Biomedical subjects
Publications and source records attributed to J P Pfeiffer.
In orthodontics, occlusion should be considered from both the static and the dynamic viewpoints. The factors which determine adequate occlusion and articulation are described. It is furthermore shown how the orthodontist can incorporate those factors which he can control into the orthodontic treatment.
Profound knowledge of craniofacial growth is of utmost importance to the clinician in order to establish a treatment plan which respects the growth type of each patient. Different growth processes and possible etiological factors leading to a skeletal Class II are discussed. Only a comprehensive analysis in all three dimensions will allow adequate choice of treatment procedure.
The vertical dimension and its implication in the etiology of the class II are described. This dimension is analysed at the level of the cranial base, the maxillary and mandibular bones and alveolar processes. Then, the facial architecture as a whole is considered and particularly the key position of the upper molar. The dorsal and low position of these teeth in the hyperdivergent cases is fundamentally different from the one they occupy in the hypodivergent cases. The therapeutic approach is completely different in both cases and is illustrated by means of three deep overbite and three open bite cases.
Normal facial growth displaces maxilla and mandible forward and downward. The result is the skeletal and facial equilibrium described by Angle. In classe-II and class-III cases, growth patterns are modified as well as sagittal and vertical dento-facial dimensions. Development and differential diagnosis of skeletal and dental class-II cases are presented, in relation to their sagittal parameters only. The evolution of a class-II can be predicted with the help of several cephalometric measurements, so that the adequate therapy can be used in time to reestablish proper growth.
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The importance of an exact differential diagnosis of the Class II malocclusion and its indications for treatment with activators, extraoral forces, and fixed appliances has been shown. Four schematized malocclusions with their cephalometric characteristics and their individualized orthopedic therapeutics have been presented. Special attention has been given to the subsequent fixed mechanotherapy showing the limited need for fixed appliances. This approach is attractive, for it reduces considerably the stress imposed on the patient and the orthodontist, it bypasses the iatrogenic hazards entailed in extensive and prolonged mechanotherapy, and it consistently increases chances for long-term stability.
The author explains his orthodontic philosphy. He emphasizes the importance of the differential diagnosis for the choice of the appliances. He illustrates his therapeutic conception by means of four schematic cephalometric tracings. Both, the removable and the fixed appliances can very well be present in the therapeutic arsenal of the same orthodontist, provided that each one be used only on the basis of an exact indication. Three tables try to classify the cases which can be handled by removable only, fixed only or both kinds of appliances. Finally, photographs of a case treated with a mixed method are shown.