in treatment and with no sign differences compared to headgear. The results confirm that there were very few significant differences between patients’ perceptions of skeletal and conventional anchorage systems during orthodontic treatment. Consequently, these new appliances were well accepted by the patients in a long time perspective and can thus be recommended.

• The monitoring of gingival crevicular fluid volume during orthodontic treatment: a longitudinal randomized split-mouth study
  European Journal of Orthodontics - current issue
  

  This randomized split-mouth study was aimed at evaluating whether an orthodontic appliance per se or orthodontic tooth movement can induce detectable changes in gingival crevicular fluid (GCF) volume, and thus whether GCF volume is a predictable biomarker for tissue remodelling incident to orthodontic tooth movement. Materials and Methods: Sixteen healthy orthodontic patients (7 females and 9 males; mean age, 17.7 years; range, 13–27 years) with the need for extraction of the first upper premolars were enrolled. One randomly chosen maxillary canine was subjected to a distalizing force by a 0.017 x 0.025 inch titanium-molybdenum alloy archwire and considered as the test tooth (TT). The contralateral canine, which was not subjected to any force but was included in an orthodontic appliance, was used as a control (CT). GCF sampling was performed at both mesial and distal sites of the CTs and TTs at baseline, immediately before applying the orthodontic appliance, and after 1 hour, 24 hours, and 7, 14, and 21 days. A Periotron was used to measure the GCF volume.

  A modest but significant increase in the GCF volume over time was seen in both the CTs (mesial sites) and the TTs (both mesial and distal sites) with no differences between the experimental teeth.

  Subclinical tissue inflammation consequent to the placement of the orthodontic appliance might be responsible for these GCF volume changes. The GCF volume does not appear to be a reliable biomarker for tissue remodelling during orthodontic treatment.