[Semiology and diagnosis of mandibular prognathism].
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Biomedical subjects
Publications and source records attributed to A Coutand.
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Study of profile teleradiographies and the inclination of the molars in relation to the lateral occlusal plane, make it possible to distinguish various types of Angle's classification: 1. those associated with displacement, 2. those resulting from dento-maxillary disharmony, 3. those resulting from a dento-dental or temporary disharmony, 4. those connected with abnormality of the occlusal path. Examination of the contact of the arches is not then sufficient to establish a diagnosis.
Orthodontic diagnosis cannot be made from the morphological appearance of the patient alone. The skeleton cannot be seen except by radiography. And the positioning of the dental system within the cranio-facial mass depends on the caprice of the musculature which may even simulate displacement of mandible in connection to maxillae. It is to illustrate this fact that we have selected from the Orthodontic Dept. of the Institute of Stomatology the cases of 3 children presenting with an abnormality in incisal contact, characterized by vestibular occlusion of the lower incisors clinically reminiscent of mandibular prognathism. In all of them we found evidence of abnormalities in neuro-muscular behaviour, at rest and in action, whilst teleradiography showed only one case with sagittal displacement of the maxillae, with a Coutand guide mark 9 mm below the bissector.
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