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PubMed2006

Dentofacial characteristics of Chinese obstructive sleep apnea patients in relation to obesity and severity.

OBJECTIVE: To evaluate dentofacial characteristics in relation to obesity and degree of severity of obstructive sleep apnea (OSA) in male Chinese patients and to elucidate the relationship between demographic parameters (age, body weight, height, and body mass index [BMI]) cephalometric parameters and OSA in these subjects. MATERIALS AND METHODS: Lateral cephalograms of 121 Chinese male patients in natural head posture were obtained. Based on BMI value, the patients were divided into three groups. Based on apnea-hypopnea index (AHI) value, the patients were divided into a mild-to-moderate and a severe group. RESULTS: The hyoid position and soft palate length were significantly different among the three obesity groups. Soft palate length was significantly longer (P < .01) in the severe OSA group than in the mild-to-moderate OSA group. Tongue base was significantly more inferiorly placed (P < .05) in the severe OSA group than in the mild-to-moderate OSA group. Craniocervical extension was significantly increased (P < .05) in the severe OSA group. Statistically significant differences were found among the three obesity groups in mandibular length, mandibular body length, maxillary length, anterior cranial base length, and overbite. The multiple stepwise linear regression analysis identified body weight, lower posterior facial height, mandibular body length, craniocervical extension, and sella-hyoid distance as the significant predictive variables for AHI. CONCLUSIONS: This study revealed the existence of craniofacial and upper airway soft tissue differences in relation to obesity and severity of OSA among male Chinese OSA patients. Body weight and certain cephalometric parameters were significant predictors of OSA in Chinese male subjects.

Adult↗
PubMed2006

Lip-to-incisor relationship and postorthodontic long-term stability of cover-bite treatment.

OBJECTIVE: To investigate the impact of a persisting high lip line and other potential relapse-inducing factors on long-term stability of orthodontic correction of retroinclined maxillary central incisors. MATERIALS AND METHODS: Thirty-one cover-bite ("Deckbiss") patients with retroinclined maxillary central incisors and a deep frontal overbite were evaluated. The maxillary central incisor inclination was determined odontometrically with study models made pretreatment, posttreatment, and at a follow-up examination (mean posttherapeutic interval: 9.0 years). The lip-to-incisor relationship, the interincisal angle, and the anteroposterior maxillary central incisor position were measured on lateral cephalograms taken after active treatment. RESULTS: The relapse tendency of the orthodontic correction of the retroinclined maxillary central incisors displayed great interindividual variability with a range of posttherapeutic inclination change of -6.75 degrees to +8.00 degrees. Multiple regression analysis revealed an increased tendency for relapse in patients with (1) a high posttherapeutic (dorsal) lip line level combined with the maxillary central incisor and lower lip contact only in the incisal crown area (P < .01) and (2) a marked therapeutically induced inclination change of the maxillary central incisors (P < .05). Interrelations between the relapse of the corrected maxillary central incisors and other evaluated parameters were not statistically significant. CONCLUSIONS: For maximum treatment stability, the elimination of an excessive overlap of the upper incisors by the lower lip should be regarded as one of the most important therapeutic objectives when treating this malocclusion.

Adolescent↗
PubMed1994

A case of open bite accompanied by temporomandibular joint disorder. A comparison of occlusal conditions before and after treatment in lateral-oblique radiogram.

According to the authors' clinical experience, malocclusion accompanied by temporomandibular joint disorder involves mainly cross bite, open bite, deep overbite or axillary protrusion. However, it is possible that the symptoms of this disorder are associated with other types of malocclusion or even with nearly normal occlusion. In fact, it can be said that temporomandibular joint disorder may develop with any type of occlusion. This paper reports a case of open bite accompanied by temporomandibular joint disorder occurring in a patient who visited our hospital because of pain in the left temporomandibular joint region, vertigo and partial deafness. In this patient, the temporomandibular symptoms disappeared after orthodontic treatment. The patient received no particular treatment thereafter because follow-up observation confirmed that the therapeutic results were favorable without any relapse of the symptoms of temporomandibular disorder. The positions of the temporomandibular joint and mandibular condyle were determined in lateral-oblique radiograms obtained using our radiographic system, by which the mandibular condyle is radiographed using a projection consistent with its long axis.

Adult↗
PubMed1996

Lip form responses to changes in maxillary incisor position.

A study was conducted to assess the measurement accuracy of a laser three-dimensional measurement system for measuring facial profile and to investigate the changes in lower facial morphology caused by experimental protrusion of the upper incisors, and also to examine the relationship between the changes in lip form and lip thickness. The study subjects were 24 Japanese male dental students attending Nihon University School of Dentistry at Matsudo, who had normal overbite, overjet, and normal occlusion, and a good facial profile. The mean age was 23.2 years with a range of 21.5 to 25.8 years. Three-dimensional measurements obtained by a computerized 3D laser scanning system were used to evaluate facial morphology. The measurement error of this system was less than 0.5 mm in any three-dimensional linear measurements. The stability and reproducibility of the recording procedure were evaluated. The changes in facial morphology caused by orthodontic treatment and orthognathic surgery were visualized in any direction by this three-dimensional graphic system. Lip thickness was not associated with changes in lip form. However, a relationship between the right and left corners of lip and lip thickness was noted. With regard to the ratio of changes in hard tissue and lips, the value of the original position for a 4 mm protrusion was not the same as that for a 4-8 mm protrusion. Also, the correlation of the changes in both groups was very low. The changes in lip thickness were associated with changes in stomion position, which in turn were related to the vertical change in the upper lip.

Adult↗
PubMed2000

Discriminant validity of temporomandibular joint range of motion measurements obtained with a ruler.

STUDY DESIGN: Prospective, descriptive study. OBJECTIVE: To determine the discriminant validity and intrarater and interrater reliability of measurements of temporomandibular joint (TMJ) range of motion (ROM). BACKGROUND: Although ROM measurements are a routine part of the examination of patients with TMJ disorders, few studies have examined the validity of these measures for identifying pathology of the TMJ. METHODS AND MEASURES: Two groups of subjects were tested: 15 subjects (2 men, 13 women; mean age = 35.2 years) with a TMJ disorder and 15 subjects (3 men, 12 women; mean age = 42.9 years) without a TMJ disorder. Six motions were measured (opening, left excursion, right excursion, protrusion, overbite, and overjet) by 2 therapists. RESULTS: Mouth opening was the only TMJ ROM measurement to discriminate between subjects with and without TMJ disorders (mean 36.2 +/- 6.4 versus 43.5 +/- 6.1 mm). The technical error of measurement of the measures varied from .2 to 2.5 mm. Intrarater reliability coefficients (ICC 3,1) varied from .70 to .99. Interrater reliability coefficients (ICC 2,k) varied from .90 to 1.0. CONCLUSIONS: Although all TMJ ROM measurements tended to be reliable, only mouth opening was found to be valid in discriminating between patients with and without a TMJ disorder.

Adult↗
PubMed1987

Relationship between disorder in the stomatognathic system and general joint involvement in individuals with rheumatoid arthritis.

Seventy-one individuals with rheumatoid arthritis (RA) were examined and compared with 52 individuals without history or symptoms of joint disease (C group) with regard to disorders of the stomatognathic system. Laboratory findings and articular and functional rheumatologic indices were compared. The clinical dysfunction index of Helkimo for the stomatognathic system was positively correlated to both the articular Ritchie index and the functional Lee index. The concentration of C-reactive protein (CRP) and the Ritchie index were positively correlated to temporomandibular joint (TMJ) pain. Vertical overbite was negatively correlated to the Ritchie index. In addition, there were positive correlations among TMJ crepitus, anterior open bite, sagittal distance between retruded position and intercuspal position, and erythrocyte sedimentation rate (ESR). The concentration of CRP, the ESR, and the Ritchie and Lee indices were highest in the individuals with bilateral current TMJ symptoms and lowest in those with previous but not current TMJ symptoms. It was concluded that the severity of TMJ involvement in RA is correlated to concentration of serum acute-phase reactants and to rheumatologic indices.

Arthritis, Rheumatoid↗
PubMed1987

Clinical findings in the stomatognathic system for individuals with rheumatoid arthritis and osteoarthrosis.

A group of 123 individuals with rheumatoid arthritis (RA group) and 28 individuals with osteoarthrosis (OA group) were compared with 52 individuals without general joint symptoms (C group). The individuals in the RA and OA groups constituted 35% and 14%, respectively, of all individuals with RA and OA at the Rheumatism Hospital in Strängnäs, Sweden, during the period of investigation. All individuals answered a questionnaire concerning subjective symptoms from the stomatognathic system and general joint symptoms and were given a clinical examination comprising the temporomandibular joint (TMJ), masticatory muscles, mandibular mobility, and occlusion. Most signs of disorder in the stomatognathic system were more frequent and more severe in the RA and OA groups than in the C group. The clinical signs were of a similar character in the RA and OA groups, but the individuals in the RA and OA groups had less occlusal support, more occlusal interferences, greater distance between RP and IP, and less vertical overbite than the C group. Anterior open bite was found with higher frequency and severity in the RA and OA groups than in the C group and was correlated to clinical dysfunction score and reduced maximum mouth opening capacity.

Adult↗
PubMed1989

Individual changes in malocclusion from adolescence to 35 years of age.

It was the aim of this follow-up study to assess the extent of individual changes in the occurrence of specific pronounced traits of malocclusion in a sample of 176 subjects who were selected from a catchment population examined in adolescence in 1965-66 and who were re-examined in 1986-87 (mean age, 35.5 years). Orthodontic treatment had been received by 10% of the subjects, and extraction rates were low. Deep overbite and mandibular crowding, especially in the incisor segment, tended to increase in frequency. However, on the whole, the various malocclusion traits remained remarkably stable in the orthodontically untreated individuals.

Adolescent↗
PubMed1983

Early bone grafting in complete cleft lip and palate cases following maxillofacial orthopedics. III. A study of the dental occlusion.

The dental occlusion of children born with complete cleft lip and palate was studied in deciduous and mixed dentition. The children were divided in two unilateral groups: one group of 39 children operated on between 1960-1965 without preoperative orthopedics and another group of 46 children operated on between 1965-1972 after preoperative orthopedics ("T-traction"). One group of 19 children with bilateral clefts operated on 1960-1972 after premaxillary retropositioning pressure, if necessary combined with outward rotation of the lateral maxillary segments was also studied. All children were bone grafted with the "four flap" technique. Comparisons were made with cleft children bone grafted with a different surgical method, with non-grafted U.S. cleft children, with cleft children operated on with infant periosteoplasty and with nonclefts. Crossbites were more frequent in clefts bone grafted with a different surgical method. The results of this study corresponded more to those operated on with infant periosteoplasty or to the non-grafted cases. However, all cleft groups differed significantly from nonclefts with a reduced overjet and overbite and narrower and shorter upper dental arches.

Bone Transplantation↗
PubMed2002

[Dental malocclusion among juveniles in Hangzhou municipality]

OBJECTIVE: To investigate the prevalence rate, malocclusion type and treatment rate as well as awareness of malocclusion among children and adolescents living in the Hangzhou municipality. METHODS: 1818 children and adolescents ages 7 approximate, equals 16 living in Hangzhou municipality were evaluated. RESULTS: The overall malocclusion rate was 35.75%. In Angle's classification: Angle I 593 cases (32.62%), Angle II 48 cases(2.64%),Angle III 9 cases (0.49%). Among the malocclusion type of crowding was mixed dentition 70.66%,permanent dentition 85.89%. In the overjet malocclusion mixed dentition was noted in 60.57% and permanent dentition in 51.05%.The type of overbite was mixed dentition 67.82%,permanent dentition 31.23%. In the crossbite of anterior teeth mixed dention was noted in 12.30% and permanent dention in 9.91%. Overall treatment rate for malocclusion was 10.15%.CONCLUSION: Among Hangzhou municipality juveniles there is both inadequate prevention and treatment of dental malocclusion.

Journal Article↗
PubMed2000

[A long-term follow-up case of multiple impacted teeth associated with large follicular cyst in maxilla].

Longitudinal record of a case of multiple impacted teeth associated with large follicular cyst in the right maxilla was presented. The patient was an 8-year-10-month-old girl whose chief complaint was delayed eruption of the right upper incisor. Clinical examination revealed a large follicular cyst in the right maxillary sinus, which greatly displaced teeth germs. Marsupialization followed by orthodontic extrusion successfully brought unerupted teeth into their positions. Greatly displaced upper right canine, which was as high as the floor of the orbit, erupted spontaneously after reduction of the lesion. During the subsequent years, the patient developed crowded dentition and reduced overbite, which needed additional orthodontic treatment with extraction of premolars. The patient was 26-years 8-months old upon completion of treatment. The surgical, orthodontic, and periodontological aspects of the case were reexamined. Marsupialization of dentigerous cysts can preserve impacted teeth, however, the outcome might be affected by several factors such as overall growth of facial bones.

Adult↗
PubMed2002

The spectral analysis of syllables in patients using dentures.

Changes in the oral cavity resulting from the loss of teeth and the ensuing reconstruction of a set of teeth by dentures (partial or complete) may cause changes in the speech and voice of the patient. The aim of the present investigation was to study the changes in speech and voice in patients suffering from teeth loss and the degree of speech improvement using dentures. Voice and speech parameters of a set of tested syllables were analysed in 10 patients at the 2nd Clinic of Stomatology. The analysis was carried out by means of an FFT, SoundForge 5.0 programme. Differently expressed acoustic changes in both consonants and vowels were ascertained in a percentage of the patients under examination. These concerned especially the sibilant ("s", "(see text)"), labiodental ("f", "v") and vibrating ("r", "(see text)") consonants. Changes in the FFT spectrum and air leakage in constrictive consonants were also found. In some patients the vowels, especially the closed ones ("i", "u"), may change their fundamental frequency and show noise admixture manifested as a blurred delimitation of the formants. A denture should, inter alia, render it possible for the patient to produce the same articulation to which he/she had been accustomed before the loss of teeth. For the construction of dentures the most important factors from a phonetic point of view appear to be the following: overbite, overjet, the height of the plate, the thickness of the palatal material, the incisor position, and the modelling of the ruga palatina on the hard palate. In case of wrong denture construction the acoustic changes may continue, resulting in the patient's stress load dependent upon sex, age, psychic condition and seriousness of the problem.

Aged↗
PubMed2006

The prevalence of temporomandibular disorders in war veterans with post-traumatic stress disorder.

The purposes of this study were to assess the prevalence of temporomandibular disorders in Croatian war veterans suffering from post-traumatic stress disorder (PTSD) and to analyze the impact of the disease on mandibular function. One hundred eighty-two male subjects participated in the study. The examined group consisted of 94 subjects who had taken part in the war in Croatia and for whom PTSD had previously been diagnosed. Patients were compared with an age- and gender-matched group of subjects who had not taken part in the war and for whom PTSD was excluded by means of a psychiatric examination. The study used a clinical examination and standard questionnaire. Statistically significant differences were found in almost all measured parameters. With regard to restricted movements, overbite, and overjet, the differences obtained did not have clinical significance. The most significant differences were found in the parameters of pain. Headache was experienced by 63.83% of the subjects with PTSD, facial pain by 12.77%, and pain in the region of the jaw by 10.64%. Headache was the most intense pain, with an average intensity of 4.92 on a scale of 0 to 10. Pain on loading, temporomandibular joint clicking, and intrameatal tenderness were more prevalent in the PTSD group than in the healthy control group. The study supports the concept that PTSD patients are at increased risk for the development of temporomandibular disorder symptoms.

Adult↗
PubMedDate not supplied

Genetic and epidemiologic studies of oral characteristics in Hawaii's schoolchildren: V. Sibling correlations in occlusion traits.

Sibling correlations with adjustment for age, sex, and other covariates showed the highest degree of similarity in incisor width, followed by malalignment, overjet, overbite, crowding, spacing, and crossbites. The smallest intrafamily correlations were observed in the variables in buccal segment relationship, especially in neutroclusion and idealized occlusion pattern.

Adolescent↗
PubMedDate not supplied

Craniofacial features associated with amelogenesis imperfecta.

Craniofacial alterations occur with increased frequency in patients with amelogenesis imperfecta (AI). The purpose of this study was to characterize the craniofacial features associated with AI in families from the US. Twenty-seven people with AI and 14 unaffected family members from nine separate kindreds were evaluated. The diagnosis was established by history, clinical, and radiographic examination, and histological and or biochemical analysis of enamel. The kindreds were generally classified as hypoplastic AI (HPAI), hypocalcified AI (HCAI), or hypomaturation AI (HMAI) and then further subclassified based on phenotype and mode of inheritance. Linear and angular cephalometric measures were converted to z-scores using gender/age matched values from the Bolton and Behrent's standards. Statistical analyses included t-tests and ANOVA accepting P < or = 0.05 as significant. The vertical dimension of the lower face was significantly increased (ANSMe; P = 0.001), especially in affected individuals compared with unaffected relatives, in all kindreds with HCAI and HMAI but in only one kindred with autosomal recessive rough AI. Clinically, an anterior open bite (overbite < 0 mm) was observed in 26% of all dentate individuals with AI and none of their unaffected relatives. Skeletal morphology was highly variable depending on the AI type and kindred. While this study shows an association of altered craniofacial morphology with certain AI kindreds, the relationship of the AI genotype to the observed malocclusions remains to be defined.

Adolescent↗
PubMed1975

[Quantitative study on the effects of occlusal overload on the remodelling of the alveolar process in the rat].

A quantitative study of alveolar bone resorption around the first lower rat molar has been conducted on horizontal sections. The number of osteoclasts/mm2 and the percentage of resorbing periodontal membrane surface of the socket rose through an increase in occlusal forces induced by an amalgam filling in slight occlusal overbite. The increase in resorption was significantly related to the duration of force application. The number of osteoclasts was more than tripled after 18 days. But this increase was observed in areas already previously submitted to osteoclastic resorption during bone remodeling associated with physiological tooth drift.

Alveolar Process↗
PubMed2000

Evaluation of the vertical holding appliance in treatment of high-angle patients.

Controlling the vertical dimension of high-angle patients without the benefit of compliance can be a challenging aspect of orthodontic treatment. This retrospective study examines the skeletal and dental effects of a modified transpalatal bar, dubbed the vertical holding appliance (VHA), which was used in an attempt to control the vertical dimension of high-angle patients. Two cephalometrically similar groups of high-angle patients (16 patients each) were compared to determine advantages from using the VHA. Group I (n = 16, pretreatment age 13.4 +/- 1.6 years) was treated with 4 premolar extractions in conjunction with the VHA cemented in place for 17.4 +/- 6.1 months. Group II (n = 16, pretreatment age 13.4 +/- 1.9 years), which was matched for age and pretreatment skeletal pattern, was treated with the Tweed technique and 4 premolar extractions. Lateral cephalometric radiographs were taken before the placement of the VHA, as well as at the end of treatment. The results showed that although y-axis increased significantly in group II (P <.05), it remained the same in group I. Within group I, the Frankfort mandibular plane angle and gonion gnathion/sella nasion angle decreased, whereas both of these values increased in group II. However, these changes were statistically insignificant. Lower anterior face height increased more in group II than in group I (P <. 05). The percentage of lower anterior face height to total anterior face height decreased in group I, whereas it increased in group II. The difference between the 2 groups was determined to be significant (P <.01). Eruption of the maxillary first molar within group I was less than in group II. No significant differences were found between groups I and II for changes in overbite.

Adolescent↗
PubMed1999

Aberrant eruption and its relationship to crowding: the need for early detection and management.

A modular, fixed-functional method has been described using a new generation of appliances that are smaller, more comfortable and more patient friendly, while gaining the advantages of a combined fixed-functional and postural therapy. The case has been made for the middle mixed dentition as the optimal starting time. Crowding, overbite and molar rotation are managed simply with a combined use of flexible lip bumpers, bite plane and sequential primary tooth extraction. In conclusion, Phase I Postural Therapy will be shown to have the following advantages: more biologically and patient friendly more conducive to non-extraction more efficient and cost effective simple fabrication and reduced chair time reduced Phase II fixed appliance time, and completion at a younger age.

Child↗