Browsing by Author "Stewart, Kelton"
Now showing 1 - 10 of 13
Results Per Page
Sort Options
Item Accuracy of 3D Reconstructed Orthodontic Models(2014) Stewart, Kelton; Chai, Billy; Liu, Sean; Ghoneima, Ahmed; Alford, TimothyObjective: To evaluate the accuracy of 3D reconstructed orthodontic models, derived by various digitization methods, as compared to conventional orthodontic plaster models. Materials and Methods: Twenty-five maxillary orthodontic plaster models were randomly selected from the Indiana University School of Dentistry Department of Orthodontics. Each plaster model was scanned with the Cadent iOC scanner and the digital data was used to print 3D reconstructed orthodontic models. The same 25 plaster models were duplicated using alginate and poured in plaster after two days. These duplicated plaster models were also scanned with the iOC scanner and 3D reconstructed. Next, the duplicate plaster models were sent to a lab, scanned with a 3Shape R700 scanner, and the digital data was 3D reconstructed. Digital calipers were used to obtain ten linear dimensional measurements on all plaster and 3D reconstructed models for comparisons. Equivalence testing was performed using 2 one-sided paired t-tests with a significance level of P <0.05. Results: Nine of the 10 linear measurements were statistically equivalent in all groups. Clinically insignificant, but statistically significant, measurement differences in maxillary central incisor height (P <0.05) were found on 3D reconstructed models derived from the 3Shape R700 desktop scanner. Conclusion: 3D reconstructed orthodontic models derived from alginate impressions, iOC scanners, and 3Shape R700 scanners are an accurate and reliable substitute for orthodontic plaster models.Item Accuracy of Orthodontic Soft Tissue Prediction Software between Different Ethnicities(2019) Stewart, Kelton; Patel, Pranali; Eckert, George; Rigsbee III, OH; Hughes, Jay; Utreja, AchintObjective: The objective of this study was to assess the accuracy of the soft tissue prediction module of Dolphin Imaging Software (DIS) in patients requiring extractions as part of the orthodontic treatment plan and compare its accuracy between different ethnicities. Materials and Methods: Initial and final records of 57 patients from three ethnic groups (African Americans, Caucasians, and Hispanics) who completed orthodontic treatment were included for assessment. The identified cases were managed non-surgically with dental extractions. A predictive profile was generated using DIS and compared to post-treatment lateral photographs. Actual and predictive profile photographs were compared using five designated parameters. The assessment parameters were evaluated using a manual protractor. ANOVA was used to compare differences between actual and predicted parameters between the specified groups and ICC was used to assess correlations between the data. Results: Neither ethnicity nor gender had a significant effect on the difference between predicted and final values. No significant difference was noted between the predicted and final images for the nasolabial angle. Significant differences were observed for the mentolabial fold, upper lip to E-line, and lower lip to E-line between predicted and actual images. Additionally, soft tissue convexity was significantly different (p=0.019). Additionally, a clinically significant difference was found for the mentolabial fold. Conclusion: Ethnicity and gender had no impact on the accuracy of predicted and actual image parameters. Overall, DIS demonstrated acceptable accuracy when simulating soft tissue changes after extraction therapy. Additional research on the accuracy of the software is warranted.Item Advanced Dental Specialty: Orthodontics Student Manual(2022) Stewart, Kelton; Kula, KatherineFormal dental graduate programs should clearly specific the mission, goals, and expectations that a program has of its prospective and current students. Clearly, delineating these points will aid in creating a fair, transparent, and humanistic educational environment. The provided manual outlines key information that educators and programs could include when seeking to establish an effective and impartial educational experience for their students.Item COVID-19: What do we know?(Elsevier, 2020-09-21) Marshall, Steve; Duryea, Michael; Huang, Greg; Kadioglu, Onur; Mah, James; Palomo, Juan Martin; Rossouw, Emile; Stappert, Dina; Stewart, Kelton; Tufekci, Eser; Orthodontics and Oral Facial Genetics, School of DentistryCoronavirus disease 2019 (COVID-19) is a global pandemic caused by the pathogen severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).1 Preliminary assessments suggest the virus is highly transmittable and infectious,2, 3, 4, 5, 6, 7 with similarities in nosocomial and super-spreading events seen with severe acute respiratory syndrome coronavirus 1 (SARS-CoV-1) in 2003.8 Patients infected with SARS-CoV-2 display a wide range of host responses including no symptoms, mild nonrespiratory symptoms, severe respiratory illness, or organ dysfunction and death.1,5 The American Association of Orthodontists Council on Scientific Affairs was charged with examining the literature to determine the best evidence for questions pertaining to COVID-19 and its impact on the practice of orthodontics.Item Dental Professionals’ Perspective on Direct-To-Consumer Clear Aligners(2021-07-01) Stewart, Kelton; Hoagburg, Brian; Keith, Caleb; Janik, Robert; Albright, DavidBackground: Technology continues to drastically change the practice of orthodontics. One recent change includes direct-to-consumer (DTC) clear aligners, a model that omits a clinical exam by a licensed dentist and radiographic evaluation prior to initiating treatment. The purpose of this study was to collect quantitative data about dental professionals’ perspectives of the DTC treatment model. Materials and Methods: The Qualtrics-based survey was disseminated to dental professionals using several email lists. The survey included 26 questions, containing four domains: basic demographic information, perceptions of the direct-to-consumer clear aligner model, standards of orthodontic care, and patient experiences. Responses were summarized with descriptive statistics. Associations between respondent demographics and their perceptions about DTC clear aligner treatment and standards of orthodontic care were evaluated using Mantel- Haenszel Chi-squared tests. Results: There were 334 completed surveys, with 155 orthodontists (46.4%), 154 general dentists (46.1%), and 25 other dental specialties (7.5%) participants. More than 95% of respondents had a generally negative view of the DTC treatment model, with most respondents citing “suboptimal orthodontic care” and “misleading the public about orthodontic treatment” as the biggest influence in their view. Over 94% of respondents agreed that it is not within the standard of care to initiate orthodontic treatment without an in-person clinical exam or radiographs. Conclusion: Results suggest that dental professionals regard treatment rendered by DTC modalities not in the best interest of the public. Practical Implications: Dentists should be more active with educating patients about the impact of different dental treatment modalities.Item Laser-treated stainless steel mini-screw implants: 3D surface roughness, bone-implant contact, and fracture resistance analysis(Oxford University Press, 2016-04) Kang, He-Kyong; Chu, Tien-Min; Dechow, Paul; Stewart, Kelton; Kyung, Hee-Moon; Liu, Sean Shih-Yao; Department of Orthodontics and Oral Facial Genetics, School of DentistryBACKGROUND/OBJECTIVES: This study investigated the biomechanical properties and bone-implant intersurface response of machined and laser surface-treated stainless steel (SS) mini-screw implants (MSIs). MATERIAL AND METHODS: Forty-eight 1.3mm in diameter and 6mm long SS MSIs were divided into two groups. The control (machined surface) group received no surface treatment; the laser-treated group received Nd-YAG laser surface treatment. Half in each group was used for examining surface roughness (Sa and Sq), surface texture, and facture resistance. The remaining MSIs were placed in the maxilla of six skeletally mature male beagle dogs in a randomized split-mouth design. A pair with the same surface treatment was placed on the same side and immediately loaded with 200 g nickel-titanium coil springs for 8 weeks. After killing, the bone-implant contact (BIC) for each MSI was calculated using micro computed tomography. Analysis of variance model and two-sample t test were used for statistical analysis with a significance level of P <0.05. RESULTS: The mean values of Sa and Sq were significantly higher in the laser-treated group compared with the machined group (P <0.05). There were no significant differences in fracture resistance and BIC between the two groups. LIMITATION: animal study CONCLUSIONS/IMPLICATIONS: Laser treatment increased surface roughness without compromising fracture resistance. Despite increasing surface roughness, laser treatment did not improve BIC. Overall, it appears that medical grade SS has the potential to be substituted for titanium alloy MSIs.Item Mandibular advancement appliance effects on obstructive sleep apnoea: a prospective threedimensional computed tomography study(Sciendo, 2017) Ghoneima, Ahmed; Bodkin, Cynthia; Stewart, Kelton; Perlow, Mark J.; Starbuck, John; Kula, Katherine; Orthodontics and Oral Facial Genetics, School of DentistryBackground: The aim of this study was to determine the effects of an elastic mandibular advancement (EMA) appliance on upper airway dimensions, most constricted area (MCA) of the airway, and snoring in a sample of obstructive sleep apnoea (OSA) patients of varying severity. Methods: Forty-seven male subjects were classified into two groups comprising12 controls and 35 suffering from OSA. The OSA group was further divided into three subgroups based on their apnoea-hypopnoea index (AHI). All subjects completed an Epworth questionnaire and an overnight home sleep test before (T1) and at the end of the study (T2). OSA subjects were provided with a custom-made EMA appliance. Cone beam computed tomographic images were obtained for each subject at T1 and T2. Airway parameters were measured and summarised by grouping. The differences in the measurements T1 – T2 were compared using repeated measures analysis of variance (rmANOVA) and p ≤ 0.05 was considered statistically significant. Results: The use of the EMA produced a statistically significant increase in the nasopharyngeal, oropharyngeal, MCA, and total airway volume. Although sleep apnoea patients reported a reduction in snoring time, particularly in moderate and severe OSA groups, the level of improvement was not statistically significant. Patients with moderate and severe OSA demonstrated significant decreases in their AHI and Epworth scores. Conclusion: EMA is effective in reducing OSA severity and changing airway dimensions in OSA patients, specifically in the moderate and severe cases.Item Orthodontic Residency Alumni Survey Template(2022) Stewart, KeltonThe acquisition of clear and candid feedback is critical for any professional entity to grow and develop. This particularly true in academia, where programs and institutions are continually assessing their effectiveness with meeting student needs and seeking to identify better strategies to achieve their educational mission. Soliciting feedback from graduates is one possible method for securing such feedback. The creation of a well-structured and concise surveying instrument is the first step to garnering input from this group. The presented alumni survey template contains sections that seek to secure input regarding the effectiveness of the educational experience, graduate employment status, and the level of graduate engagement in their community.Item Orthodontic Residency Faculty Treatment Planning Guide(2022) Stewart, KeltonThe intentional and thorough support of new heathcare professionals is critical for their timely development. This is particularly true in the field of orthodontics, in which multiple treatment approaches can be utilized to achieve acceptable patient outcomes. The varied management techniques employed by different clinicals/faculty can be confusing to residents and potentially detrimental to their ability to establish a sound foundation. To aid in their formative development and add clarity to the patient management process, the Indiana University School of Dentistry, Department of Orthodontics has developed a Faculty Treatment Guide, which serves to provide key information and practitioner preferences during patient care. With this additional information, the department has found that students are better equipped to engage faculty during the patient treatment planning process. This strategy also provides them with the "how" as they continue to learn the "why" through faculty and patient interactions.Item Precision and accuracy assessment of single and multicamera three-dimensional photogrammetry compared with direct anthropometry(Allen Press, 2022) Staller, Sable; Anigbo, Justina; Stewart, Kelton; Dutra, Vinicius; Turkkahraman, Hakan; Orthodontics and Oral Facial Genetics, School of DentistryObjectives: To assess the precision and accuracy of single-camera photogrammetry (SCP) and multicamera photogrammetry (MCP) compared with direct anthropometry (DA). Materials and methods: A total of 30 participants were recruited, and 17 soft tissue landmarks were identified and used to complete a total of 16 measurements. Using SCP and MCP, two three-dimensional (3D) images were acquired from each participant. All 3D measurements and direct measurements were measured twice by the same operator to assess intraexaminer repeatability. Intraclass coefficients (ICCs) were used to evaluate intraexaminer repeatability and interexaminer agreement of the methods. Nonparametric bootstrap analyses were used to compare the means of the measurements among the three methods. Results: All three methods showed excellent intraexaminer repeatability (ICCs > 0.90), except interpupillary distance (ICC = 0.86) measured by SCP. Both SCP and MCP showed excellent interexaminer agreement (ICCs > 0.90), except interpupillary distance (ICC = 0.79), left gonion-pogonion (ICC = 0.74), and columella-subnasale-labrale superior angle (ICC = 0.86) measured by SCP. Overall, there was good agreement between methods, except for columella-subnasale-labrale superior angle (ICC = 0.40) between SCP and MCP. Conclusions: Both SCP and MCP techniques were found to be reliable and valid options for 3D facial imaging. SCP produced slightly larger mean values for several measurements, but the differences were within a clinically acceptable range. Because of the larger margin of errors, measurements including the gonial area and subnasale should be assessed with caution.