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Objective: To compare the postretention dental changes between patients treated with Invisalign and those treated with conventional fixed appliances. Materials and Methods: This is a comparative cohort study using patient records of one orthodontist in New York City. Two groups of patients were identified that differed only in the method of treatment (Invisalign and Braces group). Dental casts and panoramic radiographs were collected and analyzed using the objective grading system (OGS) of the American Board of Orthodontics (ABO). The cases were evaluated immediately after appliance removal (T1) and at a postretention time (T2), three years after appliance removal. All patients had completed active orthodontic treatment and had undergone at least one year of retention. A Wilcoxon rank sum test was used to evaluate differences in treatment outcomes between the groups for each of the eight categories in the OGS, including four additional subcategories in the alignment category. A Wilcoxon signed rank test was used to determine the significance of changes within each group from T1 to T2. Results: The change in the total alignment score in the Invisalign group was significantly larger than that for the Braces group. There were significant changes in total alignment and mandibular anterior alignment in both groups. There were significant changes in maxillary anterior alignment in the Invisalign group only. Conclusions: In this sample for this period of observation, patients treated with Invisalign relapsed more than those treated with conventional fixed appliances.

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Objective: To compare the forces generated by 14 different 9 mm springs supplied by five different companies. Materials and Methods: Five replicates of 14 different 9 mm springs were evaluated, resulting in 70 total specimens. Each was extended once from its resting length to 12 mm and then was deactivated. All tests were performed in a 37ЊC water bath. Forces were recorded at the 12 mm extension and deactivation distances of 9 mm, 6 mm, 3 mm, and 1 mm using an MTS force gauge. Data were collected with Testworks software, version 4.0, and were analyzed by analysis of variance (ANOVA) with one factor alternated. Results: Mean peak load forces at 12 mm were significantly different between springs, and these forces varied from 147 to 474 grams. Mean unload forces measured at 9 mm, 6 mm, and 3 mm of deactivation values were highly variable, and only 6 of the 14 springs exhibited a ''physiologic'' mean unload force of 50 grams or less over the total deactivation range. Conclusions: Few springs tested exhibited physiologic peak load forces and constant deactivation forces. This study suggests that labeling of nickel titanium closed coil springs is confusing and misleading. (Angle Orthod. 2010;80:182-187.)

IMPORTANCE Many individuals with a cleft palate also have an associated craniofacial syndrome or anomaly.OBJECTIVE To investigate the predictive associations of persistent palatal fistulas in patients with previously repaired cleft palate. DESIGN, SETTING, AND PARTICIPANTSWe performed a case-control study of patients with cleft palate repairs from January 1, 1986, through December 31, 2000, at a major tertiary care hospital center in the Bronx, New York. The study population consisted of patients who had their primary surgery before the age of 3 years and had all their cleft-related treatment completed at the same hospital center. Palatal fistula was defined as a breakdown of the primary surgical repair of the palate, resulting in persistent patency between the oral and nasal cavities. Data collection was conducted by using the hospital centers' electronic medical records and patient tracking systems and confirmed by review of hard copies of patient records. MAIN OUTCOMES AND MEASURESThe Veau classification system was used to classify the preoperative cleft severity.RESULTS A total of 130 patients were identified-23 patients with palatal fistula and 107 controls. A total of 12 girls and 11 boys were identified in the palatal fistula group and 56 girls and 51 boys in the control group. The mean patient age at the time of palatoplasty was 12.6 and 14.5 months in the palatal fistula and control groups, respectively. A statistically significant association was found between the outcome of fistula and severity of cleft, as defined by the Veau classification system (P = .01). Furthermore, for each Veau class increase, the odds of a palatal fistula increased by 2.64 (95% CI, 1.35-5.13; P = .004). No statistically significant associations were found between the outcome of fistula and the following independent variables: patient sex (P = .98), patient age at palatoplasty (P = .82), type of palatoplasty (P = .57), surgeon (P = .15), orthodontic treatment (P = .59), ear infection (P = .30), or clefts associated with syndromes (P = .96). CONCLUSIONS AND RELEVANCEPalatal fistulas are reliably associated with severity of cleft, as defined by the Veau classification system. This knowledge gives the health care professional a more reliable method of preoperatively assessing the risk of postoperative palatal fistula in the cleft palate population.LEVEL OF EVIDENCE 3.

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Objective: To quantify smile esthetics following orthodontic treatment and determine whether these changes are correlated to the severity of the initial malocclusion. Materials and Methods: A standardized smile mesh analysis that evaluated nine lip-tooth characteristics was applied to two groups of successfully treated patients: group 1 (initial American Board of Orthodontics Discrepancy Index [DI] score ,20) and group 2 (initial DI score .20). Ttests were used to detect significant differences between the low-DI and high-DI groups for baseline pretreatment measurements, baseline posttreatment measurements, and changes from pre-to posttreatment. A Spearman correlation test compared the initial DI values with the changes in the nine smile measurements. Results: Five of the smile measurements were improved in both groups following orthodontic treatment. Both groups demonstrated improved incisor exposure, an improved gingival smile line, an increase in smile width, a decreased buccal corridor space, and an improvement in smile consonance. Spearman correlation tests showed that initial DI value was not correlated to changes in any of the individual smile measurements. Conclusions: Smile esthetics is improved by orthodontic treatment regardless of the initial severity of the malocclusion. In other words, patients with more complex orthodontic issues and their counterparts with minor malocclusions benefitted equally from treatment in terms of their smile esthetics. (Angle Orthod. 2014;84:492-499.)