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A case is described in which porcelain veneers were used to improve the appearance of the upper anterior teeth and disguise a marked dental centre-line asymmetry. This followed the traumatic loss of the upper left central incisor and complete space loss. Four anterior teeth were treated so that the illusion of symmetry might be enhanced, and the rationale behind this approach is discussed.
The purpose of this study involving a sample of children with single central incisor crossbite was to determine the relationship between clinical crown lengths of the crossbite and noncrossbite mandibular incisors, incisor irregularity, and orthodontic correction of the crossbite. In addition, for comparison, the normal maturational change in position of the labial gingival margin of mandibular incisors not undergoing orthodontic correction was examined. Twenty-one children treated for single central incisor crossbite were matched individually by gender and age to a comparison group. Pre- and post-treatment mandibular central incisor crown lengths and incisor irregularity were measured. In 10 of the 21 anterior crossbite cases, the crown length of the crossbite incisor was more than 1.5 mm greater than that of the noncrossbite incisor. This difference improved with orthodontic treatment by a combination of apical movement of the gingival margin of the noncrossbite incisor (0.9 +/- 0.8 mm) and coronal movement (0.2 +/- 0.6 mm) of the gingival margin of the crossbite incisor. In contrast, for the remaining 11 anterior crossbites without such a crown length difference, and for the comparison cases, the gingival margins of both mandibular central incisors moved equally from pre- to post-treatment by 0.5 +/- 0.5 mm in an apical direction. Pretreatment crown length difference between crossbite and noncrossbite incisor was associated strongly to incisor irregularity (P < or = 0.005, r = 0.65). Orthodontic correction of the crossbite produced an improvement in irregularity index (IR) that was greatest in those anterior crossbite cases with a pretreatment crown length difference.(ABSTRACT TRUNCATED AT 250 WORDS)
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The purpose of this study was to evaluate stability of occlusion in adult cases at least 4 years after orthodontic treatment and to clarify parameters influencing this stability. The subjects were 25 cases (mean age: 19 y 8 m) who had been treated with Edgewise technique involving first-premolar extraction. During orthodontic treatment, decreases in the maxillary and mandibular incisors' irregularity index (Max.I.I. and Mand.I.I.), posterior movement of the upper and lower incisors, increases in upper incisal height, decreases in lower incisal height, and increases in upper and lower canine width were noted. In the posttreatment period, increases in Max.I.I. and Mand.I.I., anterior movement of incisors, increases in incisal height, and decreases in canine width were observed. The amounts of overjet and overbite decreased during the treatment period and increased during the post-treatment period. Multiple regression analysis was useful to deduce which parameters influenced stability of occlusion after orthodontic treatment.
A patient in whom gingival hyperplasia was caused by prolonged use of an anticonvulsant drug (hydantoin) is described. Advanced gingival hyperplasia and significant displacement of the remaining teeth caused severe damage, especially to the patient's appearance. It was not possible to cure the problems completely with routine periodontal treatment. It was decided to extract all the remaining teeth and restore function and esthetics early with complete dentures. Cephalometric analysis was used to determine the degree to which the teeth had drifted. During fabrication of the dentures, the analysis was very useful in deciding the position of the anterior teeth and checking the vertical dimension of occlusion.
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The dental compensation presented in patients with the Class III malocclusion, or mandibular prognathism, and its importance to the surgical-orthodontic treatment, was evaluated in this study. The study involved the cephalometric examination of two groups of patients, who were considered either adequately or inadequately treated during the presurgical orthodontic phase. The results showed that dental compensation is common in both the maxillary and mandibular arches. Such compensation is more frequently eliminated from the mandibular arch during presurgical orthodontic treatment. There was some correlation between decompensation and the amount of mandibular reduction during surgery and a strong correlation between cephalometric postsurgical mandibular excess and the lower anterior facial height.
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.
Mesial migration of teeth in the buccal segments is a well recognised phenomenon in the human dentition. Its aetiology is not fully understood. It has been suggested that it is, to some extent, dependent on growth changes in the lower face. The purpose of this investigation was to examine mesial movement of first molars in the intact lower arch in relation to the amount and direction of facial growth and eruption of teeth. Mesial migration of lower first molars between 13 and 18 years was measured on 60 degrees cephalograms of 22 males and 29 females with intact lower arches. Correlation analyses were used to examine the relation between mesial migration and tooth eruption, growth changes in mandibular length and anterior face height and direction of growth. There was, on average, forward movement of first molars of 2.0-3.0 mm and eruption of 2.0-4.0 mm. No relation was found between forward movement of first molars and their eruption or the amount and direction of facial growth.
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Treatment planning of posterior bite collapse cases with loss of vertical dimension can be complex. In cases where a patient's vertical dimension of occlusion has been lost, there often is drifting of posterior teeth, flaring of maxillary anterior teeth, and inadequate interarch space for a restoration. These factors are further complicated by the esthetic demands of the patient and the dentist and by the use of implants to replace missing teeth. This article presents a case report of a multidisciplinary treatment plan to achieve a functional and esthetic restoration.
Five questions are posed regarding the treatment of a patient with hypodontia. The treatment options are discussed, and the actual treatment carried out demonstrated. The treatment preferences of British Orthodontists, elicited through the CASES project, are also included.
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Lingual arch is a mandibular fixed bilateral space maintaining appliance. It prevents the first permanent molar from drifting forward and preserves the available space, especially the leeway space in mixed dentition cases. The purpose of the present article is to present a simplified way of lingual arch appliance fabrication in the dental office, which will result in effective space maintenance and time savings for both the patient and the dentist.
Dental arch size and form change systematically because of tooth emergence and because teeth migrate into shorter and broader arch forms in the deciduous dentition and again in the permanent dentition. The present longitudinal analysis describes changes in arch form in a cohort of 52 black American children (Nashville, Tenn) between the ages of 3 and 18 years. The anterior (incisor-canine) arch dimensions were analyzed. Incisor-to-canine depth remained static in both arches between 3 and 5 years but shortened significantly between 12 and 18 years. Intercanine width broadened significantly in both arches, first during the deciduous dentition, then again as the primary teeth were supplanted by the permanent incisors and canines. But there was no change in intercanine width once the permanent canines were in functional occlusion (approximately 11-18 years). These changes alter anterior arch form (the ratio depth/width). This index decreased significantly during the deciduous phase as the arches broadened; the index increased from 6 to 10 years as teeth were replaced, then again decreased during the duration of the study (approximately 10-18 years). Dimensions of these black American children all exceed comparable values for white American children, although the anterior shapes are indistinguishable. The present data focus attention on the dynamics of arch form in which considerable, protracted change occurs by physiologic migration, not just during the short phase of tooth replacement.
The skull of a prehistoric, Middle Mississippian, American Indian shows two mesodens that migrated to the distal margin of the palate. These teeth are positioned in such a way as to avoid the most common intraoral forces affecting tooth movement. The resorption of the palatal bone, distal to the teeth indicates movement caused by forces predicted by the Blood Vessel Thrust Theory.