DEPARTMENT OF REVIEWS AND ABSTRACTS

Edited by
Alex Jacobson, DMD, MS, PhD
Birmingham, Ala.
All inquiries regarding information on reviews and abstracts should be directed
to the respective authors. For ordering books, contact your local bookstore or
write directly to the publishers. Articles or books for review in this department should be
addressed to Dr. Alex Jacobson, University of Alabama School of Dentistry,
University Station/Birmingham, AL 35295

Duration of orthodontic treatment involving
orthognathic surgery
Paul A. Dowling, Lisen Espeland, Olaf Krogstad,
Arild Stenvik and Alan Kelly.
Int J Adult Orthod Orthognath Surg 1999;14:146.
The purpose of this study was to analyze factors influ-
encing the duration of treatment in a sample of patients
treated by a combined orthodontic/orthognathic surgery
approach. Presurgical and postsurgical treatment times were
assessed for 315 patients processed through an orthognathic
team over a 7-year period. The median total treatment dura-
tion for all patients was 21.9 months, the median presurgical
duration was 15.4 months, and the median postsurgical dura-
tion was 5.9 months. Treatment involving extractions resulted
in significantly increased presurgical and total treatment
times. Treatments performed in the university clinic showed
reduced presurgical duration and increased postsurgical dura-
tion compared to treatments carried out by specialists outside
the university. Presurgical, postsurgical, and total treatment
times were significantly reduced when the orthodontist had
treated 10 or more patients during the period. An earlier reg-
imen of orthodontic treatment did not appear to have a sig-
nificant effect on treatment duration.
Alex Jacobson
A prospective study of external apical root resorption
through the course of orthodontic treatment
Brandon W. Boggan
University of Tennessee, Memphis
External apical root resorption (EARR) is a physical
reduction of root length. Whether in association, with ortho-
dontic mechanotherapy or as a naturally occurring phenome-
non, EARR is a complex biological process of which many
aspects remain unclear. This is a longitudinal, prospective
study that reports on 153 patients during the first and second
year of orthodontic treatment. Standardized periapical radi-
ographs were taken of the 4 maxillary incisors 2 or 3 times
per year throughout treatment. EARR was scored with a 5-
grade ordinal scale of severity, and tooth length was mea-
sured by using a computerized imaging system. For ordinal
and ratio scale data, there was no significant association
between EARR and sex, age, extraction pattern, overbite,
overjet, SNA, headgear use, or intrusion mechanics. Based
on ratio scale data, patients treated with Tweed mechanics
exhibited more root resorption than straightwire cases during
the second year of orthodontic treatment. More than half of
the incisors at the end of the first year of orthodontic treat-
ment showed signs of EARR, 58% of lateral incisors and
52% of central incisors, respectively. At the end of the second
year of orthodontic treatment, 83% of laterals and 79% of
centrals experienced root loss. However, only 1% and 5% of
incisors showed moderate resorption (an ordinal score of 3)
at the end of the first and second year of orthodontic treat-
ment, respectively. None of the maxillary incisors experi-
enced severe resorption. Ratio results showed that after 1
year of orthodontic treatment lateral incisors lost a greater
amount of root structure than central incisors (P = 0.03). The
central and lateral incisors of older individuals tended to
experience more root resorption than younger individuals
during the second year of treatment (P = 0.05). Both ordinal
and ratio scale data revealed that the greater the U1 to SN
angulation, the greater the extent of EARR (P = 0.03). Step-
wise linear regression was used to test for associations
between EARR and the use and duration of specific treat-
ments. The use of a closing loop arch wire, intra-arch elas-
tics, and interarch elastics explained between 9% and 18% of
the variation in EARR of lateral incisor. Results showed that
the use of closing loops arch wires, intra-arch elastics, inter-
arch elastics, and U1 to SN angulation explained between 8%
and 22% of the variation in EARR of central incisors. The
extent of resorption during orthodontic treatment seldom
approaches an amount that would be clinically significant.

American Journal of Orthodontics and Dentofacial Orthopedics/October 1999 479