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PubMed2004

The impact of osteoporosis on patients with maxillofacial trauma.

BACKGROUND: Although maxillofacial injuries in the elderly population frequently result from falls and motor vehicle crashes, the association between osteoporosis and fractures of the maxillofacial region remains poorly defined. OBJECTIVE: To evaluate the relationship between osteoporosis and maxillofacial trauma in the elderly. DESIGN, SETTING, AND MAIN OUTCOME MEASURES: A retrospective review of 59 patients 60 years or older treated for maxillofacial fractures at a trauma center between 1989 and 2000 was performed. The severity of osteoporosis was graded by evaluating the radiographic appearance of the vertebral bodies of each trauma patient using the Saville index. The number of maxillofacial fractures and the severity of osteoporosis in each patient was assessed to determine whether an association between osteoporosis and maxillofacial trauma exists. RESULTS: Of the 59 patients evaluated, 51% were injured by falls and 46% were involved in motor vehicle crashes. Seventy-three percent of the patients had multiple facial fractures. As the severity of osteoporosis worsened, patients were more likely to sustain a greater number of maxillofacial fractures (P=.01). The mechanism of injury had no impact on the relationship between osteoporosis and the number of fractures. CONCLUSIONS: Osteoporosis is an independent risk factor for the development of maxillofacial fractures. Since more than half of these patients are injured by falls, safety measures must be instituted to prevent fall-related maxillofacial injuries in the home and the community.

Accidental Falls↗
PubMed2004

Sagittal and vertical growth of the jaws in Class II, Division 1 and Class II, Division 2 malocclusions during prepubertal and pubertal development.

AIM: The aim of the present study was to evaluate the sagittal and vertical development of the jaws in Class II, Division 1 (II/1) and Class II, Division 2 (II/2) malocclusions. In addition, facial morphology was to be investigated in probands with these malocclusions. PROBANDS AND METHODS: Maxillary and mandibular development was investigated with reference to lateral cephalograms of orthodontically untreated probands from the Belfast Growth Study at 7, 9, 11, 13 and 15 years of age. Moreover, development of facial width was assessed from the associated posteroanterior cephalograms, with radiographic magnifications being corrected in both the lateral and the posteroanterior cephalograms. A Class II/1 group (n = 17) and a Class II/2 group (n = 12) were compared with two control groups: a group with good occlusion (n = 18) and a Class I group (n = 37). RESULTS AND CONCLUSIONS: With respect to the sagittal position of the maxilla, no significant differences between the Class II groups and the controls were found. In the Class II/1 group, mandibular retrognathism was observed. The posterior position of the mandible present at 15 years of age had been present even at 7 years of age, and growth increments in the Class I and Class II/1 subjects were similar. In the Class II/2 groups no uniform pattern with respect to mandibular position was found. With respect to vertical development, a deficit in lower anterior facial height was found in the Class II/2 groups. In addition, between 7 and 15 years of age, growth increments in lower anterior facial height were significantly smaller in the Class II/2 subjects than in the controls. Furthermore, the Class II/2 groups displayed a more euryprosopic facial form on average. The cause of this characteristic facial morphology was the vertical deficit in lower anterior facial height. Overall, however, the broad variability and the small sample sizes, in particular of the Class II/2 groups, in the present study have to be seen as limitations.

Adolescent↗
PubMed1980

The dentomaxillary complex and overjet correction in Class II, division 1 malocclusion: objectives of skeletal and alveolar remodeling.

In recent years it has become apparent that there are limitations to the amount of tooth movement that can be accomplished by alveolar remodeling. Retraction of the maxillary incisor teeth should therefore be avoided during overjet correction if penetration of the palatal alveolar cortex is a probability. Since the Class II, Division 1 phenotype is characterized by abnormalities in both dentoalveolar process and maxillomandibular reactions, trying to compensate for the skeletal discrepancy through alveolar remodeling alone does not have logic on its side. Indeed, treatment philosophies based entirely on a concept of alveolar remodeling cannot be justified on biologic grounds. The most reliable method of avoiding destruction of the palatal alveolar cortex during overjet correction is by means of headgear mechanics designed to produce clinically significant skeletal remodeling. This holds as a general principle, even where extractions are an essential part of the treatment program. Furthermore, because the facial skeleton responds to mechanical deformation more readily in the growing person, the policy adopted by many orthodontists of deferring treatment until the permanent teeth have erupted has little to recommend it.

Alveolar Process↗
PubMed1995

Male postpubertal facial growth in Class II malocclusions.

Maxillary and mandibular postpubertal growth changes were assessed from lateral cephalograms taken when subjects were 16 and 20 years of age. The sample consisted of 39 male subjects with no previous orthodontic treatment who exhibited Class II skeletal characteristics. Significant increases in mean maxillary and mandibular measurements were observed over the age period studied. Mean mandibular growth (Co-Gn) was approximately three times that of maxillary growth (Co-A). Total mandibular growth observed between 16 to 20 years of age was approximately 4.3 mm. The mandible appeared to rotate anteriorly superiorly, reflected by a mean reduction in mandibular plane angle of 1.47 degrees and a greater increase in posterior versus anterior face height. There were not statistically significant changes in incisor angulation. Mean growth changes in this Class II sample were comparable to those previously reported for male subjects with Class I malocclusions over the same age period, suggesting a similarity in postpubertal development between these two groups.

Adolescent↗
PubMed1997

Congenital temporomandibular joint ankylosis--a case report.

A case of congenital temporomandibular joint (TMJ) ankylosis which caused facial disfigurement, significant reduction in mouth opening, difficulties in feeding and breathing, and general interference with physical and mental development is presented. The wide range of manifestations exceed the typical picture of TMJ ankylosis and resemble a syndrome rather than an isolated defect of the TMJ.

Ankylosis↗
PubMed2000

[Synthesis and evaluation of the clinical approach to growth].

A critical reflection based on literature is presented to the lectures given at the symposium "A clinical approach to growth" at the 73rd Réunion Scientifique of the Société Française d'Orthopédie Dento-Faciale in Deauville, France, on may 13th, 2000. Uncertainty is expressed about the long-term effects on the growth pattern after early surgery in children. It is apparent that conventional dentofacial orthopedics have a limited long-term effect on the growth pattern. Surgical as well as non-surgical (orthopedic) approaches are plagued by complications and relapse. The need for unbiased clinical research and standardized, complete documentation and analysis--also on how/why clinical decisions were taken--seems of utmost importance for a balanced future development of conventional and newly introduced techniques.

Adolescent↗
PubMedDate not supplied

[Shape of dental arches and their dimensions in children without malocclusion aged 3 years].

The dental arches were analysed in 3-year-old children without malocclusion evaluating the shape of arches, measuring their with, length and depth. The index of the dental arch and the palatal index were calculated. In children aged 3 years the shape of the upper dental arch was in most cases similar to a semi-ellipse and that of the lower arch approached parabole. This suggests that the semicircular shape of dental arches is not characteristic of this period of occlusion development.

Child, Preschool↗