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At least 595 records · Page 33Linked to original sources
PubMed2000

Dentoalveolar and skeletal changes associated with the pendulum appliance.

The purpose of the study was to examine the dentoalveolar and skeletal effects of the pendulum appliance in Class II patients at varying stages of dental development and with varying facial patterns (high, neutral, and low mandibular plane angles). Specifically, the amount and nature of the "distalization" of the maxillary first molars and the reciprocal effects on the anchoring maxillary first premolars and incisors were studied, as were skeletal changes in the sagittal and vertical dimensions of the face. Pretreatment and posttreatment cephalometric radiographs obtained from 13 practitioners were used to document the treatment of 101 patients (45 boys and 56 girls). The average maxillary first molar distalization was 5.7 mm, with a distal tipping of 10.6 degrees. The anchoring anterior teeth moved mesially, as indicated by the 1.8-mm anterior movement of the upper first premolars, with a mesial tipping of 1.5 degrees. The maxillary first molars intruded 0.7 mm, and the first premolars extruded 1.0 mm. Lower anterior facial height increased 2.2 mm; there was no significant difference in lower anterior facial height increase between patients of high, neutral, or low mandibular plane angles. In patients with erupted maxillary second molars, there was a slightly greater increase in lower anterior face height and in the mandibular plane angle and a slightly greater decrease in overbite in comparison to patients with unerupted second molars. Similar findings were observed in patients with second premolar anchorage versus those with second deciduous molar anchorage. The results of this study suggest that the pendulum appliance is effective in moving maxillary molars posteriorly during orthodontic treatment. For maximum maxillary first molar distalization with minimal increase in lower anterior facial height, this appliance is used most effectively in patients with deciduous maxillary second molars for anchorage and unerupted permanent maxillary second molars, although significant bite opening was not a concern in any patient in this study.

Activator Appliances↗
PubMed2003

Long-term outcome of skeletal Class II Division 1 malocclusion treated with rapid palatal expansion and Kloehn cervical headgear.

The treatment of a patient with a skeletal Class II Division 1 malocclusion, with excessive overjet, complete overbite, airway obstruction, and severe arch length deficiency in the mandibular dental arch, is presented. The maxilla was narrow compared with the mandible, and the posterior teeth were compensated, with the maxillary teeth inclined buccally and the mandibular teeth inclined lingually. The palatal vault was extremely high. Treatment included rapid palatal expansion to correct the transverse maxillary deficiency and Kloehn cervical headgear to correct the anteroposterior skeletal discrepancy. Long-term stability (12-year follow-up) is reported.

Cephalometry↗
PubMed2003

Class II subdivision treatment success rate with symmetric and asymmetric extraction protocols.

The purpose of this study was to compare the success rates of Class II subdivision malocclusion patients treated with either symmetric or asymmetric extractions. The sample consisted of 51 patients with Class II subdivision malocclusion. The patients were divided into 2 groups. Group 1 included 28 patients who were treated with 4 premolar extractions. The 23 patients in group 2 were treated with 3 premolar extractions (2 maxillary premolars and 1 mandibular premolar on the Class I side). The initial and final study models were evaluated by means of Grainger's treatment priority index (TPI). Individual evaluations of improvements in maxillary-to-mandibular dental midline deviation, overjet, and overbite were also made. The final mean TPI and the mean improvement in TPI and in the other variables of each group were compared with independent t tests. The results showed a statistically significant difference only for the improvement in maxillary-to-mandibular dental midline deviation of the groups. The 3-premolar-extraction group had a greater improvement of the initial interdental midline deviation. There is a tendency for a slightly better treatment success rate when Class II subdivision patients are treated with asymmetric extraction of 3 premolars, compared with extraction of 4 premolars.

Adolescent↗
PubMed1993

A longitudinal evaluation of the anterior border of the dentition.

Posttreatment changes of orthodontically treated dentitions are inherent to every orthodontic practice. Various studies have documented the ideal posttreatment dental and cephalometric norms that could pertain to stable long-term occlusal results. Clinically, changes in these parameters are often observed as mandibular incisor crowding. The purpose of this study was to evaluate the longitudinal changes in certain variables representing the anterior border of the dentition. Eighty-eight white subjects were assessed regarding stability of the dentition after edgewise orthodontic treatment. (44% nonextraction, 56% extraction) The following variables in proximity of the anterior limit of the dentition (overbite, overjet, mandibular arch length, upper and lower incisor position, Little irregularity index) were assessed and correlated with each other. The data were subjected to descriptive statistics, the Friedman test for significant changes and pairwise comparisons, and the Spearman correlation test. Mandibular intercanine width was not significantly altered during treatment, but although not significantly, p > 0.05 did decrease beyond the original measurement during posttreatment evaluation (mean 7 years after treatment). The other variables influenced by the orthodontic manipulation were all within normal ranges and remained stable. The arch length decreased significantly (p < 0.05) during the entire evaluation period and was the only variable not stable. It was concluded that: (1) sound treatment leads to attainment of ideal occlusal parameters, (2) mandibular intercanine expansion could lead to failure of results, (3) arch length change plays a major role in causing irregularity of mandibular incisors after treatment, and (4) patient education regarding posttreatment orthodontic changes is imperative.

Adolescent↗
PubMed1991

Crozat appliance therapy for an arch-length discrepancy problem.

The case involved a white male subject, aged 10 years 6 months, with a Class I molar relationship complicated by a deep overbite and impaction of all four permanent canines, which were completely blocked out of the arches. The growth rate of the arches was found to be abnormal, and there was premature loss of the deciduous teeth. Over a period of approximately 5 years, with intermittent pauses to allow growth to catch up with treatment, the Crozat removable appliance was used to help establish the arch form and correct the plane of occlusion.

Activator Appliances↗
PubMed1994

Employing Tip-Edge brackets on canines to simplify straight-wire mechanics.

The straight-wire appliance was developed in part to reduce wire bending and therefore make treatment results more predictable. Because tip prescription is built into the bracket slots, teeth are held at their final crown angulations throughout treatment. Straight-wire brackets are used in an attempt to produce bodily tooth movement. However, teeth tend to tip when a force is applied. This tipping, especially when canines are retracted, can deflect the arch wire causing supereruption of the incisors with a resultant increase in anterior overbite and an open bite in the canine/premolar area. Placing Tip-Edge brackets (TP Orthodontics, Inc., LaPorte, Ind.) on canines and employing tipping and uprighting mechanics on these teeth can overcome these problems. Two cases are presented to illustrate this approach to treatment.

Adolescent↗
PubMed1994

Risk factors associated with temporomandibular joint sounds in children 6 to 12 years of age.

The relationship between temporomandibular joint (TMJ) sounds and a person's dental and skeletal characteristics is poorly understood. In this study, data were obtained from 3428 grade schoolchildren (mean age = 9.0 years, SD = 0.8, range 6 to 12 years), without a history of orthodontic treatment. Each child had been examined independently by one of six orthodontists to assess: TMJ sounds (none, click, crepitus), gender, age, race (white/black), skeletal relationships (convexity, maxillary, and mandibular positions), malocclusion (molar class, overjet, overbite, anterior crowding, posterior crossbite), maximum opening, chin trauma (none, cut, scar), and history of lower facial trauma. Temporomandibular joint sounds were present in 344 children (10.0% of the sample); 276 (8.1%) had an isolated unilateral sound, 254 (7.4%) had unilateral clicking, 50 (1.5%) had bilateral clicking, 22 (0.6%) had unilateral crepitus, and 11 (0.3%) had bilateral crepitus. Univariate analyses compared children with and without sounds for each variable; logistic regression analyses examined the relationship between groups of variables and TMJ sounds. The prevalence of TMJ sounds was associated with examiner (chi 2 = 23.4, df = 5, p < 0.001); increased prevalence of TMJ sounds occurred in children with maxillary anterior crowding (t = 2.8, p < 0.006), mandibular anterior crowding (t = 3.0, p < 0.002), and increased maximum opening (t = 4.7, p < 0.001). In contrast to other reports on children, the prevalence of joint sounds was not associated with age, race, gender, or molar class.(ABSTRACT TRUNCATED AT 250 WORDS)

Analysis of Variance↗
PubMed1994

The effects of the Fränkel's function regulator on the Class III malocclusion.

The material of this investigation consisted of 40 functional Class III malocclusion subjects. Each treatment and control group consisted of 20 Class III cases (10 boys and 10 girls). The mean age of the subjects in the function regulator, FR-3, group was 9.5 years at the beginning of the treatment, and in the control group 9.3 years at the beginning of the observation period. The mean treatment period of the FR-3 group was 1.9 years and the mean observation period of the control group is 1.8 years. In this study, as a result of FR-3 appliance therapy in the functional Class III malocclusion group, the negative overjet that was present at the beginning of the treatment has been converted into a positive overjet by an average increase of 3.8 mm at the end of the treatment. The sum of downward and backward rotation of the mandible, the decrease in the SNB angle with a subsequent increase of the ANB angle, and the retrusion of the lower incisors were effective in the increase of the overjet. The increase in the SNA angle and the protrusion of the upper incisors were found to be insignificant. The overbite decreased due largely to the downward and backward rotation of the mandible.

Cephalometry↗
PubMed1995

The morphologic basis for the extraction decision in Class II, division 1 malocclusions: a comparative study.

The purpose of this study was to compare the pretreatment dentofacial characteristics of persons with Class II, Division 1 malocclusions treated with either an extraction or a nonextraction approach. Such comparisons might help identify which parameters influence the extraction decision. Lateral cephalograms were available on 91 Class II, Division 1 cases, 44 were eventually treated with first premolar extractions and 47 were treated nonextraction. Twenty-four landmarks were located and digitized on each cephalogram. From these landmarks, 33 angular and linear dimensions were obtained. The Class II cases were also compared with normal subjects matched for age and sex. Comparisons between the Class II, Division 1 groups and normals indicated that, in general, the Class II, Division 1 malocclusion is associated with a larger overjet, deeper overbite, larger ANB angle, more retrusive mandible, and a convex soft tissue profile. Comparisons between subjects treated with and without extractions indicated that at pretreatment, the extraction groups had significantly larger tooth size-arch length discrepancies in both the maxillary and mandibular arches. In addition, the upper and lower lips in male subjects, and the lower lip in female subjects were significantly more protrusive in the subjects who were eventually treated with four first premolar extractions. These results indicate that in this group of patients, lip protrusion is one of the important parameters on which the extraction decision was based.

Adolescent↗
PubMed1995

Segmented approach to simultaneous intrusion and space closure: biomechanics of the three-piece base arch appliance.

Deep overbite correction and space closure in patients with flared incisors are mechanically difficult to achieve with conventional orthodontic treatment. The purpose of this article is to present an appliance design that allows simultaneous intrusion and retraction of anterior teeth as well as correction of their axial inclinations. A three-piece base arch was used to achieve simultaneous intrusion and space closure. Various clinical situations are discussed and analyzed from a biomechanical standpoint. Sequences of treatment, appliance design, and management of side effects are described in detail. The segmented approach to simultaneous intrusion and space closure is useful for achieving precise control of tooth movements in the anteroposterior and vertical dimensions.

Child↗
PubMed1996

The inclined biteplane--a useful tool.

A technique is described to help maintain overjet and overbite reduction achieved with a functional appliances, while waiting to proceed with definitive treatment or for use after a definitive course of fixed appliance therapy to help maintain the achieved result.

Child↗
PubMed1996

An American Board of Orthodontics case report: an adult nonsurgical patient whose treatment required combined dental disciplines.

This is a case report of a 27-year-old, white woman who had a Class II, Division 2 malocclusion with 100% overbite and mild skeletal mandibular retrognathia. Missing teeth were the maxillary right canine, second premolar, and second molar; the maxillary left canine and second molar; the mandibular left first premolar and second molar; the mandibular right first premolar and second molar. The maxillary first premolars were used as canines and the molars were in an Angle Class I relationship at the end of 31 months of treatment. Bonded lingual retainers were placed: a maxillary lateral incisor-to-lateral incisor, a mandibular canine-to-canine, and a maxillary Hawley retainer. Later, a fixed restoration to replace the maxillary right second premolar was completed. Included are 3-year posttreatment records.

Adult↗
PubMed1996

Facial structure and functional findings in patients with progressive muscular dystrophy (Duchenne).

The investigation of 15 patients who have a progressive muscular dystrophy of the Duchenne type (PMD) shows the affection of various groups of muscles of the stomatognathic system, studied by means of electromyography and mechanical force measurements. We observed the following deviations in patients with PMD; transversal overdevelopment and sagittal shortening of the dental arch; reduction of overbite and overjet; sagittal underdevelopment of the cranial, maxillary and mandibular base; retrusion of incisors; concave profile; increase in bizygomatic width; and a difference in time between the attack on the musculi orbicularis oris and that on masticatory muscles. In our study, the activity of the jaw muscles diminished 2 years earlier compared with the perioral muscles. This, and also the enlargement of the hypotonic tongue, causes a transversal expansion of skull and dental arches. This expansion was strongly pronounced in the lower jaw; we invariably observed a posterior crossbite. In contrast to the transversal overdevelopment, we observed a sagittal underdevelopment of skeletal and dental parameters, as well as a retrusion of the incisors. The results of surface electromyography showed the affection of the masseter muscle in patients who had PMD. By means of the Fast-Fourier transformation, we observed a displacement of the median frequency as compared with the lower frequency range.

Adolescent↗
PubMed1996

Treatment and postretention changes in dental arch width dimensions--a long-term evaluation of influencing cofactors.

The aim of the present long-term follow-up study of orthodontically treated patients was to analyze postretention changes in arch width dimension and to isolate factors that may serve as predictors of long-term prognosis. Pretreatment, end-of-treatment, and postretention (at least 10 years) models of 226 cases with different malocclusions were used to measure intercanine and intermolar width, arch length, sum of the mesiodistal dimension of the incisors, irregularity index, crowding, molar and canine relationship, overjet, and overbite. To assess the influence of initial and end-of-treatment alignment, kind of treatment (extraction versus nonextraction) and the amount of expansion in postretention stability, the sample was divided into different subgroups. The findings indicate that postretention arch width relapse occurred more frequently in the upper intermolar (25.8%) and lower intercanine region (23.9%) than in the lower intermolar (19.0%) and upper intercanine (13.8%) region. Pretreatment and posttreatment alignment as well as the kind of treatment and the amount of expansion were found to be influencing factors. The study concludes by proposing a reassessment of the definition of stability. The influence of the pretreatment anomaly, kind of treatment, amount of expansion, and posttreatment alignment on long-term stability should be recognized. Patients should be apprised of treatment limitations before treatments.

Adolescent↗
PubMed1996

Posttreatment changes in male and female patients: a comparative study.

The purpose of this study was to determine whether the posttreatment changes in patients with Class II, Division 1 malocclusions who were treated with either extraction or nonextraction express similar trends in the male and female patients. The material for this investigation was obtained from the records available in the Graduate Orthodontic Clinic at the University of Iowa. Ninety-one patients were treated for their Class II, Division 1 malocclusions, 44 subjects (21 males and 23 females) had four first premolar extractions and 47 subjects (20 males and 27 females) were treated with nonextraction. Matched normal subjects included 20 male and 15 female subjects for whom complete sets of data were available for the period of this study. None of these subjects had undergone orthodontic therapy. Thirty-nine cephalometric anteroposterior and vertical skeletal, dental, and soft tissue linear and angular measurements were derived. Twenty-four dental arch parameters were evaluated and included: overbite, overjet, maxillary and mandibular arch lengths, and arch widths, as well as tooth size-arch length discrepancies. Student t tests were used to compare male and female subjects for the following parameters: (1) absolute dimensions recorded before treatment, after treatment, and at retention; (2) the incremental changes between the various stages; (3) the relative posttreatment changes. The level of significance was predetermined at p < 0.05. From the current findings the following can be concluded: (1) There were significant differences in the size as well as the incremental changes of the various cephalometric dentofacial parameters between normal male and female subjects. (2) There were significant differences in the absolute posttreatment cephalometric changes between male and female subjects, particularly in linear dimensions. Similar, but less frequent, findings were observed in the relative posttreatment changes. (3) Significant differences in the posttreatment dental arch changes between male and female subjects were the least frequent. (4) Male and female subjects expressed similar statistical trends in the direction of posttreatment changes. Therefore clinicians should not expect to observe significant differences in the posttreatment trends on the basis of the gender of the patient. On the other hand, the changes in linear dimensions are larger in male than female subjects. Therefore, for a more accurate interpretation of growth and/or treatment changes, it is advisable to independently analyze data on male and female subjects.

Adolescent↗
PubMed1996

A Class II, Division 1 malocclusion: A malocclusion with a significant mandibular arch length deficiency.

The malocclusion had a dental asymmetry that was corrected with the extraction of the maxillary right and left premolars and the mandibular left first premolar. Treatment objectives included: alleviation of maxillary and mandibular arch length deficiencies, maintenance of the maxillary midline conincident with the facial midline, correction of the mandibular midline which was off to the right, overbite and overjet correction, and attainment of a Class I canine relationship on the right side. [This case was presented to the American Board of Orthodontics in partial fulfillment of the requirement for the certification process conducted by the Board.]

Adolescent↗
PubMed1997

An assessment of treatment outcome in American Board of Orthodontics cases.

In a retrospective study, 90 American Board of Orthodontic (ABO) cases were evaluated for treatment outcome. Changes in occlusion, cephalometric skeletal and dental variables, soft tissue variables, and root resorption were evaluated. The occlusions of completed ABO cases were compared with 147 naturally occurring good-to-excellent occlusions from the Andrews Foundation for Education and Research, using the Ideal Tooth Relationship Index (ITRI). Cephalometric variables were evaluated in relation to an "acceptable range" based on established standards. Photographs were evaluated for lip posture at rest and at closure, and the incidence and the severity of root resorption of maxillary and mandibular teeth excluding second molars were evaluated from panoramic radiographs. After treatment, occlusions of ABO cases scored significantly higher overall and for all ITRI segments except the anterior interarch segment when compared with Andrew's sample. In all the ABO cases, ideal overjet and overbite were attained. Cephalometrically, the mandibular plane and the Y-axis angle showed no significant change as a result of treatment. However, skeletal dysplasia (ANB) and skeletal convexity (Na-A-Po) showed improvement. Dentally, the maxillary incisor position and inclination, the interincisal angle, and the lower incisor position ended within the acceptable range, whereas the lower incisors were proclined. Soft tissue variables also improved, lip balance and harmony, closure at rest, and closure without strain all improved. The nasolabial angle showed little change. Most of the root resorption was minor in nature and involved the maxillary and mandibular central and lateral incisors. In conclusion, the ABO cases were well treated and showed marked improvement in occlusion, cephalometric, and soft tissue changes, although experiencing minor iatrogenic effects.

Adolescent↗
PubMed1997

Nonsurgical treatment of a skeletal vertical discrepancy with a significant open bite.

A case report of a patient who exhibited with a skeletal Class II, dental Class I malocclusion with maxillary right first molar to maxillary left first molar open bite. A hyperdivergent cranial base/mandibular plane angle is presented. Maxillary-mandibular arch form and arch width discrepancies, a low labial frenum, multiple diastemas, and mandibular dental protrusion were present. A history of thumb sucking was evident. Active tongue thrusting and inadequate tongue posture at the time of treatment were documented. The patient was treated without extraction with an 0.022-inch edgewise appliance. A modified tongue crib with a palatal button was used until stable bite closure was achieved. Ideal overbite and overjet relationships were established. A Class 1 molar and canine occlusion was obtained. The transverse discrepancy was solved, and excellent dentofacial esthetics were achieved. Posttreatment records for 38 months document the stability of the treatment result. [This case report was presented to the American Board of Orthodontics in partial fulfillment of the requirements of the certification process conducted by the Board.

Cephalometry↗