Biomedical subjects
Publications and source records attributed to P J Sandler.
This article reviews the literature on orthodontic treatment involving extraction of first molars and highlights many of the clinical considerations when treating such cases. Case reports illustrate the potential problems and indicate some solutions.
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Commonly, clinicians' principal tool in the alignment phase of orthodontic mechanotherapy is the nickel-titanium wire. During the course of orthodontic treatment, however, there are times when some segments of the dental arch require flexible wires, while the rest would benefit from rigid wires. In this report, we describe a technique where both of these needs are satisfied simultaneously. Specifically, a segment of nickel-titanium wire is piggybacked onto a stainless steel wire in regions where flexibility is desired. This method eliminates the problems associated with the activation, de-activation forces created along a continuous archwire and might be more economical. Clinical pictures illustrate the point.
Methods of exposing impacted teeth in order to bring them into the line of the arch include gingivectomy, the apically repositioned flap and closed eruption techniques. These procedures aim to facilitate the eruption of the impacted tooth with a minimum of disruption or damage to the tooth itself or adjacent structures. The aim of this paper is to discuss the various surgical methods of exposing impacted teeth and to help to identify where the use of the apically repositioned flap is indicated. Clinical examples are presented and a surgical method for carrying out this procedure recommended.
Films used in orthodontics such as lateral cephalograms and orthopantomograms provide excellent visualisation of the maxillary sinuses and the nose, and therefore should be routinely examined for pathology and foreign bodies. We report a case of a long-standing asymptomatic nasal foreign body detected on routine orthodontic films.
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This prospective controlled study investigated the net effects of the Twin Block functional appliance taking into account the effects of normal growth in an untreated control group. The treatment group consisted of 36 subjects, mean age of 12.4 years, consecutively treated with Twin Block appliances for an average period of 0.9 years. Each subject had immediate pre- and posttreatment lateral cephalograms. The control group consisted of 27 subjects with a mean age of 12.1 years. These patients were observed for a mean time of 1.2 years and had radiographic investigation at the initial consultation and immediately before the start of Twin Block therapy. The data were then annualized and subjected to multiple regression analysis. In the treatment group, a reduction in ANB of 2.0 degrees (p < 0.001) was observed largely because of an increase in SNB of 1.9 degrees (p < 0.001). No statistically significant restraint in the maxillary growth was observed. Treatment resulted in an increase in Ar-Pog of 5.1 mm (p < 0.001) compared with the control group increase in Ar-Pog of 2.7 mm, resulting in a net gain of 2.4 mm. The overjet was reduced by combination of a net maxillary incisor retroclination of 10.8 degrees (p < 0.001), net mandibular incisor proclination of 7.9 degrees (p < 0.001) and forward movement of the mandible. Buccal segment relationships were corrected by means of lower molar eruption, restraint in the eruption of the upper molars and forward growth or repositioning of the mandible. Any possible fossa adaption was not assessed.
The present case illustrates a nonsurgical method of fixing a minimally displaced mandibular fracture with use of an easily prepared orthodontic appliance. This method offers several advantages for both the attending staff and the patient.
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In conventional surgically assisted rapid palatal expansion, a diastema is opened between the central incisors. A case is presented in which the surgical procedure was modified so that the split of the maxilla occurred in the region of a missing lateral incisor rather than at the midline. This facilitated restoration of the space with a prosthetic tooth almost immediately following surgery.
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A visit to the Orthodontic Institute in Warsaw was kindly sponsored by American Orthodontics in order to enable a straight wire typodont course to be conducted. The entire orthodontic department turned out for the course, and it proved to be a stimulating and enjoyable few days. This report details the state of orthodontics in Poland and aims to outline various similarities and differences between dental training in Warsaw and in Great Britain, both at undergraduate and postgraduate levels.
The use of neodymium-iron-boron micro-magnets as a fixed retainer which does not hinder oral hygiene, is reported. A patient with persistent midline spacing treated using this method is described.
These two cases illustrate variations of an alternative technique for moving unerupted teeth into the mouth. Previously described techniques may damage the tooth or the periodontium and the regular adjustments required can be uncomfortable and are unpleasant for the patient and the operator. The method described provides a stress free alternative which is readily acceptable to patients. Adjustments are rarely needed, but if required they usually involve repositioning a magnet in the removable appliance, a procedure carried out simply by the operator or technician using cold cure acrylic.
The first part of this paper is a literature review of magnets and their uses in orthodontics. The biological safety of magnets is considered and a report is given of experiments carried out on rat osteosarcoma cell line UMR-106. The second part of the paper describes a case where neodynium-iron-boron magnets were used to assist eruption of an unerupted, vertically impacted upper right canine. Previously, space was available for this tooth, but it failed to show signs of eruption. Following surgical attachment of a magnet, and the use of a second magnet attached to an upper removable appliance, rapid eruption occurred producing a favourable position for bonding.
The purpose of this study was to assess the contribution to tracing error of positioning the patient within the cephalostat. It was carried out by comparing the differences between repeated measurements from two 'same day' radiographs, with the differences between measurements from two tracings of the same radiograph.
An aesthetic solution is offered to the problem of space maintenance following the re-opening of space for an upper central incisor.