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Biomedical subjects

J L Vaden

Publications and source records attributed to J L Vaden.

16 recordsLinked to original sources
PubMed1996

Straight talk about extraction and nonextraction: a differential diagnostic decision.

At one stage or another, orthodontics is usually a space management procedure, particularly during the correction of a Class I or Class II malocclusion. Orthodontists use space that is available or create space to correct malocclusions. There are anterior, posterior, lateral, and vertical dimensions of the dentition and its supporting structures. If the muscular balance is normal, the clinician should try to respect these dimensions. The orthodontic clinician should not be an extractionist or a nonextractionist. Rather, the clinician should use differential diagnostic skills and artistic ability to arrive at the most appropriate treatment outcome for each patient.

Decision Making↗
PubMed1995

Adult versus adolescent Class II correction: a comparison.

The interest of the adult patient in orthodontics has increased as the demographics of the specialty of orthodontics has changed. There are major intreatment and posttreatment differences in Class II malocclusion correction between the adolescent and the adult. This article outlines the differences--and the similarities--between adolescent and adult Class II malocclusion correction. The differences and similarities are illustrated with case reports of a representative adolescent from the adolescent group and a representative adult from the adult group.

Adolescent↗
PubMed1994

Clinical ramifications of posterior and anterior facial height changes between treated and untreated Class II samples.

Some clinicians have suggested that one primary difference between successful and unsuccessful Class II treatment outcomes is the relative change of anterior and posterior facial heights. Successfully treated cases are claimed to exhibit greater increases in posterior facial height (PFH, articulare to gonion) than in the anterior facial height (AFH, menton to palatal plane). This conjecture was tested here by recalling a treated Class I sample and a treated Class II sample and by comparing the differences found in these samples to an untreated Class II sample at the same ages. The PFH/AFH ratio increased significantly more in the treated Class I and Class II samples during the active phase of treatment than in the untreated Class II sample at the same ages. During the years from posttreatment to recall (mean = 6 yrs), there was a significant increase in the PFH/AFH ratio in the treated Class II sample due to a greater increase in PFH than AFH. This ratio continued to improve after all appliance therapy had been discontinued, and it did not occur in the treated Class I sample nor in the untreated Class II sample. The conclusion was that the patient with a Class II malocclusion, if treated, continues to change favorably over time. This favorable change, in turn, helps maintain the Class II correction.

Adolescent↗
PubMed1994

Differential diagnostic analysis system.

This article links clinical research to fundamental orthodontic concepts to give the clinician a workable differential diagnosis system. The clinical research, conducted by the Charles Tweed Foundation, attempted to establish a "profile" for the Class II malocclusion correction, which, because of certain characteristics, was destined to failure. The Cranial Facial Dental Analysis integrates this clinical research with the total space analysis to give the clinical orthodontist a useful tool for differential diagnosis.

Cephalometry↗
PubMed1994

Effects of patient age on postorthodontic stability in Class II, division 1 malocclusions.

The increase in the proportion of adults in the typical orthodontic practice merits closer scrutiny of the treatment differences involved in adult vis-à-vis adolescent patients. Orthodontic treatment in the adolescent relies heavily on growth; in the adult, the practitioner must reposition teeth within the nongrowing arches. This difference may create the potential for greater postretention relapse in the adult; alternatively, continued growth in the subadult might detract from stability of the case. Two samples of Class II, Division 1 cases, all treated by one specialist, were examined an average of 5 years out of treatment. One group had been treated during adolescence (approximately 12 years of age), the other in adulthood (approximately 28 years). The orthodontic corrections were stable in both groups, but for different reasons: Posttreatment changes in the bony and dental structures of the adults were minimal. Bony changes (i.e., continued midface and mandibular growth) were appreciable in adolescents, and this growth--notably growth of the mandible--compensated for unfavorable drift of the dental elements (primarily mesial shift of the maxillary molar) after treatment. In sum, orthodontic corrections in adults were found to be at least as stable as those in the conventional adolescent patient.

Adolescent↗
PubMed1994

Posttreatment stability in adult and adolescent orthodontic patients: a cast analysis.

Orthodontic treatment of adults differs in many ways from that of the conventional adolescent patient. Adults are essentially nongrowing and have lower turnover rates of alveolar bone. These and other factors may affect the posttreatment stability of adult dentitions. This study compared the stability of orthodontic outcomes in matched samples of adolescents (about 13 years of age) and adults (about 30 years old) at an average of 5 years out of treatment. Analysis disclosed few differences between age groups; both exhibited considerable stability. Regarding key treatment considerations--such as midline alignment, incisor overbite and overjet, incisor irregularity, and molar relationship--both groups changed to equivalent degrees (and very little on average). Although minor differences were found (eg, arch length decreased more in adults), treatment changes in this sample of adults were at least as stable as those in the adolescents for all clinically relevant variables.

Adolescent↗
PubMed1991

Age effects on orthodontic treatment: adolescents contrasted with adults.

Skeletodental treatment changes in 30 adolescent girls and 26 women who had Class II, Division 1 malocclusions were contrasted cephalometrically, primarily with the McNamara analysis. The data show that adult treatment does not obligate the practitioner to longer treatment. In this study, both age groups were treated in 2.5 years on the average. Apical base corrections were achieved with equal facility in both groups by the posterior remodeling of point A, and this (in conjunction with unrestrained mandibular growth) is the major source of correction in the adolescents. In adults, in whom growth is trivial, an appreciable source of sagittal correction is the steepening of the occlusal plane. Several sequelae of Class II elastic force occurred as by-products of molar correction in the adults: increased mandibular molar eruption, increased maxillary molar intrusion, increased maxillary incisor eruption, increased mandibular incisor intrusion, and steepening of the occlusal plane.

Adolescent↗
PubMed1991

Age effects on orthodontic treatment: skeletodental assessments from the Johnston analysis.

We have compared differences in treatment outcomes dependent on patient age, either adolescent (means = 12.5 years at start) or adult (means = 27.6). Subjects were female patients whose Class II, Division 1 malocclusions were treated with Tweed edgewise mechanics and four-premolar extractions. Cephalometric records were assessed according to the Johnston analysis. The functional occlusal plane remained stable during mechanotherapy in the adolescents, whereas it steepened considerably in the adults. Differential mandibular growth in adolescents contributed 70% of the total molar correction, with orthodontic tooth movement accounting for the other 30%. Maxillary growth in the adults detracted from the Class II molar correction; tooth movement accounted for virtually all of the correction.

Adolescent↗
PubMed1991

Sequential directional forces treatment: two Class II case reports.

Two types of Angle Class II, Division 1 malocclusion that were treated with Tweed-Merrifield directional forces are presented. The cases are entirely different. Each required a different diagnosis, but the results are similar. In both cases the resultant vector of all the orthodontic force systems was upward and forward in direction.

Bicuspid↗
PubMed1987

Lower incisor space analysis: a contrast of methods.

Two current methods to assess spacing-crowding among lower anterior teeth are described and contrasted. These are the anterior space analysis of Merrifield and the irregularity index of Little. There is only a modest correlation between these methods (rs = +0.53) because they provide complementary information; space analysis is more attuned to tooth displacements while the irregularity index is susceptible to axiversions. Cases illustrating major divergences between the two methods are illustrated.

Adolescent↗