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At least 235 records · Page 13Linked to original sources
PubMed1997

Morphometry of the cranial base in subjects with Class III malocclusion.

The significance of the cranial base in the development of Class III malocclusion remains uncertain. The purpose of this study was to determine whether the form of the cranial base differs between prepubertal Class I and Class III subjects. Lateral cephalographs of 73 children of European-American descent aged between 5 and 11 years with Class III malocclusion were compared with those of their counterparts with a normal, Class I molar occlusion. The cephalographs were traced, checked, and subdivided into seven age- and sex-matched groups. Average geometries, scaled to an equivalent size, were generated based on 13 craniofacial landmarks by means of Procrustes analysis, and these configurations were statistically tested for equivalence. Bivariate and multivariate analyses utilizing 5 linear and angular measurements were undertaken to corroborate the Procrustes analysis. Graphical analysis, utilizing thin-plate spline and finite element methods, was performed for localization of differences in cranial base morphology. Results indicated that cranial base morphology differed statistically for all age-wise comparisons. Graphical analysis revealed that the greatest differences in morphology occurred in the posterior cranial base region, which generally consisted of horizontal compression, vertical expansion, and size contraction. The sphenoidal region displayed expansion, while the anterior regions showed shearing and local increases in size. It is concluded that the shape of the cranial base differs in subjects with Class III malocclusion compared with the normal Class I configuration, due in part to deficient orthocephalization, or failure of the cranial base to flatten during development.

Aging↗
PubMed1997

Symptoms and signs of temporomandibular disorders in girls with normal occlusion and Class II malocclusion.

Mandibular function, headaches, and symptoms and signs of temporomandibular disorders (TMD) were studied in one group of girls with a well-defined normal occlusion (n = 60) and another group with class II malocclusion (n = 123). Frequent headaches and temporomandibular joint clicking, muscle tenderness to palpation, pain on mandibular movement, awareness of tooth clenching, and grinding were commoner in the class II malocclusion group. Awareness of tooth clenching had the largest influence on the odds for symptoms and signs of temporomandibular disorders (TMD) in a logistic regression analysis. Occlusal variables that increased the odds for symptoms and signs of TMD were large overjet, frontal open bite, few occlusal contacts, lateral sliding retruded-intercuspal contact position, crowding, and non-working side interferences. We concluded that normal occlusions have lower odds for symptoms and signs of TMD, whereas some occlusal characteristics, more frequently found in the class II malocclusion group, increased the odds for symptoms and signs of TMD.

Adolescent↗
PubMedDate not supplied

[Facial prognathism and its relation to the cranial base in Brazilian children with Class I malocclusion].

The objective of this work was to study the degree of the facial prognathism, considering the relationships between the SNA and SNB angles with the saddle angle (NSAr and NSBa). The sample consisted of eighty cephalometric roentgenograms, taken in lateral norm, of Brazilian white children, forty boys and forty girls, with both dental and skeletal, class I malocclusions, with ages between 9 years and 2 months old and 13 years and 7 months old. Data were statistically analysed and the sample was divided in three groups considering the mean value and the standard deviation of the NSAr angle. Sixteen subjects (seven boys and nine girls, 20 percent of the sample) presented an NSAr angle that was smaller than 119.5 degrees (x - 1s); twenty subjects (forteen boys and six girls, 25 percent of the sample), showed an NSAr angle more than 127.5 degrees (x + 1s) and forty-four subjects (nineteen boys and twenty-five girls, 55 percent of the sample) had an NSAr angle value between 119.5 and 127.5 degrees (x +/- 1s). The results led to the following conclusions: 1. There is a negative correlation, statistically significant between the saddle angle (NSAr and NSBa) with the SNA angle in subjects with class I malocclusions. An NSAr or NSBa angle higher than the mean value plus one standard deviation, it is associated with of the maxilla retrognathism and contrariwise. 2. There is a negative correlation, statistically significant between the sadle angle (NSAr and NSBa) with the SNB angle in subjects with malocclusions. An NSAr or NSBa angle higher than the mean value plus one standard deviation, it is associated with the mandible retrognathism and contrariwise. 3. The normal values of the SNA and SNB angles for an individual and the degree of the facial prognathism should be determined individually, since that the values of these angles might be affected for cranial base morphology.

Adolescent↗
PubMed2026

Assessment of temporomandibular joint space changes after orthognathic surgery in skeletal malocclusion patients: a systematic review.

PURPOSE: To interpret postoperative changes in temporomandibular joint (TMJ) joint space dimensions and condylar position following orthognathic surgery in patients with skeletal malocclusions, and to determine whether reported alterations represent clinically meaningful displacement or physiological adaptive remodeling. MATERIALS AND METHODS: A comprehensive search of PubMed, SCOPUS, Web of Science, EBSCOhost, and Cochrane Library was performed to assess pre- and postoperative TMJ changes using three-dimensional imaging. Joint spaces including anterior (AJS), superior (SJS), and posterior (PJS) and condylar morphology were evaluated. Methodological quality was appraised using the Joanna Briggs Institute (JBI) checklist. Due to methodological and clinical heterogeneity, findings were synthesized narratively with attention to malocclusion type and surgical movement. RESULTS: A total of 16 studies consisting 628 patients undergoing BSSO, Le Fort I osteotomy, vertical ramus osteotomy, or bimaxillary surgery were included. Most studies reported minor, adaptive postoperative changes in AJS, SJS, and PJS. Class II patients showed more consistent increases in AJS/SJS, whereas Class III patients demonstrated variable posterior or anterior remodelling depending on surgical movement. Volumetric analyses revealed region-specific adaptations without significant condylar displacement. Postoperative temporomandibular disorder symptoms were infrequent, and no consistent evidence supported detrimental TMJ effects attributable to surgery. CONCLUSION: Postoperative TMJ joint space changes after orthognathic surgery primarily represent physiological adaptive remodeling rather than pathological condylar displacement, with reported variability driven by malocclusion type, surgical movement, fixation method, and imaging protocol. Recognizing these predictable patterns is essential to prevent overinterpretation of postoperative imaging and to improve clinical assessment through standardized three-dimensional and long-term evaluation strategies.

Humans↗
PubMed1978

An epidemiologic survey of malocclusions among American Negroes and American Hispanics.

The malocclusions of thirty-six Negro and fifty-six Puerto Rican orthodontic patients from a specific area were surveyed. The population was divided according to sex, age, and skeletal classification. The total Negro malocclusion sample was compared to available Negro norms for both Downs and Steiner analyses. The total Hispanic malocclusion group was compared to available Negro and Caucasian norms for the same analyses. Ranges, means, and standard deviations were developed for each measurement recorded. The comparative frequency of individual skeletal classifications was found to be remarkably similar in both groups, and the percentage of open-bites was greater in both groups than in the general population. The need to expand available material to include a Puerto Rican group is noted.

Adolescent↗
PubMed1982

The adaptive value of dental crowding: a consideration of the biologic basis of malocclusion.

Malocclusion, an ambiguous concept that refers to structural disharmony of the teeth and jaws, can be defined only in reference to normal occlusion. If normal occlusion is synonymous only with ideal occlusion, then normal occlusion becomes a rare occurrence. A biologically valid concept of normal occlusion includes a range of variation in the relevant occlusal variables that is compatible with health and unimpaired function. The difficulty in defining malocclusion is the determination of the point at which normal variation becomes abnormal. A clearer concept of malocclusion is obtained if the occlusal variables that it comprises are considered. Dental crowding is endemic among technologically advanced populations and uncommon in primitive groups. The significant elements in the development of most dental crowding are mesial migration and the lack of interproximal attrition. Mesial migration of the posterior teeth provides the functional replacement for the tooth surface lost to attrition because of the rigors of a primitive diet. In modern man there is little attrition of the teeth because of a soft, processed diet; this can result in dental crowding and impaction of the third molars. It is postulated that the tooth-jaw size discrepancy apparent in modern man as dental crowding is, in primitive man, a crucial biologic adaptation imposed by the selection pressures of a demanding diet that maintains sufficient chewing surface area for long-term survival. Selection pressures for teeth large enough to withstand a rigorous diet have been relaxed only recently in advanced populations, and the slow pace of evolutionary change has not yet brought the teeth and jaws into harmonious relationship.

Adaptation, Biological↗
PubMed1986

Malocclusion associated with temporomandibular joint changes in young adults at autopsy.

The purpose of this study was to identify variables of malocclusion that might be associated with previously reported temporomandibular joint morphologic findings. Before removing the left TMJ from each of 96 cadavers (age means equals 26.4 +/- 6.8 years), an intraoral examination was performed. Angle classification, crossbite, overbite, and overjet were evaluated. These parameters were analyzed with respect to their association with the following TMJ features: overall shape of the condyle and temporal bone, gross and histologic evidence of remodeling, and position of the articular disk. When combined with age, Angle Class II and III dentitions were associated with temporal and condylar deviation in form (DIF) (P less than 0.05) and more Class II dentitions were accompanied by histologic evidence of remodeling changes in the TMJs. Crossbite was associated with increasing presence of DIF in all components (P less than 0.01). Anterior crossbite was associated with DIF on the articular eminence (P less than 0.01). Deep overbite was more common in persons with flat condyles, open mandibular fossae, and anterior extension of the temporal articular surfaces (P less than 0.05). Abnormal overjet was more evident in those with DIF in the disk (P less than 0.05); greater overjet was associated with disk displacement (P less than 0.05). Considered together, abnormal overbite and overjet were associated with more extensive DIF on the condyle (P less than 0.05). In conclusion, malocclusion was associated with morphologic changes in the TMJ, particularly when combined with age. This evidence supports the belief that longer exposure to malocclusion may be associated with more extensive TMJ changes.

Adolescent↗
PubMed1990

Prosthodontic rehabilitation of patients with Class II malocclusions.

The Angle's class II malocclusion patient challenges the prosthodontist because optimal treatment may include orthodontic therapy, orthognathic surgery, periodontics, and fixed or removable prosthodontics. Compromises in the treatment plan are necessary when patients cannot accept optimal dental treatment. However, specific prosthodontic principles should be observed. This article discusses Angle's class II malocclusions, including the theories and therapies to treat patients with this malrelationship successfully. Prosthodontic management of the malocclusion is an adjunct to other care rendered.

Dental Occlusion↗
PubMed1993

A study of clinical signs and symptoms of temporomandibular dysfunction in subjects with normal occlusion, untreated, and treated malocclusions.

In the light of the universally growing concern over the suggested relationship between orthodontic treatment and temporomandibular (TM) dysfunction, the purpose of the present investigation was to compare the status of signs and symptoms of TM disorders in three groups of adolescents and young adults. The groups consisted of 30 persons with normal occlusions, 41 with untreated malocclusions, and 31 with treated malocclusions. The clinical status and subjective symptoms of TM dysfunction were recorded according to the principles introduced by Helkimo. The results showed that the normal occlusion group had the maximum number of persons free from any dysfunction, but the differences between the groups in the distribution of persons according to the anamnestic and clinical dysfunction indices were not significant. The only statistically significant finding was the difference in the clinical dysfunction index scores of the persons with normal occlusions and untreated malocclusions. According to anamnesis, the most frequently reported symptoms were related to periods of stress. Among the clinical signs and symptoms, the most commonly occurring were crepitations on palpation and sounds on auscultation of the joints in all the three groups. In conclusion, the absence of substantial differences between the three groups indicates that the role of orthodontic treatment in either precipitation or prevention of TM dysfunction remains questionable.

Adolescent↗
PubMed2004

The postural basis of malocclusion: a philosophical overview.

Over the last 100 years, many theories have attempted to explain the cause of malocclusion. Most have stated that it is inherited, but, more recently, greater emphasis has been placed on the influence of the environment, especially the activity and the posture of the oral soft tissues. Unfortunately, it is not possible to measure long-term posture with any precision, and this has reduced its perceived importance. When some evidence is missing and much of the rest conflicting, there is merit in moving from the traditional "prove-it" attitude to philosophical reasoning to separate the probable from the improbable. We do not know to what extent posture and parafunction might be inherited, but there can be no doubt that facial and dental structures are, at times, strongly influenced by the soft tissues and that some malocclusions appear to have a postural basis. This article undertakes a philosophical examination of the conflicting strands of evidence that link oral posture with malocclusion, hoping to create a theory based solely on the restricted evidence that is broadly accepted by all sides in this age-old debate.

Environment↗
PubMed2004

Nonsurgical correction of skeletal deep overbite and class II division 2 malocclusion in an adult patient.

Treatment modalities for Class II Division 2 malocclusion include growth modification, dental compensation, and surgical-orthodontic therapy; which treatment is chosen depends on the patient's age and growth potential. Deep overbite can be corrected by intrusion of anterior teeth, extrusion of posterior teeth, or a combination of both. Treatment considerations include the patient's facial profile, skeletal pattern, growth potential, and severity of dental malocclusion. Here, we present the nonsurgical orthodontic treatment of an adult patient with deep overbite and underlying skeletal Class II discrepancy. He had a hypodivergent facial pattern, Class II Division 2 malocclusion, and traumatic deep overbite due to supereruption of the mandibular anterior teeth. He refused orthognathic surgery but would accept orthodontic treatment alone, with the understanding that the treatment results could be compromised. We corrected the deep overbite by proclining the mandibular incisors; this helped to level the exaggerated curve of Spee. The posttreatment occlusion was significantly improved, both functionally and esthetically, with stable interincisal contacts. However, the improvement in occlusion and esthetics was achieved at the expense of reduced periodontal support for the mandibular anterior teeth.

Adult↗
PubMed2006

Alignment stability in Class II malocclusion treated with 2- and 4-premolar extraction protocols.

INTRODUCTION: The purpose of this study was to compare the postretention stability of the correction of mandibular anterior-tooth irregularity in patients with Class II malocclusions whose orthodontic treatments included extraction of 2 or 4 premolars. METHODS: A total of 66 patients were selected who initially had at least one-half-cusp Class II malocclusions. Nineteen patients (9 male, 10 female) with an initial mean age of 14.04 years were treated with extraction of 2 premolars (group 1); 47 patients (20 male, 27 female) with an initial mean age of 13.03 years were treated with extraction of 4 premolars (group 2). A subgroup of group 2, with a similar amount of initial anterior-tooth irregularity as group 1, was also compared with group 1. Little's irregularity index was used to evaluate anterior tooth irregularity in dental casts obtained from each patient before treatment, after treatment, and 5 years after active treatment. Initial cephalometric variables, initial treatment priority index, pretreatment age, treatment time, and posttreatment time of the groups were compared with t tests. Similarly, Little's irregularity index values at prettreament, posttreatment, and postretention were also compared with the t test. Cephalometric treatment changes within groups were evaluated with dependent t tests. RESULTS: There were no statistically significant differences in posttretention anterior-tooth irregularity between groups 1 and 2 or the subgroup. CONCLUSIONS: Treatment of Class II malocclusion with extraction of either 2 maxillary premolars or 4 premolars provides the same mandibular anterior-tooth alignment stability.

Adolescent↗
PubMed2006

Morphology of the temporomandibular joint in subjects with Class II Division 2 malocclusions.

INTRODUCTION: Temporomandibular joint (TMJ) morphology has not been studied adequately in subjects with various types of malocclusion, and it is not known if TMJ morphology and facial morphology are related. Such knowledge might assist in the establishment of biological treatment strategies, especially when the TMJ is the target of the treatment plan. The aim of this study was to explore the morphological characteristics of the TMJ in subjects with skeletal Class II Division 2 malocclusions. METHODS: The material consisted of corrected lateral tomograms of 94 joints in 47 subjects with Class II Division 2 malocclusions (age range, 8.3-42.8 years). The subjects were divided into 5 groups according to age. RESULTS: Intragroup comparisons showed statistically significant differences for condylar angle, condylar position, eminence height, eminence inclination, ramus height, and condylar-neck height. These differences were found mainly between the youngest and oldest groups. The Pearson correlation coefficient was greater than 0.60 for eminence height and eminence inclination, eminence height and ramus inclination, eminence inclination and ramus inclination, fossa posterior-eminence midpoint and fossa posterior-eminence top, and fossa posterior-eminence midpoint and fossa posterior-fossa roof. Condylar shape was most often round, followed by oval, flattened, and triangular; fossa shape was most often oval, followed by triangular, trapezoidal, and round. CONCLUSIONS: The results suggest that (1) fossa morphology and condylar length attain their final sizes early; (2) articular eminence and ramus morphology (height, inclination) have great variability; (3) some joint components such as eminence height with eminence inclination, eminence height with ramus inclination, eminence inclination with ramus inclination, and fossa anteroposterior dimensions are highly correlated with each other; and (4) the most prevalent condylar and fossa anteroposterior shape is oval.

Adolescent↗
PubMed2003

Dental malocclusion and upper airway obstruction, an otolaryngologist's perspective.

INTRODUCTION: This paper, through the presentation of eight case reports and a limited literature review, attempts to illustrate the negative effect that upper airway obstruction can have on developing dental occlusion and the positive effect that upper airway relief can have on the 'normalization' of various malocclusion patterns believed to be related to chronic obligate mouth breathing. OBJECTIVE: To study the effect of airway relief (usually through tonsillectomy and/or adenoidectomy) on various patterns of dental malocclusion. METHODS: Children coming to the office of the lead author (D.J.W.) found to be obligate mouth breathers and who also had dental malocclusion had Polaroid 'bite' pictures taken at the time of their initial visit. One year or more after their surgery for upper airway relief (tonsillectomy and adenoidectomy in these cases) a second 'bite' photograph was taken and compared to the first. RESULTS: In all cases selected in this study there was observed improvement in their dental occlusion within a year following surgery to improve their breathing. CONCLUSION: It is the opinion of the authors of this paper that upper airway obstruction may have a negative effect on the developing transitional dental occlusion and that eliminating the cause of upper airway obstruction can lead to 'normalization' of occlusion in such children. Further orthodontic corrective modalities may be required for optimal occlusal results.

Adenoidectomy↗
PubMed2000

Dental and facial skeletal characteristics and growth of males and females with class II, division 1 malocclusion between the ages of 10 and 14 (revisited)-part I: characteristics of size, form, and position.

The purpose of this study was to describe and analyze the craniofacial and dentofacial skeletal characteristics associated with Angle's Class II, Division 1 malocclusion. The material examined included 613 lateral head radiographs comprising 2 series: (1) 278 films of children with "normal" occlusion and (2) 335 films of children with Class II, Division 1 malocclusion. Each series was subdivided into 6 samples (3 female and 3 male; skeletal ages 10, 12, 14, [+/-6 months]), representing children with chronological ages ranging from 8.5 to 15.5 years. The radiographs were converted to computer-readable X and Y coordinate data and 52 linear, angular, and coordinate axis measurements were taken. Findings were visually verified by superimposing the computer-drawn composite plots of the Class II, Division 1 series over those of the normal series. In all 6 intergroup comparisons, it was found that: (1) the mandible and its dentition is similar to the controls in size, form, and position except for the position of the lower incisors in males; (2) the forehead (Gl), anteriorcranial base (Nas), maxilla (A) and dentition (molars and incisors) are protrusive (mesial positioned), with an increased frontal bone thickness at the level of the sinus, and a larger A-P maxilla, the palate of which is inclined superiorly at its anterior half; (3) no vertical dysplasia was evident; (4) the cranial base angle is larger, as are the anterior and posterior sections that compose it, but it is not related to mandibular position; (5) angular indexes of maxillary and mandibular position that included point Nasion are highly misleading indicators of maxillary and mandibular size and position. Visualized diagnosis via a composite norm based on age and sex might offer a more reliable alternative or supplement to the numeric reference standards now in use. Enlarged sinuses may contribute to the cause of Class II, Division 1 malocclusion.

Adolescent↗
PubMed1991

Nonextraction treatment of severe Class II, division 2 malocclusions. Part 2.

Nonextraction treatment of a severe Class II, Division 2 malocclusion is presented. Timing, sequencing of appliance therapy, and segmental arch treatment are discussed. The effects of orthodontic treatment, pubertal growth, and postpubertal growth are illustrated with different growth responses. Correction of the handicapping malocclusion was achieved by the development of arch circumference, torque, intrusion of incisors, and vertical buccal dentoalveolar development. Various subtypes of Class II, Division 2 malocclusion are presented. Pretreatment and posttreatment records are evaluated.

Cephalometry↗
PubMed1994

Mandibular skeletal and dental asymmetry in Class II subdivision malocclusions.

Mandibular symmetry was compared between a group of 28 subjects exhibiting Class II subdivision malocclusions and 30 subjects with Class I malocclusions who served as the control group. With submentovertex radiographs, symmetry was assessed by measuring the relative difference in spatial position of mandibular landmarks in both anteroposterior and transverse dimensions as determined by coordinate systems representing the cranial floor, mandible, and mandibular dentition. Only those variables representing the anteroposterior difference between right and left mandibular molar positions showed a statistically significant difference between the groups. Whether the position of the mandibular molars was measured relative to the cranial floor or within the mandible itself, the mandibular first molar was located more posteriorly on the Class II side of the subdivision malocclusion within a mandible that exhibited no other unusual asymmetry.

Adult↗
PubMed1995

Treatment of Class II malocclusions with the Jasper Jumper appliance--a preliminary report.

The effect of the Jasper Jumper appliance (American Orthodontics, Sheboygan, Wis.) on the dentofacial complex was studied in 17 consecutive growing patients who had Class II, Division 1 malocclusions. Lateral cephalograms taken before treatment and immediately after removal of the Jumpers were analyzed according to the method of Pancherz. The following results were found: (1) Class I occlusal relationships were achieved in all patients in an average treatment time of 6 months. (2) The correction of the Class II malocclusion was a result of skeletal (40%) and dental (60%) changes. (3) Skeletal Class II correction was predominantly restricted to the mandible. (4) The dentoalveolar part of total molar relationship correction took place to the same extent in both jaws, whereas in overjet correction the maxillary dental changes outweighed the mandibular changes by far. (5) When compared with normal growth changes (Bolton standards), treatment with Jasper Jumpers distalizes the upper dentition and moves the lower teeth mesially. Mandibular growth seems to be increased to some extent. It was concluded that treatment with the Jasper Jumper appliance presents an effective method to correct Class II malocclusion in growing patients.

Activator Appliances↗