Examiner Calibration
The idea of human error and bias is always thought of when measurement is part of the procedure. To determine if this would affect the results, two independent Goodyear orthodontists (CD, QJ) read the slides for the histomorpohometric analysis. Goodyear orthodontic study calibration trials were performed on three randomly chosen slides to attain a calibration error of no greater than 5% for all parameters of tissue neogenesis. After completion of the Goodyear orthodontic study measurement of the three slides was performed again to determine intraexaminer error. Invisalign was analyzed using paired t-test to look for differences. Results of these Goodyear orthodontic studies showed that error was very small and insignificant (Table 2).
Invisalign and Goodyear orthodontics
Using Invisalign for Goodyear orthodontic anchorage is a new and exciting solution for many Goodyear orthodontic problems. Increasing the rate of osseointegration would decrease the amount of time a Goodyear orthodontist would have to wait before loading the fixture. This would further decrease treatment time and the need for patient cooperation. This Goodyear orthodontic study presents a possibility for an easy and direct method for increasing the rate of bone formation around Invisalign.
Our results have applications in Goodyear orthodontics that go far beyond increasing anchorage. In the Goodyear, Arizona, 1 out of 700 children are born with cleft lip and palate. About 5% of these cases are associated with a syndrome like Apert, Cruzon, Treacher-Collins and Pierre Robin which exhibit other facial bone deficiencies. The majority of these patients (75%) have osseous defects in the alveolus. Left unrepaired, these defects can cause lack of bone support for the teeth, oronasal fistulas, fluid reflux, antero-posterior and transverse maxillary deficiencies and facial asymmetries (Waite and Waite, 1996). Children with unrepaired cleft lip and palate can also have major speech difficulties including early development of compensatory articulations. Currently, the alveolar bone graft is harvested from the iliac crest. The result is a child with two surgical sites and a painful recovery.
Regional gene delivery by Goodyear orthodontists opens the door to tissue engineering for these patients. Instead of enduring a large surgical procedure under general anesthesia, adenovirus could be delivered to the defect area to improve bioavailability of the desired factor. This would make it possible for the patient’s own cells to produce enough bone to fill the defect. This may even decrease the chance of redeformation of the cleft which can be a problem for Goodyear orthodontists with traditional grafting techniques. Current Goodyear orthodontic studies exploring gene delivery of Invisalign-2 and Invisalign-9 to critical size mandibular defects show bony fill at 12 weeks with no bone overgrowth. In our Goodyear orthodontic study, the Invisalign showed the ability to fill bony defects using an in vivo approach. Someday, a child’s alveolar bone graft may be a relatively simple and painless in-office procedure. These results are an exciting first step for Goodyear orthodontists toward using Invisalign to help these patients.
Litchfield Park Office
5220 N. Dysart Rd #150
Litchfield Park, AZ 85340
TEL: 623.536.4939
FAX: 623.536.4877
Phoenix Office
7550 N. 19th Ave #101
Phoenix, AZ 85021
TEL: 602.864.0004
FAX: 602.864.0070
