A cautionary tale of simplified retention.
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Biomedical subjects
Publications and source records attributed to H J Remmelink.
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The results of reconstruction of residual alveolo-palatal bone defects in 40 patients are evaluated clinically and radiographically in a retrospective study. Age at the time of surgery varied from 7.4 to 32.7 years. The patients were divided into two age groups: before and after 12 at the time of operation. Free autogenous anterior iliac crest bone grafts were used in 26 patients and free autogenous mandibular symphyseal bone grafts were used in 14 patients. The results show unsuccessful closure of the oronasal communication in the alveolo-palatal area of the cleft in 3 out of 31 patients. In 3 out of 40 patients, radiographic incorporation of the bone graft was unsuccessful. The radiographic success was not related to increasing experience of the surgeons. The study indicates that the best grafting results are achieved when grafting is performed before 12 years of age. The radiographic results of mandibular symphyseal bone grafts tend to be slightly better compared with results obtained with anterior iliac crest bone.
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Sixty-six growing Class II, division 1 patients were treated with a headgear-reactivator combination. The appliance included a mandibular advancement mechanism, that was reactivated during treatment. Lateral roentgenograms in centric occlusion were taken at the beginning and end of the active treatment period. At the end of treatment the sagittal jaw relationship was significantly improved. However, considerable maxillary incisor retroclination and mandibular incisor proclination also occurred. No marked changes in the vertical skeletal situation could be demonstrated.
An overview is presented of causes, consequences and treatment possibilities of snoring and the obstructive sleep apnea syndrome. Snoring and the obstructive sleep apnea syndrome are widespread sleep disorders, which may result in serious physical and psychosocial problems. The contribution of oral surgery and orthodontics to the team management of these patients is discussed.
The effects of sagittal expansion with a cemented expansion appliance were studied in nine noncleft macerated human maxillae ranging from 1-10 years. It was found that opening of the premaxillo-maxillary suture did occur in the youngest maxilla. Movement of the incisor roots through the labial cortical plate was observed in seven specimens. In one maxilla, dislocation of the maxillary tuberosity occurred. The results of this investigation suggest that it seems questionable that sagittal expansion using cemented appliances in noncleft human maxillae will in most instances result in breaking the ossification of the premaxillo-maxillary suture together with the interlocking serrations.
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