Browsing by Author "Dirlam, James H."

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    A Cephalometric Skeletal and Dental Analysis of Selected Black American Children in the Indianapolis Area
    (1975) McDonald, Jeanne L.; Garner, LaForrest D.; Shanks, James C., Jr.; Arbuckle, Gordon R.; Potter, Rosario H.; Dirlam, James H.
    This study was conducted to obtain hard-tissue cephalometric standards for Black American children of twelve years of age. A sample of twenty-four Black American children from the Indianapolis area (thirteen boys and eleven girls} was analyzed and compared with the existing Denver (Caucasian} sample of comparable age. This study was conducted to obtain hard-tissue cephalometric standards for Black American children of twelve years of age. A sample of twenty-four Black American children from the Indianapolis area (thirteen boys and eleven girls} was analyzed and compared with the existing Denver (Caucasian} sample of comparable age. There were only eight measurements that showed no statistical difference from the White standards for both males and females: cranial flexure angle, gonial angle, mandibular plane angle, A-B(OP}, A-B(FH}, A-Pg(OP}, Y-axis angle, and cant of the occlusal plane. There were no significant differences between Black males and Black females. All the linear measurements were significantly larger for the Black sample, except for the chin button (which was significantly smaller in the Blacks}. There was a proportionally larger increase in the mandibular body over the ramus of the mandible in the Black sample; there was a proportionally larger increase in the lower facial height over the upper facial height. In the Black sample, the nasal floor converged upward anteriorly with respect to Frankfort Horizontal. The denture bases and lower face were more protrusive in Blacks; the incisors were more flared and bodily forward. Black patients, therefore, should not be compared to standards set up for Caucasians, but to a set of standards based on normals of their own ethnic group.
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    An Investigation of Dental Arch Form in a Sample of Malocclusions
    (1975) Page, Robert M.; Garner, LaForrest D.; Shanks, James C., Jr.; Dirlam, James H.; Potter, Rosario H.; Barton, Paul
    The objective of this study was to investigate the geometric arch forms found in a sample of malocclusions. The specific objectives were to determine if there was a basic geometric arch form which described all of the sample, to identify the typical arch form in each of the classes of malocclusion, and to determine if there was a statistical difference in form among the various classes in each arch. A sample of 99 maxillary and mandibular plaster casts were collected from the Department of Orthodontics, Indiana University School of Dentistry, and classified according to Angle's classification of malocclusion. Occlusograms were taken of all casts. The center of incisal edges, cusp tips of cuspids and bicuspids, and bifurcation of molars were marked and traced on acetate tracing paper from the occlusogram). A straight line was drawn between these points giving the final dental arch form. A coordinate· system was established on each arch form which allowed the classification of the arch form by Hayashi's method 60. The results showed that no basic arch form described the sample. The average arch form for each classification of malocclusion varied between classes and between arches. Statistically, maxillary arch form of the Class II division 2 differed significantly from maxillary Class I, Class II division 1, and Class III malocclusions. Class II division 2 mandibular arch form differed significantly only from the mandibular Class I malocclusion.
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    The Analysis of Three Space Closing Assemblies
    (1976) Cook, Thomas Bowers; Garner, LaForrest D.; Shanks, James C.; Potter, Rosario H.; Dirlam, James H.; Barton, Paul
    This investigation compared the spring characteristics of three space closing assemblies; the classic "Bull" loop and two new spring designs currently being used in the Department of Orthodontics at Indiana University. Using interbracket distance and the degree of gable preactivation as variables, a complete laboratory analysis was carried out on each spring design. A total of two hundred springs were tested. A statistical investigation was conducted to determine if the spring designs had significantly different load-deflection rates, moment to force ratios, and range of activation. The range of activation for all three spring designs was large enough to be of some minor importance in determining the difference in efficiency of each design. However, when the load-deflection rates and moment to force ratios of the "Bull" loop and the two new spring designs were compared, the new spring designs invariably proved to be superior. From this laboratory study, it was concluded that the two new spring designs have the potential of providing a more efficient method of orthodontic space closure.
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    A Cephalometric Investigation of Cleidocranial Dysplasia
    (1974-06) Davis, James Paul; Garner, LaForrest D.; Tomich, Charles E.; Bixler, David; Weinberg, R. Bernd; Dirlam, James H.
    The characteristics of cleidocranial dysplasia were first reported in 1897 by Pierre Marie and Paul Sainton. Since this first classification of the disease, many radiographic and clinical signs have been associated with this entity. Individuals with this disease have been repeatedly described as having a relative prognathism of the mandible due to a small, retropositioned maxilla and an enlarged cranial base. The present study was designed to determine, through the use of cephalometric measurements, if there is truly a difference in the size and position of the maxilla and an enlargement of the cranial base in these affected individuals. Ten cleidocranial dysplasia patients ranging in age from three years to 53 years, and their immediate families were studied. Non-affected members were studied to provide an intrafamilial comparison of skeletal development. The data obtained from the cephalometric measurements showed that the cranial bases for this group were within normal limits, or tending towards the small size. The maxilla was of normal size and the position was normal or anteriorly positioned in all cases. The mandible was considerably larger in 70% of the affecteds studied. Radiographic investigation showed this group to have delayed ossification of cranial sutures and mandibular symphysis. Absent frontal and mastoid sinuses, orbital hypertelorism, osteopetrotic appearance of the cranium, and absent or hypoplastic nasal bones were also observed.
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    Facilitating the Location of Porion to Compare True Frankfort Horizontal with Sella-Nasion
    (1979) Gormley, Douglas A.; Garner, LaForrest D.; Shanks, James C.; Kasle, Myron J.; Dirlam, James H.
    The constructed cephalometric line sella-nasion minus seven degrees (SN-7°) has long been used as a substitute for the Frankfort horizontal in the descriptive analysis of orthodontic cases, due to the difficulty in locating anatomic porion. To eliminate this problem, the cephalostat was modified by replacing the original ear rods with hollow, cylindrically shaped shafts which permit the consistent visualization of anatomic porion. Location accuracy was tested by the double determination method. Then, using anatomic porion, the hypothesis that the constructed line SN-7° is an accurate and reliable substitute for Frankfort horizontal in the descriptive analysis of cases was tested. In an adult sample, the mean Frankfort horizontal - sella-nasion angle was 9.03° (S.D.=2.58) with a range of 2.0° to 17.5°. It was concluded that neither SN-7° nor any other constructed line is a reliable substitute for the Frankfort horizontal, due to the wide range of values determined. The mean Frankfort horizontal - mandibular plane angle was determined to test the hypothesis that when anatomic porion is utilized to construct the Frankfort horizontal, this angle is significantly different from that measured in other similar samples. The mean angle was 19.50° (S.D.=5.74) with a range of 8.0° to 35.5°. This value was significantly less than those determined for the Frankfort horizontal – mandibular plane angle in previous research.
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    A Survey of Sterilization/Disinfection Techniques Used By Orthodontists in the U.S.
    (1986) Burns, Richard H.; Garner, LaForrest D.; Barton, Paul; Dirlam, James H.; Miller, James R.; Stone, Edward
    Questionnaires were sent to 500 orthodontists in all states of the U.S., inquiring about the methods of sterilization used for hand instruments (mirrors, explorers, band pushers, etc.) and hinged instruments (pliers). The practitioners were asked if their sterilization/disinfection methods had been changed recently, and if any changes in methods were due to the risk of disease transmission. Opinions were also solicited regarding the importance of complete sterilization (i.e., destruction of all organisms). An opportunity was provided to rate the effectiveness of the sterilization method in use. Finally, information was requested on any barrier methods used routinely. The most commonly used method for hand and hinged instruments was cold sterilization with a 2% glutaraldehyde solution. This solution was used by 46.5% of the office for hand instruments, and by 33.5% of the offices for hinged instruments. Quaternary ammonium compounds were used by 26.5% of the offices for hand instruments, and by 19.2% for hinged instruments. Wiping with alcohol was used by 30.4% of the offices for hinged instruments. The most common heat sterilization method used was the chemiclave system (11.5% for hand instruments and 9.1% for hinged). Of the offices surveyed, 45.5% had changed their methods within the past two years. Of that group, 66.9% had changed as a result of the increased problem with transmissible diseases. Of the offices that had not changed recently, 64.1% were considering doing so as a result of the disease transmission concern. Complete sterilization was considered very important by 47.5% of respondents, while 41.6% ranked it somewhat important. Of the orthodontists surveyed, 16.1% felt that they achieved an excellent level of asepsis in their offices, followed by 58.7% who rated it good, 23.4% average, and 1.4% poor. Protective eyewear was worn by 52.4 % of those surveyed, while gloves and masks were worn routinely by 21.3% and 21.6% of the practitioners, respectively. On the basis of the literature review, the most effective cold sterilization method (other than ethylene oxide) for the orthodontic office appears to be a 2% glutaraldehyde solution. This technique will not corrode plier joints or the stainless steel surfaces. The best heat sterilization method for the orthodontic office is the chemiclave system, due to its lack of corrosion problems, as well as its relatively rapid cycle time. Ultrasonic cleaning of all instruments prior to sterilization is highly recommended.