The aim of this study was to develop a psychometric instrument for assessment of orthodontic-specific aspects of quality of life. The study subjects, 194 young adults aged 18-30 years, were interviewed using a pool of 23 items dealing with the psychosocial impact of dental aesthetics. Self- and interviewer-rating of the dental aesthetic appearance of each subject were carried out using the Aesthetic Component (AC) of the Index of Orthodontic Treatment Need (IOTN). Additionally, the Perception of Occlusion Scale and a modification of the Dental Aesthetic Index (DAI) were applied. Factorial analyses identified four measures within the item pool, namely Dental Self-Confidence, Social Impact, Psychological Impact, and Aesthetic Concern. The factor structure was confirmed in an independent sample of 83 subjects aged 18-33 years. The reliabilities of the factor analysis-derived scales were between alpha (alpha) 0.85 and 0.91. They differed between respondents with varying severity of malocclusion, as assessed by subject and interviewer ratings. The results suggest that the proposed instrument, termed the 'Psychosocial Impact of Dental Aesthetics Questionnaire' (PIDAQ), meets the criteria of factorial stability across samples and criterion-related validity and reliability, and might be a promising tool for further research and clinical application in orthodontics.

Modification of material surfaces aimed at bestowing them with antimicrobial properties is a promising approach in the development of new biomaterials. Antimicrobial peptides (AMPs) are an attractive alternative to conventional antibiotics because of lack of toxicity, inherently high selectivity, and absence of immune response. As the antimicrobial mode of action of the AMP cathelin LL37 is formation of pores and disruption of microbial membrane, the purpose of the present study was to develop and test a method of covalent immobilization of LL37 on titanium surface. The application of a flexible hydrophilic poly(ethylene glycol) spacer and selective N-terminal conjugation of LL37 resulted in a surface peptide layer which was capable of killing bacteria on contact.

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During the course of treatment orthodontic patients frequently endure a number of functional complaints and are anxious about their appearance. The aims of this longitudinal study were to follow the progress of patients' adaptation to discomfort, to elucidate the putative relationship between the type of appliance worn and functional and social discomfort experienced, to study potential predictability by their attitude to treatment and to evaluate the effects of discomfort as predictors of patients' compliance. Eighty-four patients undergoing either removable, functional, or fixed appliance treatment monitored their complaints during the first 7 days of treatment and rated them retrospectively 14 days, and 3 and 6 months after appliance insertion. The most frequent complaints were impaired speech, impaired swallowing, feeling of oral constraint and lack of confidence in public. A significant reduction in the number of complaints was observed between 2 and 7 days after insertion of the appliance. No further differences were revealed after longer periods of appliance wear. The type of appliance had an effect on impaired speech and swallowing. Patients' expectations of favourable treatment performance and appreciation of dental aesthetics were predictive of reported feeling of oral constraint and lack of confidence in public. There was a relationship between the complaints and acceptance of the appliance, as well as between lack of confidence in public and compliance with treatment. The results of this study highlight the importance of patients' attitudes to treatment and of functional and social discomfort associated with appliance wear for the theory and practice of the management of orthodontic patients, and the necessity for early intervention by clinicians.

The aim of this study was to monitor, by means of quantitative light-induced fluorescence (QLF), the natural behaviour of white spot lesions detected immediately after orthodontic treatment and 2 years post-treatment. The buccal tooth surfaces of 51 subjects (>or=12 years), 24 males and 27 females, were examined with QLF for the presence of caries immediately after debonding (T0), and 6 weeks (T1), 6 months (T2), and 2 years (T3) thereafter. The fluorescence loss [Delta F (per cent)] and area [A (mm(2))] of any lesions were determined using dedicated software. The lesion development and influence of gender were determined by a general linear model (Friedman repeated-measures analysis and two-way repeated-measures analysis of variance). Using QLF, 370 carious surfaces were recorded at T0. During the study, 19 lesions were lost from QLF analysis of which 16 lesions (Delta F(0)=7.6-39.2 per cent) in two subjects were restored and three teeth with lesions were extracted or crowned. This resulted in 351 lesions that were included in this study with a median Delta F at T0 of 8.5 per cent (quartiles 6.6 per cent; 11.9 per cent). The lesions varied from incipient (Delta F<10 per cent, n=227) to advanced (Delta F>25 per cent, n=6). Overall, the lesions showed improvement between T0 and T2 (P<0.01) but no further significant improvement at T3. Thirty-five lesions became significantly worse after 2 years. The majority of lesions (n=171) were considered to be stable, and 145 lesions improved significantly of which only 10 lesions improved to such an extent that they disappeared. White spot lesions developed during orthodontic treatment have very limited ability to improve after appliance removal. Further research to investigate the potential of preventive measures to enhance lesion improvement is necessary.

Jaw muscles are versatile entities that are able to adapt their anatomical characteristics, such as size, cross-sectional area, and fibre properties, to altered functional demands. The dynamic nature of muscle fibres allows them to change their phenotype to optimize the required contractile function while minimizing energy use. Changes in these anatomical parameters are associated with changes in neuromuscular activity as the pattern of muscle activation by the central nervous system plays an important role in the modulation of muscle properties. This review summarizes the adaptive response of jaw muscles to various stimuli or perturbations in the orofacial system and addresses general changes in muscles as they adapt, specific adaptive changes in jaw muscles under various physiologic and pathologic conditions, and their adaptive response to non-surgical and surgical therapeutic interventions. Although the jaw muscles are used concertedly in the masticatory system, their adaptive changes are not always uniform and vary with the nature, intensity, and duration of the stimulus. In general, stretch, increases neuromuscular activity, and resistance training result in hypertrophy, elicits increases in mitochondrial content and cross-sectional area of the fibres, and may change the fibre-type composition of the muscle towards a larger percentage of slow-type fibres. In contrast, changes in the opposite direction occur when neuromuscular activity is reduced, the muscle is immobilized in a shortened position, or paralysed. The broad range of stimuli that affect the properties of jaw muscles might help explain the large variability in the anatomical and physiological characteristics found among individuals, muscles, and muscle portions.

Direct surface modification of biodegradable polycaprolactone (PCL) was performed without the necessity of synthesis of functionisable co-polymers. An easy-to-perform three-step procedure consisting of amination, reaction with hetero-bifunctional cross-linkers and conjugation of an RGD-motif-containing peptide was used to modify polymer films and improve the attachment of endothelial cells. The biological activity of modified surfaces was assessed by estimating microvascular endothelial cell attachment. Covalent coating with RGD resulted in an approximately 11-fold increase of endothelial cell attachment on modified PCL surfaces compared with untreated polymer. The specificity of the attachment enhancement was confirmed by using a control peptide. It is concluded that chemical surface modification is an appropriate method of rendering degradable polymers, such as PCL, cell-adhesive.

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