New Release by Robert L Vanarsdall
Craniofacial Growth Series, Jan 2017
Rapid palatal expansion (RPE) has been used primarily to treat dental crossbites or for space gai... more Rapid palatal expansion (RPE) has been used primarily to treat dental crossbites or for space gaining to prevent extractions with little or no attempt made to coordinate or normalize the transverse skeletal pattern. Traditionally, maxillary orthopedics has been performed using the dental units only as anchorage (e.g., Hyrax or Haas appliances). Dental anchorage not only has created limited skeletal orthopedic change, but also can cause significant adverse periodontal outcomes and unstable side effects. There is a clear correlation between buccal tooth movement and gingival recession and bone dehiscences. These adverse periodontal responses with RPE indicate the importance of early treatment. The beneficial periodontal effects of transverse skeletal correction have been a primary focus of our research for the past 35 to 40 years. We have emphasized the importance of correcting transverse skeletal discrepancy to: 1) prevent periodontal problems; 2) achieve greater dental and skeletal stability; 3) improve dentofacial esthetics by eliminating or improving buccal corridors; and 4) improve airway resistance. When it may be critical to save the natural dentition, we do not want to introduce adverse dental/skeletal changes for adolescent patients and/or patients with advanced periodontal disease. New advances in skeletal anchorage should permit orthopedic change without adverse dental changes by applying force directly to the maxillary bone; an innovative technique to maximize the skeletal maxillary changes in the transverse dimension is explained in this chapter. Furthermore, diagnosis of the transverse dimension—the use of cone-beam computed tomography (CBCT) for 3D evaluation of skeletal changes, the benefits of the skeletal transverse changes of the whole maxillofacial complex and its periodontal response, the changes in airway and non surgical RPE with bone-anchored appliances utilizing temporary anchorage devices (TADs)—is described and discussed.
Book Chapters by Robert L Vanarsdall
Orthodontics: Current Principles and Techniques. 6th ed. In: Graber LW, Vanarsdall RL, Vig KWL, Huang GJ, editors. Elsevier., 2017
As we see more adults entering comprehensive orthodontic treatment, we must be more attuned to th... more As we see more adults entering comprehensive orthodontic treatment, we must be more attuned to the implications of periodontal issues. In this updated chapter, Robert Vanarsdall, Ignacio Blasi and Antonino Secchi review periodontal issues that impact orthodontic tooth movement. They describe periodontal "high risk" factors, mucogingival considerations, and problems with ectopic as well as ankylosed teeth. A new section on alveolar decortication and augmentation grafting has been added to address the increased use of these procedures designed to develop the alveolar housing and potentially increase the speed of tooth movement. Excellent clinical examples are pictured throughout the chapter.
Papers by Robert L Vanarsdall
Seminars in Orthodontics, 2010
The strategy for managing unerupted teeth has been debated for more than half a century. Duration... more The strategy for managing unerupted teeth has been debated for more than half a century. Duration of treatment, adverse responses, and type of surgical procedure and mechanotherapy to align ectopically positioned teeth has been analyzed, with disparate approaches endorsed. This report will describe the most frequent adverse problems encountered with management of unerupted teeth and suggest a means to prevent them. A recent study will be reviewed that will demonstrate a time-tested evidence-based approach that can prevent these commonly encountered adverse problems as well as reduce treatment time required to position the malposed tooth into the line of occlusion regardless of the patient's age. (Semin Orthod 2010;16:212-221.)
Periodontology 2000, 1995
Seminars in orthodontics, 1999
This article emphasizes the critical importance of the skeletal differential between the width of... more This article emphasizes the critical importance of the skeletal differential between the width of the maxilla and the width of the mandible. Undiagnosed transverse discrepancy leads to adverse periodontal response, unstable dental camouflage, and less than optimal dentofacial esthetics. Hundreds of adult retreatment patients corrected for significant maxillary transverse deficiency using surgically assisted maxillary expansion (similar to osseous distraction) has produced excellent stability. Eliciting tooth movement for children (orthopedics, lip bumper, Cetlin plate) in all three planes of space by muscles, eruption, and growth, develops the broader arch form (without the mechanical forces of fixed or removable appliances) and has also demonstrated impressive long term stability.
The effect of orthopedic or orthodontic treatment on the transverse dimension has been the subjec... more The effect of orthopedic or orthodontic treatment on the transverse dimension has been the subject of endless debate among orthodontists. The purpose of this investigation was to examine the response on the transverse dimension of the basal structure of the mandible and maxilla following two different modalities of treatment: group A--standard edgewise orthodontic treatment and group B--maxillary orthopedics with a bonded (tissue borne) rapid palatal expander (RPE) combined with a mandibular lip bumper. Each group had a matched paired untreated control according to age, sex, race, and treatment duration. For all subjects the width of the maxilla (Mx-Mx) and mandible (Ag-Ag) were measured on pre- and posttreatment posteroanterior cephalograms. The rate of width change in the maxilla and mandible was calculated (in mm/y). Results showed that group A had no treatment effect on the transverse dimension of the maxilla and mandible when compared with controls. However, group B had a significant increase in the transverse dimension of Mx-Mx (P < .001) and Ag-Ag (P < .001) when compared with controls. It was concluded that the RPE treatment increased the maxillary skeletal width, and the lip bumper increased the transverse dimension of the basal structure of the mandible.
Compendium of continuing education in dentistry (Jamesburg, N.J. : 1995), 2007
The incorporation of miniscrews into orthodontic treatment planning has allowed for predictable c... more The incorporation of miniscrews into orthodontic treatment planning has allowed for predictable control of anchorage and has increased the ability to correct severe skeletal discrepancy with nonsurgical orthodontics. It is the goal of this article to review the terminology, design, placement, and activation of miniscrews, as well as the advantages and complications associated with their use so that the multidisciplinary team will become familiar and comfortable with this novel treatment modality.
The Angle orthodontist, 2004
The effect of orthopedic or orthodontic treatment on the transverse dimension has been the subjec... more The effect of orthopedic or orthodontic treatment on the transverse dimension has been the subject of endless debate among orthodontists. The purpose of this investigation was to examine the response on the transverse dimension of the basal structure of the mandible and maxilla following two different modalities of treatment: group A--standard edgewise orthodontic treatment and group B--maxillary orthopedics with a bonded (tissue borne) rapid palatal expander (RPE) combined with a mandibular lip bumper. Each group had a matched paired untreated control according to age, sex, race, and treatment duration. For all subjects the width of the maxilla (Mx-Mx) and mandible (Ag-Ag) were measured on pre- and posttreatment posteroanterior cephalograms. The rate of width change in the maxilla and mandible was calculated (in mm/y). Results showed that group A had no treatment effect on the transverse dimension of the maxilla and mandible when compared with controls. However, group B had a signi...
World journal of orthodontics, 2004
Amer J Orthodont Dent Orthop, 1994
The International Journal of Adult Orthodontics and Orthognathic Surgery, Feb 1, 2002
ABSTRACT
Introduction: The purpose of this retrospective study was to evaluate the dentoskeletal changes a... more Introduction: The purpose of this retrospective study was to evaluate the dentoskeletal changes after slow maxillary expansion in adults. Methods: Three kinds of maxillary expanders (Haas [Dyna Flex, Laboratory, St Louis, Mo], MAX-2000 [Dyna Flex], and DMAX-2000 [Dyna Flex]) were used randomly in 3 study groups of 65 adults treated with nonsurgical slow maxillary expansion, followed by full straight-wire appliance therapy. A control group of 22 adults, meeting the same inclusion criteria, were treated only with full straight-wire appliance therapy without expansion. Posteroanterior and lateral cephalometric records were taken before the start of treatment (T1) and after fixed orthodontic treatment (T2). The data were analyzed statistically by using paired t tests and Kruskal-Wallis H tests. Results: From T1 to T2, there was no significant change in nasal width, maxillary width, and mandibular width in the 3 groups. The sella-nasion-mandibular plane angle increased 0.97 (P \0.05) in the DMAX-2000 group. The mandibular incisor-mandibular place angle in the Haas, MAX-2000, DMAX-2000, and control groups had mean increases of 4.90 , 4.42 , 4.55 , and 5.20 (P \0.05 for each), respectively. The maxillary incisor-nasion-A-point angle increased 3.04 (P 5 0.05), and the distal root of the maxillary first molar-nasion perpendicular decreased 1.48 mm (P \0.05) in the control group. The distal facet of the maxillary first molar-nasion perpendicular decreased 3.57 mm (P \0.05), and the distal root of the maxillary first molar-nasion perpendicular decreased 2.50 mm (P \0.05) in the MAX-2000 group. Conclusions: After expansion treatment, there were no evident transverse or significant sagittal and vertical skeletal maxillary changes in the 3 groups. (Am J Orthod Dentofacial Orthop 2009;136:348-54)
AORN Journal, 1985
ABSTRACT
American Journal of Orthodontics and Dentofacial Orthopedics, 2001
American Journal of Orthodontics and Dentofacial Orthopedics, 1990
American Journal of Orthodontics and Dentofacial Orthopedics, 2005
The purpose of this study was to evaluate the effects of prestretching on time-dependant force de... more The purpose of this study was to evaluate the effects of prestretching on time-dependant force decay of synthetic elastomeric chains. Methods: Five-unit (12.5 mm) and 6-unit (15.5 mm) modules (Generation II, Ormco, Glendora, Calif) were prestretched 100% for 1 hour (n ϭ 12), 24 hours (n ϭ 12), 2 weeks (n ϭ 12), and 4 weeks (n ϭ 12) in 37°C distilled water. The prestretched and unprestretched (control) modules were then stretched to 30 mm in 37°C water, and their forces were measured at 0 hour, 1 hour, 24 hours, and weekly for 4 weeks with a digital force gauge. Results: The prestretched 5-and 6-unit modules yielded significantly lower initial force than the controls. All 5-and 6-unit prestretched and control groups showed substantial force decay during the first hour. However, at 1 hour, similar remaining forces were found in the 5-unit prestretched and control groups (P Ͼ .05), and small differences were seen in the 6-unit groups. The rates and patterns of force decay from 1 hour to 4 weeks were quite similar between the control and the prestretched modules of both the 5-and 6-unit groups. Conclusions: The effects of prestretching on force decay of elastomeric chains were noted mainly in the first hour. Thus, the clinical value of prestretching a synthetic elastomeric chain is questionable. (Am J Orthod Dentofacial Orthop 2005;128:477-82)
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New Release by Robert L Vanarsdall
Book Chapters by Robert L Vanarsdall
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