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PubMed1978

Variation in dental occlusion and arches among Melanesians of Bougainville Island, Papua New Guinea. II. Clinical variation, geographic microdifferentiation and synthesis.

Patterns of geographic microdifferentiation for dental occlusion and the size and shape of the dental arches are described for 14 villages on Bougainville Island, Papua New Guinea. Occlusal variables, such as overjet, overbite, molar relationships, crowding or spacing, and malalignment vary less among villages than do arch length and width. Arch length and width decrease in size from north to south. The pattern of biological distance among villages for occlusal variables and arch size correspond poorly to anthropometric, linguistic, geographic and migrational distances. The value of occlusal variables and arch size for discriminating among populations, the biological interpretation of multivariate data and the objectives of research on geographic microdifferentiation are discussed.

Black People↗
PubMed1987

Longitudinal study of craniofacial growth in Macaca fascicularis.

This paper is an analysis of normal craniofacial growth in adolescent crab-eating macaques (Macaca fascicularis). Eight female adolescent monkeys were used in this study. Their individual craniofacial growth was studied for a 24-month period utilizing tantalum implants and roentgenographic cephalograms. Throughout the observation period, each monkey consistently showed a class I molar relationship with a good overjet and overbite. The amount of anterior displacement of the maxilla and the mandible was significantly dominant compared to the vertical displacements at every observation period. The midface exhibited a maxillary differential growth pattern in which the premaxilla displaced superiorly and the posterior maxilla moved inferiorly, resulting in a counterclockwise rotation of the entire maxilla. Growth of the lower anterior teeth and alveolar bone compensated for the incremental vertical spaces which were induced by superior displacement of the premaxilla and inferior repositioning of the chin. In addition, the amount of anterior displacement of the upper and lower anterior teeth were significantly larger than that of the premaxilla and the chin. The dentocraniofacial growth pattern in Macaca fascicularis was quite similar to that seen in Macaca mulatta.

Aging↗
PubMed1999

The tooth-width relation of the incisors in closed bite.

On the basis of various opinions expressed in the literature, "closed bite" is associated in particular with an impaired front-tooth relation. Applying Tonn's index, evaluation of the records (models and cephalograms) of 1,100 patients, however, yielded no evidence of changes in the width ratio of the front teeth with regard to Angle classes, growth type, axial inclination of the central upper incisors, interincisal angle, or overbite.

Cephalometry↗
PubMed1999

Retrospective evaluation of the outcome of orthodontic treatment in adults.

The aim of this study was the retrospective evaluation of the outcome of orthodontic treatment in consecutively treated adult patients. Of 147 adult patients, it was possible to evaluate the records of 88 patients (57 female, 31 male) before (T1) and after treatment (T2), and of 20 of these patients 3.3 years on average after completion of the retention phase (T3). During treatment planning, a nearly "ideal" result was considered attainable (ideal group) for 46 patients, and a "compromise" result (compromise group) was seen as realistic for 42. The assessment was made using the PAR (Peer Assessment Rating) index and the Aesthetic Component (AC) and Dental Health Components (DHC) of the IOTN (Index of Orthodontic Treatment Need). Average length of treatment in the ideal group was 2.4 years, i.e. nearly twice as long as in the compromise group. The PAR score was reduced by an average of 56% (T2); the reduction in the ideal group was 73%, and in the compromise group 37%. Among the 20 patients for whom at least 6 months had elapsed since completion of the retention phase, a statistically significant relapse between T2 and T3 was observed. The evaluation of overjet and overbite and, in the ideal group, of the midline and maxillary front teeth were primarily responsible for the worsening of the PAR scores between T2 and T3. According to the AC, 53 patients (60%) had moderate to definite treatment needs at the beginning of treatment. Following completion of active treatment, 69 patients (78%) no longer demonstrated treatment indications for aesthetic or psychosocial reasons. Based on the DHC, 88% of the patients were in definite or moderate need of treatment (T1); in contrast, treatment was no longer indicated in 84% at T2. In general, a marked improvement of the examined morphological parameters was observed.

Adult↗
PubMed1998

Class II correction with magnets and superelastic coils followed by straight-wire mechanotherapy. Occlusal changes during and after dental therapy.

The investigation comprised 18 consecutively selected patients, mean age 14.7 years at the start of treatment, with Class II malocclusion, deep overbite and space deficiency in the maxillary arch. The first phase of the treatment consisted of 6 months simultaneous distal movement of maxillary first and second molars with repelling samarium-cobalt magnets on one side and a superelastic nickel-titanium coil on the contralateral side together with an anterior biteplane to achieve bite opening. For the second phase of the treatment, a straight-wire appliance was used for an average treatment time of 1.3 years. Lateral head radiographs and dental casts were available at the start of treatment, after molar distalisation, at the end of treatment and 1 year post-treatment. The treatment resulted mainly in dental changes. The dental Class II molar relation was corrected to Class I by bodily distal movement of maxillary molars and by mesial movement of the mandibular molars. The correction of molar relation was significantly greater on coil sides than on magnet sides, mean 3.4 mm, and 3.0 mm, respectively. Despite anchorage loss associated with the maxillary molar movement, i.e. mesial movement of the maxillary incisors (mean 1.8 mm), the net overjet was reduced, mean 2.5 mm, by the use of Class II elastics. The average net improvement of bite opening was 2.6 mm, mainly due to extrusion of mandibular and maxillary molars. During the 1-year post-treatment period no significant dental or skeletal changes were found. The long-term implications of the treatment results need further consideration.

Adolescent↗
PubMed1999

Extraction therapy in patients with Class II/2 malocclusion.

The aim of this study was to analyze the dynamic development of Class II, Division 2 malocclusion with reference to the untreated patients from the Belfast Growth Study. As a second step, the influences of premolar extraction in all 4 quadrants and of maxillary second molar extraction in the upper jaw in Class II/2 patients were examined, focusing on the cephalometric variables in comparison to those of the untreated patients from the Belfast study. The longitudinal cephalometric values of 20 patients in each group were compared. In addition, the possibility of third molar eruption was evaluated in the extraction patients from the panoramic radiographs. The overbite based on study models at the beginning and end of treatment was calculated. Furthermore, renewed spacing after premolar extraction was assessed. The results derived from cephalometric analysis demonstrated that profile flattening was also observed in untreated Class II/2 patients during the growth period. Comparison of these data with those obtained from the extraction groups revealed a significantly marked recession of the upper lip after premolar extraction. In contrast, only slightly increased flattening after maxillary second molar extraction was observed compared with the untreated patients of the control group. Whereas the interincisal angle was reduced to a value approximating that of untreated Class I patients after maxillary second molar extraction, only a small decrease was recorded after premolar extraction. From our point of view, the claim that premolar extraction facilitates third molar eruption should be seen in an extremely critical light and should not contribute to the decision in favor of extraction. In addition, there is a problem of renewed spacing in the extraction area after premolar extraction.

Adolescent↗
PubMed1998

Articulation in children with Down's syndrome. A pilot study.

The articulation of children with Down's syndrome (trisomie 21, T21) in comparison to a group of age-matched normal probands was investigated in a clinical study, using digital sonagraphics (recording of frequency, amplitude and time of the speech signal), with peripheral factors taken into consideration. The T21-Group (n = 10) revealed a higher variability as well as a longer articulation of the test word "Tasse" than the Control Group (n = 10). There was no clear-cut dependence of speed and quality of articulation on all of the peripheral factors evaluated (Angle Class, overbite, oral motor ability, hearing disorder, logopedics, Castillo-Morales stimulating plate treatment). The results of our investigation show differing patterns of articulation in T21 children compared with normal probands, using a reproducible method. A clear-cut influence of various influencing peripheral factors as reported in the literature could not be found for the T21-Group. Thus, central factors seem to have a great impact on articulation in T21 patients.

Articulation Disorders↗
PubMed1998

Computer-aided axiography of asymptomatic individuals with Class II/2.

UNLABELLED: The condylar axiographic tracings of 23 asymptomatic adult volunteers (Helkimo-index DiO) with Class II/2 axiography relationships were compared to tracings of an analogous group (DiO; n = 30) with normal occlusion. The obtained measurements were evaluated statistically and discussed with respect to possible recording errors. RESULTS: The open-close movement proceeded uncharacteristically, differences existed only in protrusion, mediotrusion and their combined rotation component. In Class II/2 cases an approximately 7 degrees higher angle of the condylar path inclination (CPI) was measured. The Class II/2 group rotated to a significantly higher angle in protrusive and mediotrusive movements and showed longer condylar path lengths than the control group. Another significant difference was found in the location of maximum CPI values and maximum rotation angles within the condylar path, because in no case was isolated rotation or translation of the hinge axis observed. CONCLUSION: The temporomandibular joint of Class II/2 individuals shows a wider range of motion than joints of subjects with normal occlusion. The reduced capacity of motion which was assumed to exist in a so-called hack-bite could not be backed up for Class II/2 deep bite cases. The investigated differences cannot be seen as pathomechanisms, because all participants were clinically free of dysfunction. The neuromuscular engram to overcome the overbite controls a complex spatial motion pattern which cannot be described by a simplified mechanical abstraction of motion in the sagittal plane. The temporomandibular joint with its complex pattern of movement is able to create physiological mechanisms of compensation to react to different dental and skeletal features.

Adult↗
PubMed1990

[The early treatment of progenia in the deciduous dentition compared to treatment in the mixed dentition].

The aim of this research was to examine the effect of the chin cap on mandibular prognathism (Angle class III) with or without a Fränkel appliance. 30 class III patients were examined. Head plates and casts made before and after active treatment were evaluated. The patients were divided into group I (initial X-ray incisivi decidui ID) and group II (initial X-ray incisivi permanentes IP). Group I (ID) showed a stronger skeletal response. Group II (IP) already showed more severe prognathic values in the initial X-rays. In group I (ID) a decrease of the gonial angle, SNB- and SNPog angle as well as an increase of both the ANB- and articulare angle were observed, however not in group II (IP) or at least not to the same extend. Overbite and overjet values reached the ideal values. In both groups dental compensation was observed.

Activator Appliances↗
PubMed1992

[Intrusion of the anterior teeth with the segmented-arch technic of Burstone--a clinical study].

The purpose of this study was to examine the efficiency of intrusion mechanics as described by Burstone. Thirty-one cases of deep bite with an overbite equal to or more than 4 mm were analysed by means of cast models, lateral cephalometric views and dental films of the front teeth prior to and after intrusion. The following parameters were considered: 1. Extent of the intrusion relative to a selective point of force application, 2. duration of the intrusion, and 3. amount of root resorption. The average extent of the intrusion in the case of the upper front teeth was 2.3 mm, and in the case of the mandible 3 mm. The rate of intrusion per month was 0.53 mm in the maxilla, and 0.54 mm in the mandible. Analysis of the point of force application showed that the centre of resistance must be presumed to be more distal than previously assumed. For an average treatment time of 4.3 months in the maxilla, and 5.5 months in the mandible, the apical root resorption was minimized by applying dosed force using a calculable force system. A buccal root torque arch employed in three cases permitted, in class II/1 cases, a combined movement comprising lingual tipping of the crown and intrusion, the intrusion component being clearly delayed in comparison with tipping. The segmented arch technique allows an objective intrusion of anterior teeth. This depends on choosing the appropriate point of force attachment and the correct amount of force.

Adolescent↗
PubMed1990

[Experiences with Burstone's segmented arch technic in the adult dentition].

In comparison to the straight wire technique the segmental arch approach offers numerous biomechanical and clinical advantages. Three typical examples: controlled tooth movement, en masse space closure and deep overbite correction serve to show the spectrum and the efficiency of the segmented arch technique.

Adult↗
PubMed1991

[The accuracy of soft tissue profile prediction with the "Dentofacial Planner" in skeletal prognathism].

30 pre- and postoperative lateral cephalograms of patients with mandibular prognathism are used to evaluate the soft tissue profile prognosis given by the "dentofacial planner". As a result, the horizontal displacement of SLS (sulcus labrale superius) and Pg' (soft tissue pogion) in patients with a normal vertical dimension and additional LMF (labiomental fold) in persons with a marked overbite are calculated well. The horizontal changes of the other points analyzed as well as all vertical changes are not predicted satisfactorily in the momentary version 4.22 A (febr. 1989), which will be improved by the company.

Adolescent↗
PubMed1993

[The interrelationships between dental parameters and electronic axiographic findings. A study on subjects with nonphysiological incisor relations].

The purpose of the present study was to discern possible relationships between dental parameters and the horizontal inclination of the condyle path. Two test groups of orthodontically untreated individuals with non-physiological incisor relationships, one group with enlarged and the other with reverse overjet, were selected for the study. An opto-electronic apparatus was employed to measure the horizontal inclination of the condyle path. The dental parameters were set by clinical examination and by measuring plaster casts. Both groups exhibited significant distribution deviations in the inclination of the condyle path and in the following parameters: "occlusal contacts of the front teeth during protrusion", "overbite", "resulting overjet", and "sagittal and vertical distance of the incisal edge of the lower incisors to the zero point of the upper incisors". Statistically no correlation between the dental parameters and the inclination of the condyle path was discerned. The influence of muscular guidance is in large measure the determining factor for the large variations in the TMJ registrations, and especially in their quantitative evaluation. The results were the same even when tracings were repeated a number of times with the same patient.

Adult↗
PubMed1989

[The Tübingen implant within the scope of adult orthodontic treatment].

Prior to the replacement of a missing tooth with an implant the adult dentition, orthodontic treatment can be carried out to widen the space mesio-distally, correct the axial inclination of the neighbouring teeth and safeguard the anterior overbite. Implantation is not possible if, as a result of orthodontic treatment the gap cannot be widened to a minimum of at least 6 mm, if the alveolar bone is not thick enough in the vertical dimension or if the implant does not have sufficient space in the oro-vestibular direction.

Adolescent↗
PubMed1996

Indications for compensatory extractions in orthodontic space closure in the frontal segments.

This follow-up study presents patients who underwent orthodontic space closure in the maxilla after traumatic loss of frontal teeth or aplasia of a lateral incisor. Comparison covers findings obtained from casts and cephalograms in 24 patients with or without compensatory extraction. The findings indicate that acceptable results regarding axial tooth positioning and profile can be obtained without compensatory extraction. Prerequisites are distal occlusion of the first molars by one premolar width and continuous monitoring for regular overbite and uncrowded lower incisors. If orthodontic space closure can be achieved only by compensatory extraction, the indication for this space closure procedure calls for even more critical judgement.

Bicuspid↗
PubMed1996

Improving dentofacial esthetics while paying attention to the anterior facial height index.

Prior to the pubertal growth spurt, a 12-year-old boy with a long face pattern, upper prognathia and class II,2 relationship was treated with a combination of edgewise appliance, statically determined intrusion base arch and Jasper Jumper. The clinical results show that, with the mechanotherapy presented here, good smile esthetics and normal class I occlusion were achieved. Furthermore, the cephalometric results reveal that, by using an appliance which leaves the extrusive effect on the molars small, the anterior facial height index can be kept constant even during the patient's growth phase, although contrary treatment goals such as incisor intrusion and occlusal correction must be met. Simultaneously, it could be demonstrated that Jasper Jumper treatment may not automatically lead to incisor flaring by individualizing the point of force application. In addition, reducing the deep overbite may prevent its destructive tendency, and the patient's growth pattern can be directed in a more horizontal direction.

Activator Appliances↗
PubMed1992

[The linkage between breast feeding and the growth of the orofacial area].

A link between the way of feeding on the one hand, and the Angle class findings, the spacing of deciduous incisors, malocclusion-normal occlusion and overjet and overbite on the other hand, has been examined on 272 children aged three years +/- two months who have been divided into two groups according to the way they were fed in the post-natal period (one group was not breast-fed and the other was breast-fed for the first six months). A chi 2-test has confirmed a statistically significant link between the variables such as the way of feeding in the post-natal period and malocclusion-normal occlusion, Angle class and overjet.

Breast Feeding↗
PubMed1997

Influence of facial growth pattern on outcome of extraction therapy.

The present clinical-radiological study analyzes orthodontic casts and lateral cephalometric X-rays (at start and finish of orthodontic treatment) of 56 extraction cases, most of them adolescent patients who had 4 teeth extracted. The test group was classified into 3 morphological categories according to growth patterns. For comparison purposes, cephalometric findings of morphologically matching non-extraction groups as well as corresponding data from the literature were used. There was no deepening of overbite in any of the extraction cases in the different test groups. However, an average bite opening of 1.2 mm was found in patients with a neutral or horizontal growth pattern. Irrespective of the growth pattern, a significant increase in anterior and posterior facial height as well as a mean reduction of the ANB angle between 0.9 degrees and 1.3 degrees was found in the different extraction groups. These results matched those of the corresponding nonextraction control groups. At the end of treatment, the longitudinal axis of the upper incisors appeared too steep (retruded). Overall, the individual growth pattern was found to be of very little relevance to treatment results, provided a well considered treatment plan had been drawn up.

Adolescent↗