acific Coast Society of Orthodontists Bulletin Summer 2018 - 54

Resident Research Review

Since its establishment in 2001, the Craniofacial
Genetics Laboratory (CFGL), led by Dr. Marie
Tolarova, has focused on finding factors that contribute to etiology of cleft lip and palate and
craniofacial and orofacial anomalies. Dozens of
residents conducted research analyzing several
candidate genes and gene variants as well as
environmental factors and candidate nutrients in
cases and controls. This research was twice recognized with the Harry Sicher Award from the
AAO. We have a strong interest in prevention of
nonsyndromic cleft lip and palate (NSCL/P). Thus,
studying variants of genes involved in the folate
cycle, dietary folic acid and other nutrients, and
variants of genes critical to craniofacial development that are important for personalized and
precision medicine, are all driving forces of the
CFGL research. At present, research is focused
on (1) a cell culture model to study how folic acid
rescues cells from endoplasmic reticulum stress;
(2) study to determine whether variants of the
IRF6 gene known to contribute to syndromic
clefts are associated with NSCL/P in the Indian
population; and (3) development of a personalized risk assessment tool for NSCL/P.
Clinical Judgment Lab Activities
A very intriguing component of our research
includes a social perspective on orthodontic
practices. Arguably, the most powerful driver
of clinical quality outcomes in orthodontics is
the judgment of the orthodontist. Although
amenable to rigorous investigation, this is a
factor that is conspicuously understudied. The
purpose of this virtual laboratory is to assemble
and publicize what is known about the role of
clinical judgment in patient care and to conduct
research on this topic.
To begin, it is important to consider our assessment of a "finished case" to perhaps determine
what constitutes completion of treatment. There
are multiple objective occlusal indices available
for use in orthodontics. It is important to determine the relevance of these indices to everyday
clinical practice. The goal of an ongoing study
is to establish whether there is a correlation

between objective measures and clinicians' judgment. This will be accomplished by asking trained
orthodontists to rate the severity of malocclusion
and/or quality of finish using a numerical scale;
these ratings will then be compared to objective
measures (numerical indices).
Another research study involves a survey interviewing patients from orthodontic offices to
determine their motivations and preferences
with regard to seeking orthodontic care. A further research study is looking at orthodontists'
decision-making process assessing a patient who
presents with possible signs and symptoms of
obstructive sleep apnea (OSA) or other airwayrelated issues. We are aiming to determine if
there's a relationship between the orthodontist's
familiarity with CBCT-derived diagnostic information and the decision to obtain 3-D imaging
before making treatment decisions, and the final
treatment planning outcomes. 
References
1. Oh H, Baumrind S, Korn EL, et al. A retrospective study
of Class II mixed-dentition treatment. Angle Orthod
2017;87:897-910.
2. Oh H, Ma N, Feng PP, et al. Evaluation of posttreatment stability after orthodontic treatment in the
mixed and permanent dentitions. Angle Orthod 2016;
86:1010-1018.
3. Baumrind S, Curry S. American Association of
Orthodontists Foundation Craniofacial Growth Legacy
Collection: Overview of a powerful tool for orthodontic
research and teaching. Am J Orthod Dentofacial Orthop
2015;148:217-225.
4. Baumrind S, Park J, Curry S, Oh H, Boyd R. Reliability
of 3D Landmark Location on CBCT Images: Skeletal
Structures. Am J Orthod Dentofacial Orthop 2018
(accepted).
5. Hatcher D. CBCT (3-D imaging): Application for
selected articular disorders and associated facial
growth. Temporomandibular disorders and orofacial
pain: Separating controversy from consensus. 2009
Monograph 46:125-145.
6. Garnett B, Mahood K, Nguyen M, et al. Cephalometric comparison of adult anterior open bite treatment
using clear aligners and fixed appliances. Angle Orthod
2018 (accepted).

PCSO Bulletin  Summer 2018

Table of Contents for the Digital Edition of acific Coast Society of Orthodontists Bulletin Summer 2018