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Biomedical subjects

H S Orton

Publications and source records attributed to H S Orton.

At least 19 recordsLinked to original sources

Extrusion of the ectopic maxillary canine using a lower removable appliance.

The ectopic eruption and impaction of maxillary canines is a frequently encountered problem. The prevalence is estimated to be between 0.92% to 2.2%. It is found to be palatal to the dental arch in about 85% of cases and buccal only in about 15% of cases. Ericson and Kurol suggested that removal of the deciduous canine before the age of 11 years will normalize the position of the ectopically erupting permanent canine in 91% of cases if the canine crown is distal to the midline of the lateral incisor. We strongly endorsed this interceptive approach. Early recognition that a canine is erupting ectopically is extremely important. Ericson and Kurol estimate that in 0.71% of children in the 10 to 13 year age group, permanent incisors have resorbed because of the ectopic eruption of maxillary canines. Resorption may be found as early as 10 years but occurs most frequently in the age groups 11 to 12 years. In this article a simple, well-clasped lower removable appliance is shown to be an excellent base for using light elastics to move the impacted canine, first posteriorly away from the incisor roots and then vertically and buccally. A gold chain is bonded to the unerupted canine to provide a simple and flexible means of traction that ensures the canine erupts into a zone of attached mucosa with normal crown length.

Adolescent

The treatment of severe 'gummy' Class II division 1 malocclusion using the maxillary intrusion splint.

This paper describes a modified Maxillary Intrusion Splint (M.I.S.) system which incorporates a near vertical pull headgear, and its use in the management of severe 'gummy' Class II division 1 malocclusion. The appliance was designed to reduce the visibility and vulnerability of the maxillary incisors in this difficult clinical situation by achieving the intrusion of maxillary teeth, restraining maxillary growth, and encouraging an element of subsequent forward mandibular rotation. The authors' initial experience using this system is presented in a retrospective cephalometric analysis of the lateral skull films of 26 treated patients contrasted with a similar number of comparable controls. The results showed that the principal effects of the M.I.S. were on the maxillary teeth giving decisive overjet control and incisor retraction with actual maxillary incisor intrusion. There was a similar effect on the maxillary molar and the M.I.S. provided effective en masse vertical control of the maxillary dentition. There was some degree of maxillary restraint in the M.I.S. group, but no noticeable difference in the change of mandibular position between the groups at the end of treatment. The possible reasons for this are discussed and suggestions made to improve this aspect of treatment in these patients.

Cephalometry

Class III malocclusion: a comparison of extraction and non-extraction techniques.

A retrospective cephalometric study was made of the hard tissue changes in a group of 90 Class III, Skeletal III children, diagnosed as suitable for treatment by orthodontic means alone. Thirty-two were treated by a combination of upper incisor proclination and headgear to an intact mandibular dentition (Group 1), while in 28 the overjet was corrected with mid-arch extractions and Edgewise mechanics (Group 2). The remaining 30 children acted as controls (Group 3). Children were initially examined as male and female subgroups, and where no significant differences were seen data were pooled. In order to standardize the results, treatment/observation effects were presented as average changes per year. The three groups were essentially comparable pretreatment. Following overjet correction, the lower incisors uprighted in both groups, with an improved relationship to the A-Po line: the upper incisors were proclined in Group 1 only. Underlying skeletal changes were restricted to the mandible, which showed a downward and backward hinging, and an increase in lower face height. The improved mandibular position was significantly greater in the non-extraction group and was accompanied by an improvement in facial convexity. In addition, treatment could be started earlier and was completed in a significantly shorter time (Table 1). It would, therefore, appear that, in the short term at least, a non-extraction/headgear approach has advantages over a standard mid-arch extraction/Edgewise technique.

Adolescent

Criteria for approval of training programmes for senior registrars in orthodontics in the United Kingdom.

To be appointed as a consultant orthodontist in the British National Health Service requires a period of 3+ years in a higher training post as a senior registrar in orthodontics. Educational approval of these training posts is controlled by the Joint Committee for Higher Training in Dentistry. The detailed monitoring and requirements of senior registrar training posts are controlled by the Specialist Advisory Committee in Orthodontics and Paediatric Dentistry. Revised criteria for the approval of training programmes have recently been issued and are appended for the guidance of aspirant trainees, trainers and for the reader seeking an understanding of the UK title of 'Consultant Orthodontist'.

Consultants

Future manpower requirements for orthodontics undertaken in the General Dental Service.

The fall in the number of births in England and Wales which took place between 1964 and 1977 is beginning to have an effect on the present-day demand for orthodontic treatment. Using the best available data a mathematical model has been used to predict the likely demand for orthodontic treatment in the General Dental Services of England and Wales from now until 2008. This suggests that there is likely to be a sharp decline in the number of new orthodontic patients presenting for treatment at practices limited to orthodontics during the next 5 years. The recent expansion in the number of places available for postgraduate study of orthodontics makes it extremely unlikely that the position will improve significantly thereafter. There can be little doubt that we are now producing too many orthodontic specialists even allowing for the increase in manpower which might be required to satisfy a future demand for higher standards of treatment.

Dentists

The management of class III and class III tendency occlusions using headgear to the mandibular dentition.

The use of extra-oral traction to the lower arch in the treatment of Class III malocclusion is described. The results of the treatment of 43 consecutive cases employing both removable and fixed appliances are analysed and compared with an untreated control group of 15 further cases. It was found that the Class III malocclusion in the study fell into three groups, the characteristic of each group giving an indication of the recommended treatment approach.

Adolescent