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PubMed1986

Tissue reaction following application of extrusive and intrusive forces to teeth in adult monkeys.

Intrusion has been regarded as a very controversial topic in the orthodontic literature. Although it seems a logical way to handle deep overbite in adult patients who have elongated teeth, reports on iatrogenic damage have led to the suggestion of alternative methods. Considering the disadvantages of these alternatives, it seems reasonable, however, to improve our knowledge of tissue reaction as related to intrusion. Three Macaca fascicularis monkeys were used for the experiment. By means of a segmented arch approach, the upper incisors and the four first premolars were submitted to forced eruption for 8 weeks followed by 12 weeks of intrusion. A split-mouth technique was used to study the influence of oral hygiene on the tissue reaction. On the right side of the mouth, the teeth were brushed with chlorhexidine three times per week. On the left side, no oral hygiene was performed. After intrusion of the teeth, a 1-to-14 day retention period with passive appliance preceded the killing of the monkeys. A buccolingual hematoxylin- and eosin-stained serial section was produced, and soft- and hard-tissue reactions described. It appeared that the hygiene program could limit but not prevent gingival inflammation. There was, however, a marked difference in the histologic picture of the marginal bone on the two sides. On the hygiene side, clear signs of bone deposited during forced eruption were still present. This was not the case on the nonhygiene side. The extension of bone resorption was also different on the two sides.(ABSTRACT TRUNCATED AT 250 WORDS)

Alveolar Process↗
PubMed1986

Light-wire treatment of a Class II, division 1 subdivision malocclusion. An American Board of Orthodontics case report.

A case report of a Class II, Division 1 subdivision malocclusion with a deep overbite and a marked overjet is presented. The patient was a 14-year-old boy with the potential for continued growth. The lip positions imposed by the teeth and the facial skeleton increased the labioversion of the maxillary incisors. A Begg light-wire appliance was used throughout the course of treatment. Since the maxilla and mandible were retrognathic to the cranial base, the malocclusion was treated by nonextraction methods.

Adolescent↗
PubMed1989

Various methods in achieving anterior guidance.

The anterior teeth are essential for esthetics, phoentics, and mastication and are equally involved in protecting posterior teeth. A 10-year longitudinal study of treatment modalities was conducted for overbite-overjet occlusal relationships. Comprehensive treatment combining orthodontics, occlusal adjustment, and selective restorations minimized the need for extensive restorative dentistry. The treatment of selected patients with a 10-year postoperative evaluation was discussed.

Adolescent↗
PubMed1992

Tooth contacts in eccentric mandibular positions and facial morphology.

Correlations between facial morphology and tooth contacts in excursive mandibular positions were studied in 75 men aged 20 to 33 years. The morphology of the dentition was verified on dental casts and the face was measured by use of roentgen cephalometry. No correlation was observed between facial morphology and the number of tooth contacts in the retruded position; however, wide dental arches and jaws displayed many contacts on protrusion. Numerous contacts on the functional side in group function were noted in individuals with a facial morphology associated with distal occlusion, such as Angle class II, division 1. Wide dental arches were associated with multiple functional-side contacts whereas tooth contacts on the nonfunctional side were related to the inclination of the mandible. A "long-face" morphology was related to contacts on the nonfunctional side. There was a negative correlation between the extent of the overbite (vertical overlap) and the number of tooth contacts on the nonfunctional side.

Adult↗
PubMed1975

Oral considerations of the myofascial pain dysfunction syndrome.

The oral health of twenth-two patients with a diagnosis of myofascial pain dysfunction syndrome was evaluated. Radiographs, photographs, study casts, visual and digital clinical examinations, hematologic data, blood pressure, and periodontal examinations were used with each patient. A review of the literature indicated a variety of causes for facial pain, including Costen's syndrome, muscle fatique and spasm, occlusion, and psychogenic factors. This study revealed the following trends: (1) The periodontal health of patients with the myofascial pain dysfunction syndrome appears to be better than anticipated. (2) Bruxism accounts for a healthy dental apparatus when other diseases are not present. (3) Groups of muscles, other than the masticatory group, may contribute to the myofascial pain dysfunction syndrome. (4) Patients presented with various ranges of malocclusions and normal occlusions, deep overbites and overjets, complete dentitions, and missing teeth (either equally missing right and left or unequally missing right and left). This article also discusses clinical considerations in the diagnosis of the myofascial pain dysfunction syndrome and offers a practical, physiologic approach to treatment. We conclude that how one uses his mandible is more of a causative factor than the relationships of the teeth.

Adolescent↗
PubMed1989

A study of the utility of measuring mandibular mobility by means of the interincisal dimension.

The purpose of this investigation was to determine the reliability of using the interincisal dimension as a measure of mandibular range of motion. Thirty patients who underwent mandibular advancement and 15 patients who underwent mandibular setback were included in this study. Preoperatively, a lateral cephalogram in centric relation and a second cephalogram with the mandible at maximum voluntary gape were obtained. Immediately following surgery, another centric relation cephalogram was obtained. A composite tracing of the two preoperative tracings was made to show how the mandible changed in position from the closed-mouth to the open-mouth radiographs. The proximal segment (ramus) of the postoperative cephalogram was then superimposed on the open-mouth mandibular ramus, and the distal segment of the postoperative mandible was drawn. This composite produced a tracing of what the postoperative maximal gape cephalogram would be if the same amount of condylar rotation and translation as in the preoperative tracing had occurred. The preoperative interincisal dimension was recorded on the composite tracings (factoring in any overbite or openbite) as was the would-be postoperative interincisal dimension. These measures were compared using the paired t test and Pearson's correlations to determine if there were any significant differences between them. The results showed that the interincisal dimension is a fairly reliable measure of mandibular mobility even when the length of the mandible is altered with surgery.

Cephalometry↗
PubMed1991

Comparative study of the treatment of mandibular fractures with vestibular and lingual wire splints.

One hundred forty-two patients with mandibular fractures were studied during the 3-year period of 1988 to 1990. One hundred ten patients treated with lingual arch wires comprised the study group and 32 treated with routine labia/buccal arch wires formed the control group. Bone healing was analyzed with clinical and sonic methods in both groups. It was estimated that the clinical and sonic evidence of the mandibular body fragments union appeared earlier and the infection rate was lower in the study group than in the control group. It was concluded that lingual wire splints are preferable for treating fractures of mandibular body, alveolar ridge, and in patients with deep overbite.

Adolescent↗
PubMed1987

Relationship of mandibular condylar position to dental occlusion factors in an asymptomatic population.

This article investigates the influence of occlusion on condylar position as seen on TMJ tomograms in a group of 44 young adults with no histories of orthodontic or occlusal therapy and no objective signs of masticatory dysfunction; the sample was screened from a population of 253 students. Nonconcentric condylar position at ICP was a feature of Class II malocclusion with significantly more anterior positions in Class II, Division 1 than in Class I. Condylar position was unrelated to the amount of sagittal RCP-ICP slide, although most slides were less than 0.5 mm. The frequency of lateral slides was low, but was mildly related to bilaterally asymmetric condylar positions. Position was unrelated to the degree of overbite, which ranged from 0 to 10 mm. Bilateral condylar position asymmetry was not related to the direction of dental midline discrepancy, which ranged from 0 to 2 mm. No open bites or mandibular overjets were seen in this asymptomatic normal sample.

Adult↗
PubMed1988

An American Board of Orthodontics case report.

A case report is presented of a Class II, Division 1 malocclusion with severe overjet and deep overbite with crowding and irregularities of the anterior teeth. The case was treated according to the standards of the American Board of Orthodontics.

Adult↗
PubMed1988

An American Board of Orthodontics case report.

A case report is presented of a Class II, Division 2 malocclusion in the mixed dentition with excess overjet, deep overbite, and mandibular arch-length deficiency. The case was treated to the standards of the American Board of Orthodontics.

Activator Appliances↗
PubMed1989

A multivariate approach to analyzing the relation between occlusion and craniofacial morphology.

This study examined the association between occlusion and craniofacial morphology using univariate and multivariate statistical methods. Data were obtained from study casts and lateral cephalometric radiographs of 164 children in the early permanent dentition. The following multiple features of occlusion were assessed: molar relation, overjet, overbite, and anterior crowding. Angular skeletal measures assessed cranial base flexure, maxillary horizontal and vertical positions, mandibular horizontal and vertical positions, horizontal and vertical maxillary-mandibular relations, and positions of the incisors. The relation between the Occlusal Index, which is a malocclusion severity index, and skeletal morphology was also investigated. Associations were examined by use of linear correlation, stepwise multiple regression, and canonical correlation analyses. Individually and in combination, occlusal features were poorly associated with individual skeletal measures (r2 less than or equal to 0.35). The strongest association occurred between a linear combination of occlusal features and a linear combination of skeletal measures (R2 = 0.66, p = 0.0001). A malocclusion severity index did not aid in the identification of craniofacial morphology. The results suggested that combinations of certain occlusal characteristics may be associated with specific skeletal types; however, a generalized statement of this concept could not be supported.

Adolescent↗
PubMed1989

The relationship between temporomandibular joint sounds and malocclusion.

The relationship between temporomandibular joint (TMJ) sounds and the occlusion was evaluated in a sample of 226 patients before commencement of orthodontic treatment. TMJ sounds were recorded on videotape, using an audiovisual system, for subsequent classification into various categories. The prevalence of joint sounds was 36.3% (N = 82) of which 50% (N = 41) were categorized as reciprocal clicks. The occlusion (static and functional) and skeletal relationships generally did not appear to be significant factors in contributing to TMJ sounds in patients with malocclusions. However, a larger interincisal angle in the sound-present group, and dental wear and increased overbite in the reciprocal-clicking subgroup may be associated factors.

Adolescent↗
PubMed1989

The effect of the amount of protrusion built into the bionator on condylar growth and displacement: a clinical study.

To evaluate the treatment effects of a variable degree of forward posturing of the mandible incorporated into the Bionator, a study was undertaken on 14 patients with Class II, Division 1 malocclusion, treated for 1 year with a Bionator, maintaining the mandible in an edge-to-edge incisal position (Be group). This group was compared with a matched group of patients treated with the Bionator in whom the mandible was maintained in a "functional maxipropulsion" (Bmax group). Both groups were subdivided further according to sex for selected parameters. Twenty-nine measurements on cephalometric x-ray films taken before and after 1 year of treatment were statistically analyzed. According to this study, "edge-to-edge" protrusion is superior to "functional maxipropulsion" in increasing ramal height. The difference in increase in corpus length after treatment (greater in boys than in girls) was sex related rather than dependent on appliance characteristics. When studying the effect of functional appliances, it is suggested that a patient group be subdivided by sex. After treatment a repositioning of the condyle was found in a more downward and possibly slightly forward direction relative to sella point (S) in both groups. A relocation of the condyle should be considered as another treatment effect of functional appliances. The more important lowering of the condyle found in the Bmax group may partly explain the significant increase in SNB, the 1.6-fold larger decrease in overbite, and the highly significant increase in anterior lower facial height in this group.(ABSTRACT TRUNCATED AT 250 WORDS)

Activator Appliances↗
PubMed1989

Intrusion of incisors in adult patients with marginal bone loss.

Elongated and spaced incisors are common problems in patients suffering from severe periodontal disease. Thirty patients characterized by marginal bone loss and deep overbite were treated by intrusion of incisors. Three different methods for intrusion were applied: (1) J hooks and extraoral high-pull headgear, (2) utility arches, (3) intrusion bent into a loop in a 0.17 x 0.25-inch wire, and (4) base arch as described by Burstone. The intrusion was evaluated from the displacement of the apex, incision, and the center of resistance of the most prominent or elongated central incisor. Change in the marginal bone level and the amount of root resorption were evaluated on standardized intraoral radiographs. The pockets were assessed by standardized probing and the clinical crown length was measured on study casts. The results showed that the true intrusion of the center of resistance varied from 0 to 3.5 mm and was most pronounced when intrusion was performed with a base arch. The clinical crown length was generally reduced by 0.5 to 1.0 mm. The marginal bone level approached the cementoenamel junction in all but six cases. All cases demonstrated root resorption varying from 1 to 3 mm. The total amount of alveolar support--that is, the calculated area of the alveolar wall--was unaltered or increased in 19 of the 30 cases. The dependency of the results on the oral hygiene, the force distribution, and the perioral function was evaluated in relation to the individual cases. It was obvious that intrusion was best performed when (1) forces were low (5 to 15 gm per tooth) with the line of action of the force passing through or close to the center of resistance, (2) the gingiva status was healthy, and (3) no interference with perioral function was present.

Adult↗
PubMed1990

An American Board of Orthodontics case report.

This case report describes an adult patient with a bilateral Class II malocclusion and an extremely deep overbite. The patient was treated without extraction to the standards of the American Board of Orthodontics. [This case was presented to the American Board of Orthodontics in partial fulfillment of the requirements for the certification process conducted by the Board.]

Cephalometry↗
PubMed1990

Cephalometric comparisons of dentofacial parameters between Egyptian and North American adolescents.

The purpose of this study was to develop cephalometric standards for the Egyptian adolescent boys and girls and to compare them to a matched Iowa adolescent sample. The Egyptian sample consisted of 39 boys and 51 girls with a mean age of 12.5 years. The Iowa sample consisted of 33 boys and 22 girls with a mean age of 13.0 years. Basic descriptive statistics were calculated for 35 cephalometric dentofacial parameters. The general linear models procedure, analysis of variance, was used for the comparisons between the groups. F values were calculated for the overall group comparisons, and the statistical significance was predetermined at the 0.05 level of confidence. Comparisons between the boys and girls in both populations indicated that the boys were larger in the linear dimensions of the cranial base and face heights than the girls. Comparisons between the Egyptians and the Iowans indicated that Egyptian boys have a tendency toward bimaxillary dental protrusion and a decreased overbite as compared with Iowa boys. Egyptian girls have a relatively more convex profile and a tendency toward mandibular dental protrusion. When the overall findings are evaluated, it could be concluded that, in general, there is a great similarity in the overall facial morphology between the Egyptian and Iowa populations.

Adolescent↗
PubMed1991

An American Board of Orthodontics case report.

A case report of a Class II, Division 1 malocclusion with a deep overbite and severe overjet. The case was treated with the extraction of four first premolars and differential force mechanics. No adjuncts such as functional appliances, headgear, or surgery, were used. [This case was presented to the American Board of Orthodontics in partial fulfillment of the requirement for the certification process conducted by the Board.]

Bicuspid↗
PubMed1991

The skeletodental adaptations in deep bite correction.

The purpose of this study was to analyze the skeletal and dental changes produced by orthodontic correction of a deep bite. A comparison was made between the adolescents' and the adults' responses in an attempt to observe any differences that accounted for increased stability in a growing patient. Records on 30 patients were analyzed before and after treatment. These patients were divided into two equal groups on the basis of their stage of maturational development. The group of "growers" had an average age of 12.2 years, and the group of "nongrowers" averaged 26.7 years in age. All represented nonextraction cases with an excessive overbite before treatment. Deep bite was corrected by leveling with conventional continuous arch wires. Cervical headgear, Class II, or vertical elastics were used when indicated. On the average, the molars were extruded 4.7 mm in the grower's group. However, the mandibular plane angles did not change during treatment. This finding can be attributed to the greater amount of posterior mandibular development that was observed in growing patients. Even with minimal extrusion of the molars (1.3 mm on average), the adults did not maintain the original mandibular plane angle.

Adaptation, Physiological↗