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The traumatic anterior overbite.

The position of the anterior teeth and skeletal base relationship establish many of our facial characteristics, yet these same tooth positions can result in a range of dental problems that are often specific for a particular incisal relationship. Excessive loss of tooth tissue on various surfaces may result in trauma to the soft tissue and temporomandibular joint dysfunction. A range of treatment options may be required and can often be conveniently classified by the form of incisal relationship.

Crowns↗

Dentoalveolar compensation in subjects with vertical skeletal dysplasia.

INTRODUCTION: The purpose of this cephalometric study was to investigate vertical dentoalveolar compensation in untreated adults with excessive (long-face) and deficient (short-face) lower anterior face heights. METHODS: Vertical and sagittal base relationships, vertical dentoalveolar dimension in the anterior region of the jaws, incisor inclination, overbite, and overjet were assessed in 112 short-face and 95 long-face subjects. The contribution of skeletal and dentoalveolar components to achieve a normal overbite was assessed by means of regression analysis. For the 2 most important independent variables of the regression equation, the values were calculated that would render an overbite of 2 mm. It was subsequently investigated whether the calculated value fell within the range of the sample. RESULTS: In long-face subjects, overbite was mainly related to lower anterior face height; in short-face subjects, it was mainly related to mandibular anterior alveolar and basal heights. Dentoalveolar compensation occurred in both groups mainly by adaptations in mandibular incisor alveolar and basal heights. Molar height was unrelated to overbite. Cutoff values for achieving a positive overbite were calculated for lower face height and mandibular incisor alveolar and basal heights. CONCLUSIONS: The lower face height mainly determines the overbite in long-face subjects, while in short-face subjects, lower dentoalveolar morphology influences overbite. Lower dentoalveolar compensation can maintain a normal overbite in long-face subjects to a limited extent.

Adaptation, Physiological↗

Orthodontic treatment of openbite and deepbite high-angle malocclusions.

The aim of the investigation was to assess the effect of orthodontic treatment on dentoskeletal morphology in children with openbite and deepbite high-angle malocclusion. Subjects (n = 54) in the mixed dentition with a hyperdivergent mandibular plane angle (high-angle, NSL/ML > or =40 degrees) were surveyed. Pre- and posttreatment lateral roentgenographic cephalograms were analyzed. Subjects were divided into three subgroups according to the amount of pretreatment overbite: < 0 mm = insufficient/no compensation (openbite); 0-4 mm = acceptable compensation (normal overbite); >4 mm = overcompensation (deepbite). Pretreatment, 20% of the high-angle cases exhibited insufficient dentoskeletal compensation (overbite <0 mm), and 35% displayed overcompensation (overbite >4 mm). Influences of habits such as lip sucking and tongue-thrust swallowing were more common in the openbite group. No major difference in treatment approach could be found between subgroups. In 82% of the openbite group and 90% of the deepbite group, overbite was corrected by orthodontic treatment. The mandibular plane angle was unaffected in both groups. The mechanisms of overbite correction differed between groups. The openbite group exhibited a significant decrease in interjaw-base angle. Increases in anterior and posterior dentoalveolar heights were comparable. The deepbite group showed no significant changes in skeletal morphology. The increase in dentoalveolar height was approximately twice as large posteriorly as anteriorly. The majority of children (80%) with high-angle morphology had a positive pretreatment overbite, thus exhibiting compensation of jaw-base hyperdivergency. Orthodontic treatment of high-angle malocclusions did not influence the mandibular plane angle in openbite or deepbite cases. Overbite correction was accomplished by tipping the maxilla downward anteriorly in openbite subjects, and by controlling incisor eruption in deepbite subjects.

Cephalometry↗

Changes in alveolar morphology during open bite treatment and prediction of treatment result.

It has been postulated that dentoalveolar height is enlarged by a compensation mechanism in long face subjects. In this study, dentoalveolar composition was studied in 83 open bite patients. It was found that increases in overbite during treatment coincided with vertical lengthening of the symphysis, which exceeded increments in lower face height. This vertical growth coincided mainly with an increase in the area of the symphysis. Furthermore, a retrusion of the maxillary incisors enhanced bite deepening. Stability of the overbite during the retention period was studied in a subset of 22 patients. It was found that retrusion of the maxillary incisors during treatment led to a more stable overbite during the retention period. Vertical lengthening of the symphysis relative to the increase in lower face height seemed to enhance bite opening during retention. Prediction of the overbite may be reliable, if a re-evaluation of the patients takes place during active treatment. The angle NTGoGn had a substantial predictive value (multiple R = 0.46) for post-treatment overbite. It is concluded that in open bite patients, a dentoalveolar compensation mechanism results in a stable overbite at the end of treatment by enlarging symphysial height through a moderate increase in symphysial volume. In addition, retrusion of the maxillary incisors contributes to overbite reduction. However, an excessive increase in vertical height of the symphysis relative to lower face height may relapse after active treatment. For prediction of the post-treatment overbite, the angle NTGoGn may be used, although a re-evaluation during treatment is recommended.

Adolescent↗

[APDI and ODI estimated from substitute palate plane].

PURPOSE: The substitute palate plane was defined at the cephalometrics of noncleft patients. APDI and ODI were estimated from substitute PP. It is expected that the APDI and ODI estimated from PP (APDI',ODI')can be extended to the cleft patients to illustrate the anteroposterior and vertical relationship between maxilla and mandible. METHODS: The cephalometrics of 30 patients of C-I,C-II and C-III were traced and so were in 30 patients of normal overbite,deep overbite and open bite. The substitute palate plane(PP') was defined. The inclination of the PP to the FH, APDI and ODI, the inclination of the substitute PP to the FH,APDI' and ODI' were measured. The APDI and APDI' of C-I, C-II and C-III patients were compared,The ODI and ODI' of normal overbite, deep overbite and open bite patients were also compared by group t test. RESULTS: There was no significant difference between APDI and APDI' in C-I, C-II and C-III patients and also no significant difference between ODI and ODI' in normal overbite,deep overbite and open bite patients. It is showed the higher the ODI',the deeper the overbite. And the higher the APDI', the more mesial the molar relationship. CONCLUSIONS: The APDI and ODI estimated from substitute PP can be used as an important criterion to judge the vertical and anteroposterior development of the the maxilla, especially in palate clefts patients.

Adolescent↗

Anterior tooth relations in Kenyan Africans.

Dental plaster casts of 235 Maasai, 116 Kikuyu and 61 Kalenjin children aged 3-16 yr were studied to determine the incidence and magnitude of diastemas, overbite, overjet and anterior open bite. The highest prevalence of diastema was amongst the Maasai (61.3%), of overbite (84%) and overjet (99%) amongst the Kikuyu, and of anterior open bite amongst Kalenjin (24%), with values greater than 0.4 mm up to 11.5 mm. Comparison of the mean values showed that diastema (1.77 mm) and overjet (4.4 mm) were greatest in Maasai, overbite (3.53 mm) in Kalenjin, and anterior open bite (3.50 mm) in Kikuyu. In the total sample, the prevalence and mean of diastema were 49%, 1.68 mm; of overbite 77.4%, 2.96 mm; of overjet 88.6%, 3.83 mm; and of anterior open bite 16.5%, 2.69 mm (with values between 0.4-11.5 mm), while 5.5% had an edge-to-edge bite (-0.5-0.5 mm). The prevalence of diastema decreased whilst its magnitude increased with age. The mean values of overbite and overjet increased, while those for anterior open bite decreased with age. The mean values of diastema, overbite and overjet were greater amongst the females, but the difference was significant only for overjet. The high prevalence and greater values of measurements of anterior tooth relations may be related to variable growth of the bimaxillary dentoalveolar complex and soft tissue influences. This may be important in orthodontic treatment planning, dental prostheses and other clinical dental treatments in Kenyan populations.

Adolescent↗

Stability of anterior openbite treated with crib therapy.

The records of 33 openbite patients treated with cribs were collected. The sample was divided into two groups with group one comprised of 26 growing patients and group two comprised of seven nongrowing patients. There was a significant increase in overbite for both groups during treatment. The nongrowing group also showed a significant increase in overbite during the posttreatment period. During the posttreatment time interval 17.4 percent of the growing sample and zero percent of the nongrowing sample exhibited relapse. However, all patients who achieved a positive overbite during treatment maintained a positive overbite posttreatment. These findings suggest that patients who achieve a positive overbite with crib therapy have a good chance of maintaining this correction after orthodontic treatment is completed. This statement appears to be true for both growing and nongrowing patients. The reason for this increased stability may be due to a modification of tongue position or posture.

Adolescent↗

A new method of evaluating posterior occlusion and its relation to posttreatment occlusal changes.

The purpose of this study was to assess the relationship between posterior occlusion and posttreatment changes in other occlusal variables. Pretreatment (T1), posttreatment (T2), and postretention (T3) records were obtained for 49 Class I (n = 23) and Class II (n = 26) extraction cases. Overbite, overjet, mandibular incisor irregularity, right and left molar deviations, midline deviation, and mandibular arch length were measured, and occlusal registrations were made of each set of dental casts. The proximity of posterior occlusal surfaces was measured as the contact or near-contact areas at or below 300 microm thickness, based on the optical densities of scanned images of the posterior occlusal registrations. The treatment changes for overbite, overjet, right and left molar deviation, and arch length were significantly greater in the Class II group, and the reductions in incisor irregularity were greater in the Class I group. No other class differences were found. Overbite, overjet, and incisor irregularity increased after treatment, and arch length continued to decrease, with no significant class differences. Contact and near-contact areas at or below 300 microm constituted 7% of the functional occlusal table for both classes at the end of treatment, having decreased significantly in both groups (21% in Class I and 29% in Class II) during treatment. Because contact and near-contact areas increased in some patients and decreased in others, there were no significant posttreatment changes. Negative correlations were found between contact and near-contact areas at T2 and changes in overjet from T2 to T3, and between contact and near-contact areas at T3 and changes in overbite from T2 to T3. No relationships were found between posterior contact and near-contact area and incisor irregularity. We concluded that (1) the area of actual and near contacts at or below 300 microm decreased significantly with treatment, indicating that, despite excellent treatment results by conventional standards, the proximity of posterior occlusal surfaces lessened; (2) the proximity of the posterior occlusal surfaces should not be expected to increase posttreatment; (3) posttreatment contact and near-contact areas may be factors in overbite and overjet stability; and (4) posttreatment contact and near-contact areas are not related to incisor irregularity.

Adolescent↗

Anterior open bite in the deciduous dentition: longitudinal follow-up and craniofacial growth considerations.

The aim of this longitudinal cephalometric study was to evaluate craniofacial growth changes in subjects with an anterior open bite in the deciduous dentition. From longitudinal records of untreated subjects, an open bite group (n = 14) was selected at the age of 5 years based on the presence of a negative overbite and compared with a control group (n = 14) with a regular overbite at this age. Cephalometric measurements were analyzed at ages 5, 9, and 12 years. Although only 1 subject in the deciduous dentition open bite group had an open bite at 12 years of age, the overbite remained lower during the longitudinal follow-up. Early cephalometric characteristics of the open bite group included a reduced overbite depth indicator and a lower ANB angle. At ages 9 and 12 years, the open bite sample was also characterized by shorter ramus height. An underlying skeletal pattern seems to be present in the deciduous dentition open bite sample that persists during the longitudinal follow-up. The overbite depth indicator might help to identify patients with anterior open bite tendencies.

Case-Control Studies↗

The effect of retention on the relapse of Class II Division 1 cases.

Sixty cases of Class II Division 1 malocclusion were studied; 30 of them had been retained after the completion of orthodontic treatment, the other 30 had not and acted as a control group. Using measurements from lateral skull radiographs and statistical analysis, the two groups were compared in respect of skeletal pattern, soft tissue, overjet, overbite and interincisal angle. Both the retained and the non-retained group showed a tendency to relapse after the completion of active treatment; a tendency to relapse even while in retention was observed. The relapse in overjet was found to be more significant than the relapse in overbite. In both groups the relapse in overjet was found to be associated with the size of the original overjet, the overbite at the end of active treatment and the interincisal angle at the end of active treatment. In both groups the relapse in overbite was found to be associated with the size of the original overbite, the change in maxillary-mandibular planes angle and the interincisal angle at the end of active treatment.

Adolescent↗

Relationship between overbite/overjet and clicking or crepitus of the temporomandibular joint.

AIMS: Since occlusal variables such as overbite and overjet have been thought to be associated with temporomandibular disorders (TMD), and joint sounds are some of the most prevalent signs of TMD, the aim of this study was to determine whether overbite and overjet are risk factors for temporomandibular joint (TMJ) sounds. METHODS: A population-based cross-sectional study of 3,033 subjects (age range, 10 to 75 years; 53% female) was conducted in Germany. Overbite/overjet, reproducible reciprocal clicking (RRC) during open-close jaw movements that did not occur in the protrusive jaw position, and joint crepitus were assessed according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). RESULTS: When age and gender were controlled for, high or low values of overbite and overjet were not associated with a greater risk of RRC and crepitus as compared to a reference category of a normal overbite and overjet of 2 to 3 mm (multiple logistic regression; odds ratios 0.7 to 1.3; P > .05 for all). CONCLUSION: This study showed that higher or lower overbite or overjet jaw relationships, even extreme values, are not risk factors for TMJ sounds as assessed by clinical examination.

Adolescent↗

[Longitudinal observation of condylar position in anterior crossbite at the mixed dentition during orthodontic treatment].

We investigated the condylar position by transcranial radiography which can be put daily clinical use easily. The patients are 8 anterior crossbite at the mixed dentition (4 functional crossbite and 4 skeletal crossbite). We observed their condylar positions before treatment (average age is 9.3 years old), after correction of overbite (average age is 10.0 years old) and 3-4 years after correction of overbite (average age is 14.0 years old). The results were as follows: 1. Condylar position of 7 cases changed after correction of overbite. The differences between right and left condylar position of six in seven cases had been recognized before treatment decreased after correction of overbite. Their condylar position were stable during the observation period of 3-4 years after correction of overbite. The condylar position of the other one case closed to fossa and then relapsed 3-4 years later. 2. Condylar position of only one case hasn't changed during the observation. 3. In functional crossbite cases, there were some differences between right and left condylar position before treatment, but no differences after crossbite correction. In skeletal crossbite cases, there was no tendency of the changing on their condylar position through treatment. 4. The changing to same direction was observed in the decrease of differences on condylar position and in the result of frontal cephalogram analysis. 5. There wasn't special relationship between changing of condylar position and orthodontic appliances. 6. TMJ dysfunction was observed in the case which has significant difference in its condylar positions before treatment and in the other case in which difference was not corrected after treatment. We recognized the usefulness of transcranial radiography for orthodontic treatment.

Child↗