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Biomedical subjects

C Sadowsky

Publications and source records attributed to C Sadowsky.

At least 19 recordsLinked to original sources
PubMed1997

An assessment of treatment outcome in American Board of Orthodontics cases.

In a retrospective study, 90 American Board of Orthodontic (ABO) cases were evaluated for treatment outcome. Changes in occlusion, cephalometric skeletal and dental variables, soft tissue variables, and root resorption were evaluated. The occlusions of completed ABO cases were compared with 147 naturally occurring good-to-excellent occlusions from the Andrews Foundation for Education and Research, using the Ideal Tooth Relationship Index (ITRI). Cephalometric variables were evaluated in relation to an "acceptable range" based on established standards. Photographs were evaluated for lip posture at rest and at closure, and the incidence and the severity of root resorption of maxillary and mandibular teeth excluding second molars were evaluated from panoramic radiographs. After treatment, occlusions of ABO cases scored significantly higher overall and for all ITRI segments except the anterior interarch segment when compared with Andrew's sample. In all the ABO cases, ideal overjet and overbite were attained. Cephalometrically, the mandibular plane and the Y-axis angle showed no significant change as a result of treatment. However, skeletal dysplasia (ANB) and skeletal convexity (Na-A-Po) showed improvement. Dentally, the maxillary incisor position and inclination, the interincisal angle, and the lower incisor position ended within the acceptable range, whereas the lower incisors were proclined. Soft tissue variables also improved, lip balance and harmony, closure at rest, and closure without strain all improved. The nasolabial angle showed little change. Most of the root resorption was minor in nature and involved the maxillary and mandibular central and lateral incisors. In conclusion, the ABO cases were well treated and showed marked improvement in occlusion, cephalometric, and soft tissue changes, although experiencing minor iatrogenic effects.

Adolescent↗
PubMed1997

Combined orthodontic-orthognathic surgical treatment of a Class II, Division I malocclusion.

This case report shows the need to extract four first premolars in addition to orthognathic surgery, even though the initial treatment plan involved a nonextraction strategy. The extractions were necessary to reduce maxillary dental protrusion and proclination and also to recover from the mandibular incisor proclination that occurred as a consequence of leveling the mandibular arch.

Cephalometry↗
PubMed1996

Resolution of mandibular arch crowding in growing patients with Class I malocclusions treated nonextraction.

The purpose of this study was to determine the manner in which mandibular arch crowding was resolved in Class I growing patients who were treated nonextraction. A retrospective study was completed with 30 patients from a postgraduate orthodontic clinic, treated with a variety of treatment modalities. Eight study models and six cephalometric parameters were examined before treatment and at the end of active treatment (posttreatment). The results showed that statistically significant increases in arch width occurred at the canine (0.9 mm), first premolar (1.6 mm), second premolar (1.8 mm), and first molar (1.2 mm). The incisors were advanced an average of 2.1 mm and proclined 6.1 degrees. The molars showed no anteroposterior movement. Arch perimeter increased 2.3 mm and arch depth increased 1.6 mm. Multiple linear regression analysis revealed that 52% of the variance in crowding resolution was accounted for by an increase in arch perimeter. It was concluded that the resolution of crowding, in this group of patients with Class I malocclusions, was achieved by generalized expansion of the buccal segments, along with advancement of the lower incisors. In some cases, these changes may be consistent with treatment objectives; in others, they may be undesirable. It is therefore important for practitioners to carefully evaluate treatment outcome irrespective of the treatment modality, to determine whether treatment objectives are being met.

Adolescent↗
PubMed1996

Prevalence and severity of apical root resorption and alveolar bone loss in orthodontically treated adults.

This study assessed the frequency of root resorption and alveolar bone loss in 88 adults who had undergone orthodontic treatment. Pretreatment and posttreatment periapical radiographs were used to determine the amount of external apical root resorption and alveolar bone loss of the maxillary and mandibular incisors. Alveolar bone loss in the posterior quadrants was determined from bite-wing radiographs. The number of incisors showing root resorption, including blunting, increased from 15% before treatment to 73% after treatment. The number of incisors having moderate to severe apical root resorption was 2% before treatment and 24.5% after treatment. The number of anterior sites in which loss of alveolar bone height exceeded 2 mm from the cementoenamel junction to the alveolar crest increased from 19% before treatment to 37% after treatment; the number of posterior sites was 7% before treatment and 14% after treatment. Bone LOSS > or = 1.5 mm from the pretreatment to posttreatment stages occurred in 11% of the incisors and 3% of the posterior sites. A marked increase in the prevalence of root resorption and alveolar bone loss occurred over the course of treatment. The prevalence of iatrogenic effects for adults may be higher for incisors than in previously reported adolescent studies. A small subgroup with multiple sites of either root resorption or bone loss account for a disproportionate number of iatrogenic sequelae. However, in general, the iatrogenic experience did not preclude the orthodontic treatment of adults.

Adult↗
PubMed1995

An evaluation of mandibular asymmetry in adults with unilateral posterior crossbite.

A retrospective study was conducted to determine whether mandibular symmetry in adults with untreated unilateral posterior crossbite was different from that found in adults with untreated Class I malocclusions. Thirty adults, 18 years or older, with a unilateral posterior crossbite were compared with 30 adults exhibiting Angle Class I malocclusions. Skeletal and dental symmetry were assessed with submentovertex (SMV) radiographs, whereas condylar position within the glenoid fossa was analyzed with horizontally corrected tomograms. Relative to a mandibular coordinate system, the mandibular first molar on the crossbite side was found to be more lateral and relatively distal in comparison to the contralateral side. Skeletally, the mandible showed no asymmetry. Relative to the cranial floor, the mandible was "rotated" so that the condyle on the crossbite side was positioned relatively posteriorly in comparison to the contralateral side. A relative posterior positioning of the glenoid fossa was inferred, since there was no demonstrable mandibular skeletal asymmetry or condylar displacement within the fossa as shown on corrected tomograms in the crossbite group as compared with the Class I group. The results question whether it is appropriate to correct unilateral posterior crossbites in adults by orthodontic tooth movement alone, given the skeletal remodeling in the temporomandibular joint, which may have already occurred.

Adolescent↗
PubMed1994

Concomitant administration of antiemetics is not necessary with intramuscular dihydroergotamine.

The influence of concomitant administration of an antiemetic agent on the course of nausea was assessed in a field trial of intramuscular dihydroergotamine for the treatment of acute migraine. Of 311 migraine patients enrolled onto the study, 62% (191 of 311) experienced nausea at the outset; 38% (119 of 311) did not. Of those with nausea at the outset, 54% (103 of 191) received an antiemetic. Of those without nausea at the outset, 25% (30 of 119) received an antiemetic. Thus, a total of 43% (133 of 311) of patients received a concomitant antiemetic, whereas 57% (177 of 311) received dihydroergotamine alone. When changes in the incidence of nausea were compared at 30 and 60 minutes after dihydroergotamine, an antiemetic effect was discerned in patients treated with or without a concomitant antiemetic. Antiemetic treatment yielded no significant difference in the percentage of patients experiencing nausea during the study. At baseline, 50% (88 of 177) of patients who received dihydroergotamine alone experienced nausea compared with 77% (103 of 133) of those who received an antiemetic. At the 30-minute point, 35% (61 of 173) of patients who received dihydroergotamine alone still experienced nausea versus 47% (62 of 133) of patients who received an antiemetic. At the 60-minute point, only 24% (42 of 174) of those given dihydroergotamine alone had nausea, compared with 38% (50 of 132) given concomitant antiemetic. Ongoing nausea seems to be a manifestation of the migraine process rather than an adverse effect associated with intramuscular dihydroergotamine.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗
PubMed1994

Mandibular skeletal and dental asymmetry in Class II subdivision malocclusions.

Mandibular symmetry was compared between a group of 28 subjects exhibiting Class II subdivision malocclusions and 30 subjects with Class I malocclusions who served as the control group. With submentovertex radiographs, symmetry was assessed by measuring the relative difference in spatial position of mandibular landmarks in both anteroposterior and transverse dimensions as determined by coordinate systems representing the cranial floor, mandible, and mandibular dentition. Only those variables representing the anteroposterior difference between right and left mandibular molar positions showed a statistically significant difference between the groups. Whether the position of the mandibular molars was measured relative to the cranial floor or within the mandible itself, the mandibular first molar was located more posteriorly on the Class II side of the subdivision malocclusion within a mandible that exhibited no other unusual asymmetry.

Adult↗
PubMed1994

Long-term stability after orthodontic treatment: nonextraction with prolonged retention.

A sample of 22 previously treated orthodontic cases was studied to evaluate long-term stability. All cases were treated nonextraction with fixed edgewise appliances and were without retainers a minimum of 5 years. Data were obtained from study models, although 14 of the 22 cases had longitudinal cephalometric radiographs. The average retention time with a mandibular fixed lingual retainer was 8.4 years. The irregularity index pretreatment was 8.0 mm in the maxillary arch and 5.2 mm in the mandibular arch; at the end of treatment it was 0.9 mm and 1.0 mm, respectively, and at the postretention stage it was 2.0 mm and 2.4 mm, respectively. Resolution of the lower irregularity index was accomplished without incisor advancement or distal movement of the mandibular molar, however, both arches were expanded transversely. During the posttreatment stage all variables showed relapse except for the expanded maxillary canines and premolars. However, the mandibular anterior segment demonstrated relatively good alignment at the long-term stage, which may be a reflection of prolonged mandibular retention.

Adolescent↗
PubMed1993

Office-based treatment of acute migraine with dihydroergotamine mesylate.

The Regional Migraine Field Trial assessed the efficacy and safety of dihydroergotamine mesylate (D.H.E. 45) for migraine in the office setting. Patients were admitted to the study provided they met the International Headache Society definition of migraine with or without aura. Thirty-eight neurologists enrolled 311 patients (274 women and 37 men) between the ages of 13 and 70 years in this open-design study. Ninety-five percent of the patients had moderate or severe headache pain at entry, and 62% had nausea. All patients received a single intramuscular injection of D.H.E. 45 1 mg. A second intramuscular injection of 1 mg was given 60 minutes after the first injection, if needed. An antiemetic was administered concomitantly with D.H.E. 45, if needed. Rescue therapy was given at the investigators' discretion. Efficacy was judged by the relief of pain, patients' ability to function, need for a second injection, need for rescue medication, and need for an antiemetic. At 30 and 60 minutes, 46% and 72% of patients had only mild or no head pain, respectively. At 24 hours, 77% of all patients had mild or no head pain. D.H.E. 45 also improved functional ability. At 30 and 60 minutes, 58% and 75% of patients had only mild or no disability, respectively. At 24 hours, 81% had mild or no impairment. Nausea was present in 62% of patients at the outset, 40% of patients at 30 minutes, and 30% at 60 minutes. An antiemetic was given to 43% of patients at the outset. The presence of nausea was similar whether or not patients received an antiemetic.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗
PubMed1991

Orthodontic treatment and temporomandibular joint sounds--a longitudinal study.

Temporomandibular joint sounds are often recognized as a clinical sign of temporomandibular disorders. The purpose of this study was to examine changes in the occurrence and resolution of these sounds in patients before and after orthodontic treatment with full fixed appliances. From a pool of 324 patients who came to a university postgraduate orthodontic clinic specifically for treatment of a malocclusion, 160 were examined before and after orthodontic treatment. When joint sounds were either reported or detected clinically, the patients underwent an audiovisual examination to more precisely and objectively record the occurrence and timing of the sound during mandibular opening and closing. No statistically significant difference could be found in the change in occurrence of joint sounds among patients treated with extraction and nonextraction treatment strategies. Overall, fewer patients had joint sounds at the end of the active stage of orthodontic treatment than before treatment. Also, fewer patients demonstrated reciprocal clicking after treatment than before treatment. Therefore it appeared that orthodontic treatment did not pose an increased risk for developing temporomandibular joint sounds irrespective of whether extraction or nonextraction treatment strategies were used. A progression of signs or symptoms to more serious problems was not apparent over the time period studied.

Adolescent↗
PubMed1991

An evaluation of the relationship between temporomandibular joint sounds and mandibular movements.

Mandibular movements in 28 subjects with TMJ sounds (who were otherwise asymptomatic) were evaluated and compared to those of 28 control subjects with no signs or symptoms of TM disorders (including the absence of clinically detectable TMJ sounds). Mandibular movements were recorded using the Sirognathograph interfaced with a personal computer. The joint sounds were recorded with contact microphones. The variables used to measure mandibular movements were not statistically different between the two groups except for mean mandibular deviation in the frontal plane, which was greater in the study group (3.2 mm) than the control group (2.2 mm). All combinations of mandibular movements were found to occur in relation to joint sounds with no obvious pattern. The large variability in both the study and control subjects, combined with the frequent finding of joint sounds in normal subjects, indicates that caution should be exercised in interpreting the characteristics of electronically recorded mandibular movements and TMJ sounds.

Adolescent↗
PubMed1990

Timing and character of reciprocal temporomandibular joint sounds in an asymptomatic orthodontic sample.

The timing and character of opening and closing temporomandibular joint sounds were evaluated in a sample of 33 asymptomatic subjects with reciprocal clicking. Using stereophonic headphones and videotape recordings, three consecutive reciprocal sounds were recorded and analyzed. The timing of the three consecutive opening and closing sounds was consistent in the majority of subjects, and occurred generally on late opening and middle to late closing. When the timing, character (frequency, amplitude, and duration), and wave patterns were evaluated, a notable amount of variation was observed in the overall sample. This suggested a variety of intra-articular reasons for the reciprocal sounds in this particular sample of subjects.

Adolescent↗
PubMed1989

The relationship between temporomandibular joint sounds and malocclusion.

The relationship between temporomandibular joint (TMJ) sounds and the occlusion was evaluated in a sample of 226 patients before commencement of orthodontic treatment. TMJ sounds were recorded on videotape, using an audiovisual system, for subsequent classification into various categories. The prevalence of joint sounds was 36.3% (N = 82) of which 50% (N = 41) were categorized as reciprocal clicks. The occlusion (static and functional) and skeletal relationships generally did not appear to be significant factors in contributing to TMJ sounds in patients with malocclusions. However, a larger interincisal angle in the sound-present group, and dental wear and increased overbite in the reciprocal-clicking subgroup may be associated factors.

Adolescent↗
PubMed1989

Occlusal contacts following orthodontic treatment: a follow-up study.

Occlusal contacts in maximum intercuspation were examined in a sample of 40 patients at the end of active orthodontic treatment and again an average of 21 months later. An increase in the total number of contacts was due to more actual and near contacts on all posterior teeth and more near contacts on anterior teeth. When the results were compared to a previous short term study, continued settling of the occlusion occurred beyond an initial three months of retention. Few contacts changed their location between the occlusal inclined planes and central grooves, suggesting minimal settling of the occlusion in a buccolingual direction.

Adolescent↗
PubMed1988

Class II, Division 1 vertical pattern.

The treatment of a skeletal Class II, Division 1 malocclusion in the early permanent dentition is described. The patient had a vertical facial pattern and lower arch crowding; four premolars were extracted. Although some anchorage was lost in the maxillary arch and the face developed in a predominantly vertical direction, the final result demonstrated a well-balanced and pleasing profile.

Adolescent↗
PubMed1987

Timing of temporomandibular joint sounds in orthodontic patients.

The consistency of occurrence and also the timing of TMJ sounds during jaw opening and closing were studied by means of an audio-visual sound recording system in an attempt to address the possible causes of temporomandibular joint (TMJ) sounds. From a group of 347 orthodontic patients, 104 were found to have medium- or high-amplitude TMJ sounds during jaw opening or closing. Most patients (53%) had reciprocal clicking--that is, a single sound on opening and on closing; another 12% had multiple sounds on opening or closing; 22% had a single closing sound; and 13% had a single opening sound. Sounds occurred at all degrees of jaw opening throughout this sample, but in most patients opening sounds tended to be closer to maximum opening, whereas closing sounds tended to occur in the middle of the closing movement. No statistically significant association was found between the timing of the opening and closing sounds. In 42.3% of patients, the sound was inconsistent in its occurrence on successive opening and closing cycles. Twenty-three percent of patients reported pain, jaw locking, or limitation of movement, but these were not associated with the timing of the opening sound. The findings suggest that the reciprocal click, widely associated with anterior disc displacement with reduction, was relatively common, but that other explanations for the joint sounds should also be considered. Conversely, a large variation may exist in the timing and the occurrence of sounds in patients with anterior disc displacement in the absence of pain and limitation of movement.

Adolescent↗