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At least 757 records · Page 42Linked to original sources
PubMed1993

Occlusal plane rotation: aesthetic enhancement in mandibular micrognathia.

Patients afflicted with extreme degrees of mandibular micrognathia typically have vertically deficient rami as well as sagittally deficient mandibular bodies. This results in deficient posterior facial height, an obtuse gonial angle, excessively steep occlusal and mandibular planes, and a compensatory increase in anterior facial height. The entire maxillomandibular complex is overrotated in a clockwise direction. Standard orthognathic surgical correction fails to address this rotational deformity. As a consequence, the achieved projection of the lower face is inadequate, posterior facial height is further reduced, and occlusal and mandibular planes remain steep. Eleven patients with severe mandibular micrognathia underwent a surgical correction involving occlusal plane rotation to its normal orientation relative to Frankfort horizontal. This was accomplished by Le Fort I osteotomy to shorten the anterior maxilla (creating open bites in seven patients and making preexisting open bites worse in four patients) and sagittal split ramus osteotomies to advance and rotate the mandibular body counterclockwise, thus closing the surgically produced open bite. Counterclockwise rotation of the mandible afforded significantly greater sagittal displacement at the B point (mean 17 mm) than at the first molar (mean 10 mm) and produced adequate degrees of projection of the lower face when accompanied by a modest sliding genioplasty (mean 6.9 mm). Total advancement at the pogonion was a mean of 25.2 mm. In addition, posterior facial height was preserved, and mandibular and occlusal planes were normalized to mean angles of 27 and 10 degrees, respectively. At follow-up, which ranged from 9 to 24 months with a mean of 14.1 months, the mean sagittal relapse at the B point was 1.9 mm. Although heretofore considered unstable and therefore not clinically accepted, maxillomandibular counterclockwise rotation to normalize the occlusal plane rotational deformity provides stable, aesthetically superior results in patients with extreme degrees of mandibular micrognathia. Extended follow-up will be necessary to document long-term stability.

Adolescent↗
PubMed2003

Orthodontic-surgical treatment after posttraumatic bilateral condylectomy of the mandible in an adult patient.

A posttraumatic open bite associated with a bird face is reported. Condylectomy was indicated in relation to the plurifragmentary fracture of the condyles with limitation of mandibular movement. Condylectomies were mandatory as a result of delayed maxillofacial surgical treatment, which was related to the poor general condition of the patient after trauma. Functional disorder recovery and aesthetic deformity correction were planned by a team approach between orthodontists and maxillofacial surgeons with the support of a logopedist for the postural-related muscle problems. The main practical and theoretical problems presented by the clinical case were a result of the need to restore the occlusal relations and to avoid recurrence of open bite in this patient. The patient presented a wide alteration of muscular function and a strength fibrotic retraction with alteration in the relationship between upper and lower jaws and retrusion of the mandible associated to open bite. Orthodontic treatment was carried with no impact on the upper and lower axis, avoiding orthodontic correction of the open bite. Surgery corrected both the open bite and the bird face by means of bilateral sagittal split osteotomies. Wiring of the mandibular osteotomies and intermaxillary fixation allowed positioning of the mandibular ramus bilaterally because of the fibrosis and muscular action-related forces without resulting in a similar rotation of the mandible with the risk of recurrence. Myotherapy and logopedic support minimized the risk of recurrence, improved reduction of muscular tension with the resolution of the lip incompetence, and allowed functional recovery of mandibular movements.

Adult↗
PubMed1996

Electromyographic and ultrasonographic evaluation of the circum-oral musculature in children.

Muscle activity and thickness of the circum-oral musculature in children with class I molar occlusion having normal anterior relation, anterior deep-bite and anterior open-bite were measured using electromyographic and ultrasonographic techniques. The results demonstrated that the upper lip muscle thickness was least in open-bite subjects and lower lip muscle thickness was maximum in deep-bite subjects. The muscle activity in both the upper and lower lip was high in deep-bite subjects. A significantly negative correlation between muscle activity and thickness was noted only in the middle and left side of the lower lip in subjects having normal anterior relation. The upper lip contributed to the maximum EMG activity in all the three groups observed.

Case-Control Studies↗
PubMed2001

Orthodontic spring guidance of bilateral mandibular distraction in rabbits.

Although distraction osteogenesis can lengthen congenitally small mandibles, the distraction procedure can be difficult to control. To study the efficacy and safety of orthodontic spring guidance on bilateral mandibular distraction, an 8-mm anterior open bite was experimentally produced and corrected during bilateral mandibular distraction in rabbits. Orthodontic springs were attached to the anterior maxilla and mandible to redirect an ongoing distraction procedure. Sixteen rabbits underwent mandibular distraction: 6 rabbits received heavy springs (8 oz), 6 rabbits received light force springs (2 oz), and 4 rabbits served as control animals with anterior open bites without spring guidance. Nickel-titanium springs were applied during the last week of osseous distraction and the first week of consolidation. Distractors were left in place throughout a 2-month consolidation period. None of the animals developed fibrous union as a result of spring guidance. The 8-mm open bite did not close in the control group or in the light spring group after 2 weeks of spring wear or during the consolidation period. Heavy springs completely closed the experimental open bites within 2 weeks (P <.01, analysis of variance). Bite corrections did not change during the consolidation period. This study indicated that the addition of an orthodontic spring to a mandibular distraction procedure did not impair bone healing. With the distraction device in place, heavy spring forces redirected an ongoing mandibular distraction procedure and corrected an open bite, distraction side effect. Direct measurements, radiographic measurements, and tissue histologic factors described changes in segment position and shape of the distraction site.

Analysis of Variance↗
PubMed1982

Contractile properties of the muscles of mastication of rhesus monkeys (Macaca mulatta) following increase in muscle length.

The hypothesis was tested that increasing the resting length of the masseter and temporalis muscles by a bite-opening appliance with or without detachment and re-attachment of the masseter would not affect the contractile properties of these muscles. Appliances opened the bite of 10 adult female monkeys 20 mm. Five received the appliance alone (Group A); five received the appliance and in addition the masseter was detached and re-attached (Group ADR). Comparisons were made 48 weeks later. Small bundles of fibres were excised from the masseter and temporalis muscles of experimental animals and from 8 control animals. Isometric and isotonic contractile properties were measured in vitro and fibre classification and fibre areas were determined histochemically. No significant differences were observed within either masseter or temporalis muscles between animals in Groups A and ADR. In both groups, the bundles of fibres from the masseter had prolonged contraction and relaxation times compared to control masseter muscles but no difference was observed in the percentage of Type II fibres. As detachment and re-attachment had no significant effect on morphological or physiological characteristics, other than those due to lengthening, this procedure may be useful in decreasing the passive tension induced when orthognathic surgery increases muscle length. The significant prolongation of the contractile response of the masseter is similar to the adaptation induced by long-term stimulation at low frequency.

Adaptation, Physiological↗
PubMed1977

Correction of the long face syndrome by Le Fort I osteotomy. A report on some new technical modifications and treatment results.

The combined efforts of multiple specialists are needed for the successful treatment of patients with the long face syndrome. The plan of therapy is designed to correct the individual's dentofacial deformity and achieve the best possible occlusion and facial esthetics. Reduction of facial height by surgical means and proper alignment of the teeth by orthodontic and restorative procedures are the common denominators of successful treatment. By properly planned and executed Le Fort I maxillary osteotomies, the vertical dimension of the face can be shortened to improve the esthetic balance between the nose, upper lip, teeth, and chin and to achieve lip competency. Moreover, the transverse and anteroposterior discrepancies can be simultaneously corrected. Various open-bite and non-open-bite maxillary deformities in forty-one adults with the long face syndrome were corrected by Le Fort I osteotomy, orthodontic treatment, and restorative procedures. The technical problems in planning and executing treatment are discussed and illustrated by selected case reports.

Adolescent↗
PubMed2004

Survey of the present status of sleep-disordered breathing in children with achondroplasia Part I. A questionnaire survey.

An achondroplasia is known to be the inherited disease causing a growth impairment of limb bones. Recently, as a symptom of achondroplasia, a sleep-disordered breathing has been reported. Considering the scientific evidence that the sleep-disordered breathing in children such as that due to tonsillar hypertrophy inhibits somatotropin secretion and causes growth retardation, sleep-disordered breathing in children with achondroplasia may aggravate growth/developmental retardation in addition to the bone growth impairment. However, the present status of the development of sleep-disordered breathing in children with achondroplasia has been unknown. Therefore, in order to clarify the present status of sleep-disordered breathing in children with achondroplasia (AP group), we carried out a questionnaire survey of the breathing state during sleep, growth/development history and the oral state at preschool age and school age in the AP group, and compared the results with previously reported data in healthy children (control group). 1. Among the questionnaire items, the incidences of snoring, apnea, mouth breathing, anterior cross bite, and open bite at preschool age were significantly higher in the AP group than in the control group (P < 0.01) At school age, the AP group showed significantly higher incidences of mouth breathing and cross/open bite (P < 0.01) and snoring and apnea (P < 0.05) than the control group. 2. Height and weight at birth and at the ages of 1.5 and 3 years, excluding birth weight, were significantly lower in the AP group than in the control group (P < 0.01). 3. The chronological age at the initiation of eruption of the deciduous or permanent teeth did not significantly differ between the two groups. Thus, the AP group showed higher incidences of sleep-disordered breathing and malocclusion than the control group, and development of sleep-disordered breathing at preschool age.

Achondroplasia↗
PubMed1999

Evaluation of oral problems in an osteogenesis imperfecta population.

OBJECTIVE: The incidence of craniofacial and dental anomalies in children with the more severe nonlethal forms of osteogenesis imperfecta was evaluated. STUDY DESIGN: The study evaluated 40 children (age range, 1-17.5 years) with types III and IV osteogenesis imperfecta. In each case, the dentition was evaluated for the presence of dentinogenesis imperfecta, attrition, and caries, as well as for radiographic appearance, dental development, and malocclusion. RESULTS: The incidence of dentinogenesis imperfecta was greater than 80% in the primary dentition. Clinically, the color of the dentition was of predictive value in appropriate management of the primary dentition. Tooth discoloration and attrition did not occur to the same extent in the permanent dentition as in the primary dentition in either group. Class III dental malocclusion occurred in 70% to 80% of this osteogenesis imperfecta population, with a high incidence of anterior and posterior cross bites and open bites. A delay in dental development was observed in 21% of patients type III osteogenesis imperfecta, whereas accelerated development was noted in 23% of the patients with type IV. In addition, ectopic eruption occurred in 13 patients. CONCLUSIONS: In addition to dentinogenesis imperfecta, significant oral problems occur in types III and IV osteogenesis imperfecta. Other features that impact the dental management of this population are highlighted.

Adolescent↗
PubMed2005

Masticatory demands induce region-specific changes in mandibular bone density in growing rats.

This study investigates the structural adaptation of the mandibular bone when subjected to different masticatory functional and mechanical demands during growth. The effect of two experimental factors, the insertion of a bite block and the alteration of food consistency, on the bone mineral density (BMD) of the mandible was investigated in growing rats. Fifty-two male albino rats were divided into two equal groups, fed with either the standard hard diet or soft diet, at the age of four weeks. After two weeks, half the animals in both groups had their upper molars fitted with an upper posterior bite block. The remaining animals served as a control. Region-specific BMD of the mandible was subsequently measured using dual-energy X-ray absorptiometry (DXA). Soft diet and the consequent reduction of the forces applied to the mandible during mastication resulted in the reduction of BMD in all regions under study. The insertion of the bite-opening appliance (bite block) and the resulting stretching of the soft tissues led to the application of a continuous light force on the lower molars, which was associated with a significant increase of the BMD in the part of the alveolar process just below the root apices. These results raise the question of whether orthodontic treatment with similar appliances may have some, previously unsuspected, short- or long-term effects on the mandibular bone during growth and whether their effects depend on the individual soft-tissue characteristics.

Absorptiometry, Photon↗
PubMedDate not supplied

[Malocclusion in the primary dentition].

In this paper we analyze the type and frequency of malocclusions in a group of 100 health children with complete primary dentition. Bjork's method for epidemiological registration was taken as a basis. Of the examined children, 78% had some malocclusion type. The most frequent was the increased horizontal overbite. In vertical overbite relation we find anterior open bite, increased overbite, anterior open bite, increased overbite.

Child, Preschool↗
PubMed1989

[Clinical study of mandibular condyle injury].

Mandibular condyle fractures develop frequently and show the variable type of injury and complication. New opinions have emerged from recent investigation into condylar fractures. The author investigated 246 patients with condylar fractures who visited SNUDH from January 1980 to August, 1988, 8. with regard to clinical and treatment aspects, area and displacement of fractures, associated teeth injury and other body injury, complications. At last I have got the following results. 1. The incidence to condylar fractures in a series of 765 mandibular fractures may be as high as 32.2%. 2. The male patients are 3 times more than female patients. The highest frequency was recorded in the group 21-30 years of age. (34.1%). 3. Falls caused the greatest number of condylar fractures (45.2%) and next was in assult (25.6%), traffic accidents (22.4%). 4. Unilateral condylar fractures were present in 74.8%, giving a left: right ratio of 1.2:1. In cases of unilateral fracture, subcondylar fractures were by far the commonest (32.9%) but in cases of bilateral fracture, condylar neck fractures were by far the commonest. In children under 15 years of age, condylar neck fractures were more common but in patients over 16 years of age, subcondylar fractures were common. 5. Anteromedial fracture dislocations were by far the commonest (20.3%). In children under 15 years of age, fracture deviations were common but in patients over 16 years of age, fracture displacements were common. 6. 44.7% of patients with condylar fractures sustained the teeth injuries. Teeth fractures were by far the commonest. 7. Single condylar fractures showed a frequency of 30.5%. Of the concomitant fractures elsewhere in the mandible, symphysis fractures were by far the commonest (54.1%). 8. Associated other body injuries showed a frequency of 28.0%. Of them, head injuries were by far the commonest. 9. The mean interval from injury to treatment was 14.3 days. Of the treatment of condylar fractures, open reduction was by far the commonest (70.3%). Closed reduction comprised 19.9% and functional therapy comprised 8.5%. 10. In 67 patients with possible follow up period, the following complications were developed, two ankylosis, anterior open bite, mouth opening limitation, mouth opening deviation.

Adolescent↗
PubMed1998

Prevalence of malocclusion and orthodontic treatment need in the United States: estimates from the NHANES III survey.

Data from the third National Health and Nutrition Examination Survey (NHANES III) provide a clear picture of malocclusion in the US population. Noticeable incisor irregularity occurs in the majority of all racial/ethnic groups, with only 35% of adults having well-aligned mandibular incisors. Irregularity is severe enough in 15% that both social acceptability and function could be affected, and major arch expansion or extraction of some teeth would be required for correction. About 20% of the population have deviations from the ideal bite relationship; in 2% these are severe enough to be disfiguring and are at the limit for orthodontic correction. In Mexican-Americans compared to the rest of the population, incisor irregularity and both severe Class II and Class III malocclusions are more prevalent, but deep bite and open bite are less prevalent. Application of the Index of Treatment Need to the survey data reveals that 57% to 59% of each racial/ethnic group has at least some degree of orthodontic treatment need. Over 30% of white youths, 11% of Mexican-Americans, and 8% of blacks report receiving treatment. Severe malocclusion is observed more frequently among blacks, which may reflect their lower level of treatment. Treatment is much more frequent in higher income groups, but approximately 5% of those in the lowest income group and 10% to 15% of those in intermediate income groups report being treated.

Adolescent↗
PubMed2006

Real time balanced turbo field echo Cine-MRI in the analysis of deglutition events and transit times.

Investigation of swallowing is an important part of oral diagnosis. It usually plays a role in the aetiology of some orofacial deformities and open-bite as well as in the relapse of treated open-bite patients. In recent years, the movements of the anatomical structures that participate in deglutition have been investigated by several methods such as cineradiography, electromyography, electropalatography, electromagnetic articulography and ultrasonography. However, all these techniques have various disadvantages. Recently, dynamic magnetic resonance imaging has become available in the evaluation of swallowing function. In this study we intended to present this new technique to the dental literature and aimed to obtain dynamic images of the deglutition process. We also compared the timing of events in subjects with anterior open-bite and normal overbite during swallowing 10 mL water.

Adolescent↗
PubMedDate not supplied

Oral findings in a typical case of achondroplasia.

We report a 16-year-old boy who had all the typical manifestations of achondroplasia but also had a skeletal and dental class III malocclusion, a narrow maxilla, macroglossia and an open bite between the posterior teeth. The narrow maxilla and bilateral cross-bite were treated with rapid palatal expansion. The open bite and irregular teeth were corrected with fixed orthodontic treatment, taking account of the macroglossia. This case is of clinical interest since dental class III malocclusion, posterior open bite, macroglossia and benign migratory glossitis have not previously been reported in achondroplasia.

Achondroplasia↗
PubMed2004

Breast feeding, bottle feeding, and non-nutritive sucking; effects on occlusion in deciduous dentition.

AIMS: To assess the effect of the type of feeding and non-nutritive sucking activity on occlusion in deciduous dentition. METHODS: Retrospective study of 1130 preschool children (3-5 years of age) who had detailed infant feeding and non-nutritive sucking activity history collected by a structured questionnaire. They all had an oral examination by a dentist, blinded to different variables evaluated. RESULTS: Non-nutritive sucking activity has a substantial effect on altered occlusion, while the effect of bottle feeding is less marked. The type of feeding did not have an effect on open bite, which was associated (89% of children with open bite) with non-nutritive sucking. Posterior cross-bite was more frequent in bottle fed children and in those with non-nutritive sucking activity. The percentage of cross-bite was lower in breast fed children with non-nutritive sucking activity (5%) than in bottle fed children with non-nutritive sucking activity (13%). CONCLUSIONS: Data show that non-nutritive sucking activity rather than the type of feeding in the first months of life is the main risk factor for development of altered occlusion and open bite in deciduous dentition. Children with non-nutritive sucking activity and being bottle fed had more than double the risk of posterior cross-bite. Breast feeding seems to have a protective effect on development of posterior cross-bite in deciduous dentition.

Bottle Feeding↗
PubMed1993

Perceptual characteristics of consonant errors associated with malocclusion.

The characteristics of articulation errors made by subjects having a class II, class II with open-bite, class III, or class III with open-bite malocclusion were compared. Regardless of the type of occlusal defect, errors occurred primarily on the sibilants /s, z/ and "sh, ch, j, dz," which were characterized mostly by combined visual and auditory distortions. Errors on the stop consonants /p, b, m, t, d, n/ occurred less frequently and, in all cases, consisted of isolated visual distortions. The type of malocclusion had a specific influence on the nature of the sound error. Subjects having a class II malocclusion, with or without an open bite, were able to assume a variety of tongue and mandibular postures that allowed them to approximate an /s/ or /z/. These compensations did not occur in subjects with a class III malocclusion. In these cases, the tongue remained distal to the mandibular incisors, causing the air stream to scatter. This study suggests that certain groups of sounds were more susceptible to specific types of misproductions and to particular types of occlusal defects.

Adolescent↗
PubMed1994

Artificial sucking habits: etiology, prevalence and effect on occlusion.

Active digit-sucking results in 1) reduced vertical growth of the frontal parts of alveolar process which creates an anterior open bite; 2) proclination of the upper incisors as a result of the horizontal force created by the digit; 3) anterior displacement of the maxilla for the same reason; 4) anterior rotation of the maxilla, resulting in an increased prevalence of posterior crossbite in the deciduous dentition; and 6) proclination or retroclination of the lower incisors which seems to be due to the strength of the tightness of the lower lip and tongue activity during sucking. When the sucking habit stops, the anterior open bite will correct itself spontaneously, due to increased growth of the alveolar processes, provided that the patient is still growing. If the lip activity and the lip/teeth relationship is normal, the upper incisors will upright themselves, and sometimes, due to the anterior displacement of maxilla, become somewhat retroclined. The skeletal effect of the sucking habit will remain. Improper use of a pacifier can create quite disastrous effects on the occlusion, if, for instance, the child has the shield. Otherwise, the effect of the pacifier is limited to the vertical and the transversal plane. The anterior open bite is normally more obvious and visible earlier in pacifier-suckers than in digit-suckers. As in digit-suckers, the open bite is associated with tongue-thrust during swallowing. Also in pacifier-suckers, the open bite will correct itself spontaneously when the habit stops despite the tongue-thrust. Sucking a pacifier is more clearly related to a posterior crossbite in the deciduous dentition than is digit-sucking. When the pacifier is in the child's mouth, the teat occupies the upper part of the anterior and middle part of the mouth thus forcing the tongue to a lower position. In the upper jaw, the teeth in the canine area lack palatal support from the tongue during the sucking activity of the cheeks. This reduces the arch width and increases the risk of a transversal malrelation between the upper and lower arches. The low tongue position widens the lower jaw in the same area thus enhancing the probability of the development of a posterior cross-bite.

Child↗
PubMed1998

Controlled multiplanar distraction of the mandible, Part II: Laboratory studies of sagittal (anteroposterior) and vertical (superoinferior) movements.

The application of distraction osteogenesis in craniofacial surgery has significantly altered the treatment of congenital mandibular deficiencies. However, evaluation of results in both animal studies and clinical cases has revealed deficiencies, particularly in two areas. First, distraction using a uniplanar device in an anteroposterior direction can result in a persistent anterior open bite. Second, the lateralization of the distracted hemimandible was often limited, with insufficient incremental gain in the bigonial distance. To overcome these shortcomings, a multiplanar distraction device was developed and tested in the canine model. This report details canine studies addressing the first problem: combined anteroposterior or sagittal (z-axis) and superoinferior or vertical (y-axis) movements. Six dogs underwent bilateral mandibular distraction with an external (extraoral), multiplanar device and completed sagittal plus vertical distraction. Evaluation included clinical examination (facial form, jaw position, and occlusion), photography, cephalograms (posteroanterior, basilar, and lateral), three-dimensional computed tomography reconstructions, and examination of dry skulls. The dogs averaged 18.5 mm (range, 15-20 mm) of sagittal distraction and 41.0 degrees (range, 21-50 degrees) of vertical distraction. Marked anterior open bites were produced after vertical distraction secondary to premature contact of the maxillary and mandibular molars. Distraction in the vertical direction also had the additive effect of increasing the sagittal gains by approximately 5% to 10%. In conclusion, a multiplanar distraction device (with the potential for distraction in three planes) was effective in increasing mandibular anteroposterior thrust (sagittal distraction) and also in creating an anterior open bite (vertical or superoinferior distraction). Vertical distraction probably requires bilateral osteotomies to obtain optimal results. The preliminary gains in sagittal length are modified (reduced or increased) after distraction in a second plane (vertical and horizontal). Specifically, vertical distraction in the inferior direction (creating an open bite) also leads to isolated increases in the anteroposterior plane. Conversely, vertical distraction in the superior direction (closing an open bite), as seen in a human malocclusion, may lead to isolated decreases in the anteroposterior plane, but this question remains to be investigated in the laboratory.

Animals↗