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PubMed2000

Outcome of a scheme for orthodontic care: a comparison of untreated and treated 19-year-olds.

The organization of the orthodontic service within the Public Dental Health Service in the southern part of the county of Halland, Sweden is described, and data for the provision of treatment are presented. The aim of this study was to examine the outcome of this service by studying the prevalence of malocclusion and residual need, as well as attitudes to treatment in previously treated and untreated individuals. Three samples of 19-year-olds were established: patients treated by specialists (n=132), patients treated by general practitioners (GP) (n=132), and untreated individuals (n=492). All samples were examined clinically, and radiographs, photographs, and study casts were obtained from the two treated groups. Attitudes to own teeth and orthodontic treatment were recorded by use of questionnaires. Deviant occlusal traits were recorded, and all the individuals were categorised according to a treatment need index. Generally, good occlusal conditions were observed in all samples. More deviant traits were observed in individuals that had been treated by GPs, and significant differences were observed for overjet, overbite, and crowding compared to the other samples. The majority of individuals belonged to the little/no treatment need index categories. Of those treated by GPs, one third belonged to the moderate (22%) or urgent (11%) need categories. About 10% reported dissatisfaction with their dental appearance, but only 2% expressed a desire for (further) orthodontic treatment.

Adult↗
PubMed2000

Long-term dentofacial stability after bimaxillary surgery in skeletal Class III open bite patients.

The purpose of this study was to evaluate long-term dentofacial stability after bimaxillary surgery in skeletal Class III open bite patients. Twenty-three Japanese adults (5 males, 18 females) were randomly selected as the experimental group from the files of Tohoku University Dental Hospital according to the following criteria: (1) skeletal Class III malocclusion with anterior open bite, (2) simultaneous Le Fort I and sagittal split ramus osteotomies, and (3) complete set of cephalograms taken at predetermined intervals until 5 years after debonding. Based on the manner of maxillary surgical repositioning, they were divided into the following 2 groups: (1) impaction group of 13 subjects (2 males, 11 females) who had maxillary superior repositioning without rotation of the palatal plane, and (2) rotation group of 10 subjects (3 males, 7 females) who had maxillary repositioning with clockwise rotation of the palatal plane. These patients were compared to a control group of 11 adults (1 male, 10 females) with skeletal Class III malocclusion without open bite who underwent bimaxillary surgery by the same techniques. Our data showed that overbite stability in the rotation group was better than that in the impaction group. This suggests that clockwise rotation of the palatal plane, which moves the anterior maxillary structures down, is an effective way to produce a reasonably stable correction of the anterior open bite. In contrast, superior repositioning of the maxilla that significantly rotates the mandible in the closing direction should be applied with caution.

Adolescent↗
PubMed2000

Analysis of the mandibular position in malocclusion patients.

OBJECTIVE: To study the changes of condyle position and occlusion between centric jaw relation (CR) and maximum intercuspation (MI) positions. METHODS: The power centric registration advocated by Roth was used to take centric relation bite registration for 50 patients (25 Angle Class I, and 25 Angle Class II). Diagnostic models were mounted and analyzed with Panadent articulator and condylar position indicator. RESULTS: Nearly all patients had CR-MI difference in all three spatial planes. Seventy percent of the sagittal displacement was within 2.0 mm and 87% of the transverse displacement was within 1.0 mm. Movement of most of the condyles was posterior and inferior. Sixty-five percent of the initial contacts in CR occurred on the most posterior molar on one side. When the mandible moved from CR to MI, overbite deepened, overjet decreased, and molar relationship became mesialized. Correlation was found between some variables of condylar displacement and occlusion changes. No significant difference between Angle Class I and Angle Class II patients was observed in condylar position and occlusion changes. CONCLUSION: The occlusion in centric jaw relation should be analyzed before treatment to reveal the disharmony between occlusion and jaw position.

Adolescent↗
PubMed2000

[Long-term stability of orthodontic treatment].

Aim of this study was to assess long-term stability of orthodontic treatment in a sample of 1016 patients until 10 years postretention. Treatment outcome was measured with the PAR-index at 6 different stages. The mean age of the patients was 12.0 +/- 3.1 year at the start of treatment to 26.3 +/- 2.9 year 10 years postretention. The results show that 67% of the orthodontic treatment result, as measured with the PAR-index, was maintained 10 years postretention. The PAR-scores for the midline and the open bite remained about the same over the years. However, the scores for the lateral occlusion, overjet, reversed overjet, overbite, and contact point displacement of the upper and lower front teeth increased gradually over time. Nearly 50% of the total relapse took place the first two years after retention. The largest change was found for the position of the lower incisors. Ten years postretention their position was even worse than at the start of treatment.

Adolescent↗
PubMed2001

[Stability of orthodontic-maxillofacial surgical treatment of anterior open bite deformities]].

A sample of 267 patients with maxillary hyperplasia, a Class I or Class II occlusion and anterior open bite, collected from three different institutions, was analysed regarding stability after Le Fort I intrusion osteotomies or bimaxillary osteotomies. Skeletal and dento-alveolar stability of the maxilla, postional changes of the mandible and of incisors were evaluated on cephalometric radiographs. The stability of maxillary arch dimensions after correction of the open bite is measured on dental casts. Patients with anterior open bite, treated with a Le Fort I osteotomy in one-piece or in multi-segments, with or without bilateral sagittal split osteotomy exhibited good skeletal stability of the maxilla. Rigid internal fixation showed better maxillary and mandibular stability than intraosseous wire fixation. Considerable relapse of transverse dimensions, however, was measured after orthodontic and surgical expansion. The mean overbite at the 69 months follow-up was 1.24 mm and lacking of overlap between opposing incisors was present in 19%.

Adolescent↗
PubMed2001

Orthodontic treatment of a mildly crowded malocclusion using the Invisalign System.

The 35-year-old male patient was treated at the University of the Pacific, San Francisco U.S.A., as part of an on-going study investigating the feasibility of the Invisalign System of tooth movement. The study called for 40 subjects, 10 with minor, 15 with moderate and 15 with severe tooth deviation. This patient fell into the "moderate" degree-of-difficulty category, due to the position of the maxillary incisors. Treatment time with the initial series of aligners was 14 months. Treatment objectives were met, with the exception of adequate anterior overbite.

Adult↗
PubMed2000

Missing upper lateral incisors: orthodontic considerations in young patients.

Missing lateral incisors are usually discovered by age 9 when general orthodontic treatment needs are becoming apparent. Whether to close, open or maintain a space for a missing lateral incisor is an orthodontic decision that needs to fit within a total plan of dental management. Factors to consider include:- Skeletal base relationship, severity of crowding, overjet, overbite, position into which the canine erupts, crown sizes, crown shapes, crown colours, gingival contours, gingival display on smiling, patient and parent attitude toward options, availability of appropriate prosthetic services, time delay before effecting "final" prosthetic treatment, space and bone required for implant fixtures and financial and biological costs.

Anodontia↗
PubMed2000

[Durability of open bite treatment on the basis of bone density examination and evaluation of clinical status].

The aim of this work was to evaluate the results of open bite treatment with vertical elastic traction and extrusion arches, taking into account bone density and clinical findings. Bone density was assessed on Digora radiographs and on panoramic radiographs before and after treatment. Attention was also focused on side effects. The investigation was carried out in 37 patients (31 women and 6 men) with partial open bite. Patients aged 12-18 years were assigned to group I, older than 18 years to group II. Fixed appliances were attached to the upper and lower arches with vertical elastic traction. 158 radiographs of jaw bones were analyzed with the Digora computer system. Two panoramic radiographs were made in each patient. In addition, 84 Digora radiographs of upper and lower incisors were obtained in randomly selected patients. Successful correction of open bite was achieved in all patients. Mean slit size before treatment in I group was 3.2 mm. Treatment resulted in an overbite of 1.8 mm. Mean duration of treatment was 5.5 months. In group II, mean values before treatment were lower and mean duration of treatment longer. Comparison of radiographs of the incisors obtained before and after treatment revealed only very limited changes in bone structure.

Adolescent↗
PubMed2000

[Treatment of Class II division 1 extraction cases by use of edgewise technique].

OBJECTIVE: To treat class II division 1 extraction cases by means of Edgewise technique. METHODS: 27 skeletal class II division 1 malocclusion patients were extracted 2 upper first premolars and 2 lower second premolars, and treated by Edgewise principles and sequential force system. They aged from 11 to 20. The duration of orthodontic treatment was 25.5 months on average(22-28 months). RESULTS: The patients' profile was much improved; Molar relation changed from class II to class I relationship; Anterior overjet and overbite are normal; Good occlusal intercuspation is also achieved. The ANB angle was significantly changed from 5.6 degrees +/- 2.2 degrees to 3.2 degrees +/- 1.4 degrees; Z angle was altered from 60.8 degrees +/- 5.8 degrees to 76.4 degrees +/- 6.6 degrees; Distance of AO-BO was reduced from 6.8 +/- 2.4 mm to 3.2 +/- 1.1 mm. CONCLUSIONS: Edgewise technique is an effective method for treatment of class II division 1 extraction cases.

Adolescent↗
PubMed2002

A retrospective analysis of 20 surgically corrected bimaxillary protrusion patients.

This paper presents a retrospective review and analysis of 20 bimaxillary protrusion patients who visited the authors' hospital between 1986 and 1998 following surgical correction. The lateral cephalometric radiographs of each patient were taken preoperatively (T0), within 1 week after surgery (T1), and at least 1 postoperative year later (T2). Hard and soft tissue analysis was performed on each cephalometric radiograph. The matched pair t test was employed for T0-T1, T1-T2, and T0-T2 periods. The sample consisted of 20 Korean adult patients with bimaxillary protrusion (18 women and 2 men), aged 21 to 33 years. The first premolars were removed in 18 of the 20 cases. The Wunderer method was selected in 18 of the 20 maxillary cases, and the anterior subapical osteotomy was selected in all mandibular cases. Augmentation genioplasty was combined in 3 cases, and reduction glossoplasty was combined in 2 cases. Orthodontic treatment was accompanied in 8 cases. The statistical analysis of all the variables revealed that, except for overbites, there were significant differences between T1-T2 and between T0-T2 periods (P < .01). This suggests that most of the bimaxillary patients want instant esthetic facial results and that their soft tissue profiles were improved significantly. However, the postoperative course should be cautiously observed.

Adult↗
PubMed1992

[The stability of orthodontic treatment over the long term].

The long term stability of orthodontic treatment was evaluated in 7 orthodontic patients who were three to 12 years out of retention. Dental relationships and irregularities in the dental arch were recorded and scored on study models taken prior to orthodontic treatment, at the end of active treatment, and at long term follow up. Lateral skull radiographs taken at the start of active treatment were also analysed. According to the (mal)occlusion observed on the post-retention study models it appeared that the sample could be subdivided into three groups. The group of patients with relatively good results after active treatment showed less relapse than the group with relatively moderate results after active treatment. The patients with relatively good treatment results were mostly treated with extractions followed by fixed appliances in both jaws. This observation indicates that treatment planning in this group generally was correct. Patients showing skeletal Class II features before orthodontic treatment showed most relapse in overjet and overbite.

Dental Arch↗
PubMed1999

What types of occlusal factors play a role in temporomandibular disorders...? A literature review.

Recent studies and literature reviews of temporomandibular disorders (TMD) do not strongly support the role of occlusal etiologic factors. For this paper we collected and classified studies dealing with occlusion as a contributing factor to TMD through reviews, and discussions of these difficulties and possible solutions. Related articles from 275 papers covering nearly the past twenty years were selected from a prosthetic point of view and reviewed. The validity and reliability of occlusal examinations, however, are questionable since the epidemiological studies dealt with numerous varied subjects. Although occlusal relationships, such as overbite, non-working side interferences, and discrepancy between the intercuspal position and the retruded contact position, have often been considered as contributing factors of TMD, there is no consistency among even those studies that support such an occlusal factor. A project should be initiated to create a revised, precise and practical method to determine the occlusal contact and to categorize an occlusal contact scheme. To detect whether the patients' occlusal scheme works traumatically or not should be an important part of the occlusal examination. That is, the frequency and duration of tooth contact on the occlusal scheme should be studied.

Adolescent↗
PubMed2002

The characteristics of pseudo class III malocclusion in mixed dentition.

OBJECTIVE: To find the dentoskeletal characteristics of pseudo Class III malocclusion in mixed dentition. METHODS: Thirty-six patients (15 females, 21 males with mean age: 10.7 +/- 2.0 years) were included in the pseudo Class III malocclusion group. Forty patients (21 females, 19 males with mean age: 9.7 +/- 2.2 years) with Class III incisor relationship and Class III molar relationship were included in the skeletal Class III malocclusion group. All the subjects were followed up after growth spurt and were diagnosed either as pseudo Class III malocclusion or skeletal Class III malocclusion. Thirty-one patients with Class I malocclusion were included in the Class I malocclusion group. Selection criteria included: 1. skeletal Class I malocclusion with normal overjet and overbite. 2. mild to moderate crowding with Class I molar relationship. 3. straight facial profile. Cephalograms were taken in the mixed dentition for pseudo Class III malocclusion, skeletal Class III malocclusion and Class I malocclusion groups to compare the dentoskeletal characteristics. RESULTS: Females in the pseudo Class III malocclusion group showed more retrusion of "A" point with an average value of -1.63 mm compared with 0.52 mm in the Class I malocclusion group (P < 0.05). The upper incisors in the pseudo Class III malocclusion group were upright. CONCLUSIONS: Pseudo Class III malocclusion is characterized by decreased midface length, mandibular displacement, retroclined upper incisors and normal vertical development.

Adolescent↗
PubMed2002

Maxillonasal dysplasia (Binder syndrome): a lateral cephalometric assessment.

Binder syndrome or maxillonasal dysplasia was first described by Binder in 1962, and is a disorder characterised by nasomaxillary hypoplasia. The records of 33 patients who had been diagnosed clinically with Binder syndrome at the Royal Children's Hospital of Melbourne were examined. Of these 33 patients, 14 were selected because they met the incusion criteria: that they had not had prior surgical and/or orthodontic treatment, and that high-quality lateral cephalometric radiographs were available. The craniofacial morphology of these patients was determined on lateral cephalometric radiographs and compared with published age- and sex-matched norms. In agreement with published studies, the anteroposterior lengths of the anterior cranial base and maxilla were reduced, and the majority of patients had a Class III skeletal relationship. Although the lower incisors tended to be prominent, both overjet and overbite 'ell within the ranges for the normal population. Despite the fact that the orthodontic and surgical treatment for patients with Binder syndrome is normally carried out within specialised units, clinicians should be aware of the variety of ways in which this condition may present.

Adolescent↗
PubMed2002

Temporary tongue thrust: failure during orthodontic treatment.

This report presents the case of a 25-year-old male patient who sought orthodontic treatment. Oral examination revealed an Angle Class I relation, with a bimaxillary dento-alveolar protrusion, evidence of anterior crowding, and a large overbite and overjet. Radiographic examination revealed a skeletal Class I occlusion. During the distal movement of the canines, occlusal interferences between the canines occurred and the commencement of a tongue thrust was observed. After correction of the applied forces, the canine movement was completed and the habit was no longer detectable. The incident indicates that an unusual oral habit suspiciously occurring during treatment should lead to an immediate reconsideration of the orthodontic treatment strategy.

Adult↗
PubMed2003

Cephalometric soft tissue profile analysis between two different ethnic groups: a comparative study.

The aim of this investigation was to study and compare the cephalometric soft tissue profile analysis between Saudis and Caucasian Americans. The study was carried out using standardized cephalometric radiographs of 56 Saudi subjects (30 males and 26 females) with pleasant and balanced facial profiles, competent lips, normal overjet and overbite, and showing no craniofacial deformities. Subject ages ranged from 22 to 23 years. One skeletal and thirteen soft tissue variables were investigated. F-test, two samples t-test, Mann-Whitney, and Wilcoxon tests were used for data analysis. The results showed no statistical significant differences between the Saudi males and females except for the angle of total facial convexity, soft tissue facial plane angle, lower lip length, sagittal nasal tip to the most protrusive lip distance, and also sagittal chin to the most protrusive lip distance. The Saudi females had a greater angle of total facial convexity and soft tissue facial plane angle than the males. In addition, the females had a shorter lower lip. They also had a short distance between the nasal tip and chin to the most protrusive lip. These results reveal significant differences in most of the soft tissue variables when comparing Saudis with Caucasian Americans as well as in other ethnic groups. Most of these variables are essential for the diagnosis and treatment planning of cases requiring orthodontics and orthognathic surgery.

Adult↗
PubMed2003

[Comparison of extraction versus non-extraction orthodontic treatment results--a preliminary study].

OBJECTIVE: The purpose of this study was to make a comparison between extraction and non-extraction orthodontic treatment results concerning teeth alignment, occlusal relation, facial profile and treatment interval. METHODS: 39 extraction-non-extraction borderline cases were selected by 5 orthodontic specialists through reviewing their pre-treatment records. 5 specialists were then asked to rank the results by marking the post-treatment record of each case. And then the samples were divided into different groups according to extraction, non-extraction and extraction pattern by reviewing case history. RESULTS: No statistically significant difference was found in teeth alignment, overbite and overjet, midline symmetry, lateral occlusal relation and treatment intervals. However, the post-treatment facial profile of extraction groups obtained higher marks from 5 specialists (P = 0.001). CONCLUSION: While both extraction and non-extraction treatment can achieve comparable results in teeth alignment and occlusal relation with equivalent time interval in borderline cases, extraction treatment, whatever extraction of four first premolars or second premolars is performed, can achieve better facial profile.

Child↗
PubMed1992

[Straight wire appliance in orthodontic practice].

This paper is a preliminary report of using Straight Wire Appliance (SWA) in orthodontic practice in our school since 1989. Thirty finished cases including malocclusion, extraction mode, treatment sequence and time and the outcome, of treatment were analysed. Discussion of the problems concerning arch wire and correction of deep overbite was made. The authors confirm that SWA is a simple and effective type of appliance and it is easily to popularize in orthodontic practice in our country.

Adolescent↗