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Biomedical subjects

A H Owen

Publications and source records attributed to A H Owen.

At least 19 recordsLinked to original sources
PubMed1996

Rationale and utilization of temporomandibular joint vibration analysis in an orthopedic practice.

Temporomandibular joint vibration analysis (JVA) is the electronic recording of TMJ sounds, or, more accurately, vibrations occurring in the joint. Utilizing vibration transducers called accelerometers, a characteristic wave pattern is created for the various types of internal joint vibrations (conditions). Whereas the human ear cannot hear many of the frequencies that occur in the TMJ's, the accelerometers record all frequencies with equal efficiency. Once a vibration has been recorded, then it can be compared to other types of vibrations. This may make it possible to categorize the various types of internal conditions, and then, to monitor the joint status throughout treatment. Sample patients are shown with the initial and then progress joint vibration analyses. This electronic device may help answer the questions of whether orthodontic treatment helps, harms, or has any affect on the internal health of the TMJ. It may also be used to monitor different types of orthodontic treatment to help determine whether one type is more beneficial to the TMJ or not.

Adolescent↗
PubMed1991

Record keeping adjuncts for TMD therapy.

Proper record keeping is mandatory for any dental treatments, but perhaps it is even more important in temporomandibular disorder (TMD) therapy due to the nature of the problem. TMD treatment includes the management of pain and discomfort. It has been the author's experience that the patient's and the clinician's perception of progress are not frequently similar. Since pain is completely subjective, proper record keeping is even more difficult to maintain because it is not quantifiable by the clinician. This paper presents two record keeping adjuncts that the author has developed over the years, which have helped this record keeping problem. The first adjunct is to have a summary of the initial diagnostic findings located at the top of the treatment record. This summary makes it easy to refer back to the original signs and symptoms to measure the treatment progress. The second adjunct is the actual treatment chart for TMD therapy. This chart is filled out by the patient and utilizes the visual analog approach. Using this approach minimizes any misunderstanding between the patient and the clinician. Each entry is signed by the patient, which further substantiates the accuracy of this approach. This author has utilized this adjunct for the past few years and has found it to be significantly better than his former records.

Chronic Disease↗
PubMed1991

Office computerization using a scanner to maximize temporomandibular disorder correspondence.

In this time of increased temporomandibular disorder (TMD) therapy, it has become necessary for the clinician to proportionately increase his/her office documentation. The legal profession has strongly advised the dental profession that the best deterrent to litigation is maximum documentation. This has increased the paperwork of any office dealing with TMD patients on a regular basis. This paper presents the author's experiences and evaluation of one software company that claims to improve office efficiency and speed at the same time. The Patient Communications Systems, Inc. (PCS) is presented after more than four years of clinical experience in the author's practice. There are three forms that comprise the TMD package: (1) health questionnaire; (2) clinical evaluation; and (3) radiographic exam, diagnosis, and treatment plan. Each form is presented along with some of the narratives that can be generated. Some constructive suggestions have been made to help the overall flow of information that is relative to the author's office. This correspondence system has proven to be very time efficient, and has improved the level of correspondence in this referral practice multifold.

Defensive Medicine↗
PubMed1990

The stability of the arch-expansion effects of Fränkel appliance therapy.

To assess the long-term stability of the arch expansion effects of the functional regulator, mandibular dental casts were evaluated for treatment and postretention changes in intercanine width, width between first premolars, width between second premolars, intermolar width, incisor irregularity, and arch length. This study was comprised of 11 cases that were treated with the Fränkel appliance (mean = 27 mo.) and were and average of 4 years and 4 months out of active treatment. Results showed overall stability to be good, with some variability present in individual responses. Intercanine width, width of first premolars, width of second premolars, and intermolar width all demonstrated maintenance of treatment increases. Correction of incisor irregularity displayed better stability than has been reported in other stability studies. Arch length decreased with treatment and continued to decrease during the postretention period, although to a lesser extent than has been previously reported. The results of this study support the statements of Fränkel concerning the stability of this type of arch expansion.

Activator Appliances↗
PubMed1989

Orthopedic/orthodontic therapy for anterior disk displacement: unexpected treatment findings.

Craniomandibular pain dysfunction (CMPD) is of increasing clinical concern to all fields of dentistry, especially orthodontics. One of the more common manifestations of CMPD is anterior disk displacement. Orthodontic/orthopedic treatment for anterior disk displacement using anterior repositioning of the mandible has been suggested by several clinicians as the treatment of choice. Returning the mandible back toward the original occlusion or habit centric has also been suggested by several reports. Functional jaw orthopedic (FJO) appliances would appear to be ideally suited for the treatment of anterior disk displacement due to the anterior repositioning nature of these appliances. In growing individuals, among other changes, the condyle is supposed to grow back into the fossa (which would serve as the walkback procedure). This article presents three young patients who had anterior disk displacement and posterior condylar displacement before treatment. Each patient was treated using a functional appliance and each patient ended treatment still having a posterior condylar displacement and anterior disk displacement. These findings were unexpected and no explanation is offered. This occurrence is rare in the author's practice (approximately 2-3%), but this is a real concern and the patients should be made aware of this possibility before starting treatment, so that their expectations are realistic. These enigmatic findings also emphasize the complexity of TMJ as well as FJO treatment and indicate the need for further research and study.

Child↗
PubMed1988

Unexpected TMJ responses to functional jaw orthopedic therapy.

The activator, the Bionator, the Fränkel, and, more recently, the Herbst appliances have enjoyed increasing popularity. Although an increase in mandibular growth has not been shown to be clinically consistent or always significant, the popularity of these appliances continues. Another clinical goal of these functional jaw orthopedic (FJO) appliances is to correct, maintain, or protect the integrity of the TMJ--specifically, to prevent posterior condylar displacement and/or anterior disk displacement. Because all FJO appliances anteriorly reposition the condyle during treatment, it is hoped that internal derangement problems may be resolved during treatment. Even though a single TMJ radiograph is not diagnostic in itself, multiple radiographs are helpful in monitoring the net changes in the condylar position during treatment. The relative (or net) change in the condylar position may provide clues to what occurred during treatment. However, TMJ responses are not always predictable during FJO treatment. Three case histories are presented that illustrate unexpected TMJ responses in which the condyles were still posteriorly displaced in spite of FJO treatment. Only 2% to 3% of the author's practice responds in this manner and no physiologic mechanism is suggested. These findings point out the complexity of the TMJ and its treatment, regardless of the appliance, and emphasize that no one approach to TMJ treatment will always be efficacious.

Activator Appliances↗
PubMed1988

Frontal facial changes with the Fränkel appliance.

A study of 50 cases treated with the Fränkel appliance shows significantly greater increase in bigonial width and related decrease in frontofacial taper as seen in the P-A cephalometric view than in comparable cases treated with Edgewise therapy or in untreated norms from the Bolton and FOR studies.

Activator Appliances↗
PubMed1987

The maxillary sagittal appliance: a clinical study.

A clinical review of the maxillary sagittal appliance is presented. The appliance is an active plate with expansion screws in the anteroposterior direction, hence the name. It is used to advance the maxillary incisors and to distalize the maxillary molars, thereby increasing arch length. No control or reference group was used. The maxillary incisors were advanced approximately 2 mm and the inclination was increased approximately 8 degrees. Cephalometrically, the maxillary molars were not distalized, possibly because no second molars were extracted. A minor advancement was noted at A point and the upper lip was advanced 1.4 mm. Very little change was noted in the mandibular dentition or mandibular skeletal measurements except for the overall mandibular length, which increased 3.00 mm during the 7.4 months of average treatment time. The lower anterior facial height increased 2.85 mm, which was more than expected and many contraindicate the appliance in long-faced patients. The appliance is easy to manage clinically and provides another appliance that may be used to decompensate the maxillary teeth before functional jaw orthodpedic (FJO) therapy or fixed therapy in Class II, Division 1 or Class II, Division 2 patients with a flat or recessive upper lip.

Activator Appliances↗