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At least 865 records · Page 48Linked to original sources
PubMed2001

[The influences of the stress distribution on the condylar cartilage surface by Herbst appliance under various bite reconstruction--a three dimensional finite element analysis].

OBJECTIVE: The distribution of stress on the surface of condylar cartilage was investigated. METHODS: Three-dimensional model of the 'Temporomandibular joint mandible Herbst appliance system' was set up by SUPER SAP software (version 9.3). On this model, various bite reconstruction was simulated according to specified advanced displacement and vertical bite opening. The distribution of maximum and minimum principal stress on the surface of condylar cartilage were computerized and analyzed. RESULTS: When Herbst appliance drove the mandible forward, the anterior condyle surface was compressed while the posterior surface was drawn. The trend of stress on the same point on the condyle surface was consistent in various reconstruction conditions, but the trend of stress on various point were different in same reconstruction conditions. CONCLUSION: All five groups of bite reconstruction (3-7 mm advancement, 4-2 mm vertical bite opening of the mandible) designed by this study can be selected in clinic according to the patient's capability of adaptation, the extent of malocclusion and the potential and direction of growth.

Cartilage, Articular↗
PubMed1977

Sagittal osteotomy of the mandibular horizontal ramus for correction of apertognathia: report of case.

A case of anterior skeletal open bite was successfully treated with a sagittal osteotomy of the mandibular horizontal ramus. Advantages of this technique are good access and ease of surgery, broad medullary contact at osteotomy sites, and elimination of the need for a bone graft. Close cooperation between speech pathologist and surgeon is essential when apertognathia is acquired by tongue-thrust or abnormal oral habits. Removal of causal factors and adequate immobilization will reduce the chance for relapse often seen in open bite surgery.

Adult↗
PubMed1988

Surgical correction of hemifacial microsomia in the growing child.

This is a follow-up study of 20 children who had surgical correction of hemifacial microsomia in an effort to improve facial growth and minimize secondary distortion. In group 1 (skeletal types I and IIA), 10 children underwent elongation and lengthening of the mandible. In group 2 (skeletal types IIB and III), 10 children had total construction of a new temporomandibular joint and mandibular ramus with rib grafts and costochondral junction. In both groups, an open bite was created on the affected side to provide space for tooth eruption and downward growth of the middle face. The mean follow-up was 50.9 months (18 to 117 months) in group 1 and 45 months (18 to 50 months) in group 2. Analysis of our early results showed that all patients have had downward growth of the midface on the affected side. All five patients in group 1, followed to complete closure of the surgically created open bite, have maintained a level occlusal plane. In group 2, the one patient followed to completion of facial growth continues to have a level occlusal plane and facial symmetry. Appropriately timed mandibular construction and/or elongation in children with hemifacial microsomia is safe and effective. There is a decrease in secondary deformity on the affected side, and the eventual overall facial growth is optimized. Some group 2 children will need secondary elongation and augmentation of the mandible. Nevertheless, this study demonstrates that early mandibular correction may obviate the need for maxillary and orbital procedures in adulthood.

Bone Transplantation↗
PubMedDate not supplied

Damage to the primary dentition resulting from thumb and finger (digit) sucking.

It is estimated that approximately 50 percent of infants at one year of age suck a thumb or finger. The number decreases rapidly by ages four to five years. The average age for spontaneous cessation of the habit is 3.8 years of age. Anterior open bite is the most frequent malocclusion reported with digit sucking. In this study the authors investigated the influence of thumb and finger-sucking in the anterior and posterior sections of the primary dentition in three age-groups: three, four, and five years. The study population included 930 subjects. Data for the non-oral-habit group were compared with the data for the thumb and/ or finger-sucking group. At all ages the frequencies of open-bite and maxillary protrusion for the thumb and finger-sucking group were higher than the non-oral-habit group. The frequencies did not appear age-related. There appeared to be an increased tendency to a permanent malocclusion in children who continued after four years of age.

Case-Control Studies↗
PubMed1982

Orthodontic force systems: technical refinements for increased efficiency.

The efficiency of the Begg technique suffers because Class II elastics overwhelm anchor bends, which normally do not yield enough force for vertical control of maxillary incisors. This can be improved by attention to detail and modifications. Bite-opening bends in the arch wires distal to canines and lateral incisors, long (6.5 mm.) mesiogingivally angulated molar tubes, and placement of intermaxillary elastics at the distal ends of the tubes are all helpful. Intermaxillary "check elastics," having one end over the posterior end of the maxillary arch wire, both strands under the end of the mandibular arch wire, and the other end up to the maxillary anterior teeth, reinforce anchor bends and extrude upper and lower molars while keeping them upright. They augment bite opening in Stage I and counteract the adverse affects of the auxiliaries in Stage III.

Biomechanical Phenomena↗
PubMed2003

Craniofacial morphology in a patient with Simpson-Golabi-Behmel syndrome.

OBJECTIVE: We present the case of a 6-year-old boy with a coarse face, cleft palate, and malocclusion with anterior open bite who had been diagnosed with Simpson-Golabi-Behmel syndrome. Morphology of the craniofacial structures was examined on the basis of conventional radiographs, three-dimensional (3D) computed tomography (CT) and magnetic resonance (MR) scanning. PATIENT: This patient had 13 ribs on the right side, slight scoliosis, supernumerary nipples, a coarse face, hypertelorism, a short broad upturned nose, a wide mouth, a straight facial profile with incompetence of the lips, midline groove of tongue, and cleft palate. The patient also had severe anterior open bite, a distal step-type molar relationship, five congenitally missing teeth, and a supernumerary tooth. Lateral cephalometric analysis revealed a large anterior cranial base, a large maxilla and mandible, a large inferior face height, and skeletal Class I jaw relationship with a high mandibular plane angle and large gonial angle. The 3D CT image showed a large cranium, a long face height, and prominent skull sutures. The MR image showed a large tongue, midline groove of the tongue, and a small space between tongue and palate.

Abnormalities, Multiple↗
PubMed1991

[Mioconverter].

Mioconverter is a new appliance created by author used in the treatment of open bite. It is consisted of two free plates connected by added joint (similar to connection in the TMJ) Plates have lateral bite blocks, anchorage elements in the frontal region and a joint at the back. Joints are originally created by the author as an imitation of TMJ and mandibular ramus. The appliance converts muscle strength in the way of extruding frontal teeth, intruding molars, and rotating the upper and lower jaw. Finally, mioconverter reduces vertical skeletal discrepancy. The leaning plate is under the occlusal level. Therefore, mioconverter utilizes all types of forces used in the lower jaw movements. Results of treatment of a case with an open bite are illustrated.

Activator Appliances↗
PubMedDate not supplied

North American Burkitt's lymphoma presenting with intraoral symptoms.

A case is presented in which posterior tooth mobility and pain, bilateral intraoral swelling of the mandible, and anterior open bite following an incident of facial trauma were the presenting symptoms of a 4-year-old, white American male with Burkitt-type malignant lymphoma. Radiographic examination revealed multiple osteolytic lesions in the body of the mandible, with loss of osseous trabecular architecture, and generalized loss of lamina dura in both maxillary and mandibular arches. The patient also had bone marrow involvement at the time of diagnosis. Following the initial course of chemotherapy, the patient experienced a significant resolution of the bilateral mandibular swelling, anterior open bite, tooth mobility, and dental pain. Relapse occurred shortly after remission was achieved, with tumor metastasis to the central nervous system and testes. The tumor remained resistant to further chemotherapeutic treatments and radiation strategems. Because of renal and metabolic complications, Burkitt's lymphoma constitutes an oncologic emergency. If untreated, this rapidly growing tumor is fatal. Early interception and referral of these cases by the examining dentist is crucial.

Burkitt Lymphoma↗
PubMed1993

A multiple logistic regression analysis of the risk and relative odds of temporomandibular disorders as a function of common occlusal features.

A multiple logistic regression analysis was used to compute the odds ratios for 11 common occlusal features for asymptomatic controls (n = 147) vs. five temporomandibular disorder groups: Disc Displacement with Reduction (n = 81), Disc Displacement without Reduction (n = 48), Osteoarthrosis with Disc Displacement History (n = 75), Primary Osteoarthrosis (n = 85), and Myalgia Only (n = 124). Features that did not contribute included: retruded contact position (RCP) to intercuspal position (ICP) occlusal slides < or = 2 mm, slide asymmetry, unilateral RCP contacts, deep overbite, minimal overjet, dental midline discrepancies, < or = 4 missing teeth, and maxillo-mandibular first molar relationship or cross-arch asymmetry. Groupings of a minimum of two to at most five occlusal variables contributed to the TMD patient groups. Significant increases in risk occurred selectively with anterior open bite (p < 0.01), unilateral maxillary lingual crossbite (p < 0.05 to p < 0.01), overjets > 6-7 mm (p < 0.05 to p < 0.01), > or > 5-6 missing posterior teeth (p < 0.05 to p < 0.01), and RCP-ICP slides > 2 mm (p < 0.05 to p < 0.01). While the contribution of occlusion to the disease groups was not zero, most of the variation in each disease population was not explained by occlusal parameters. Thus, occlusion cannot be considered the unique or dominant factor in defining TMD populations. Certain features such as anterior open bite in osteoarthrosis patients were considered to be a consequence of rather than etiological factors for the disorder.

Age Factors↗
PubMed1999

Articular compass: the location of frontal accessories of bioelastic appliances.

In long face syndrome with skeletal open bite, strongly associated with temporomandibular disorders (TMDs), the trajectories of an incisal point are completely different. It was demonstrated by a longitudinal study that, in these cases, the Articular Compass cephalometric analysis is helpful in the construction of bioelastic appliances to provide a better location for frontal accessories, and thereby in most cases, also provide better anchorage with proper tongue and mandible position. The Articular Compass Analysis is valid in the early diagnosis. The odds ratio of success using the Articular Compass Analysis presents a confidence rate of 95%. Moreover, it was detected that subjects by the age of six with open bite, gonial angle equal to or greater than 135 degrees, with Nasion-Gonion-Menton equal to or greater than 76 degrees are risky cases for surgical treatment. These parameters are an indication of progressive problems which, with time, can reach severe levels which involve the cervical or even the lumbar spine.

Cephalometry↗
PubMed2005

Preventive and interceptive orthodontic treatment needs of an inner-city group of 6- and 9-year-old Canadian children.

OBJECTIVE: Early recognition of developing malocclusions and the potential for uncomplicated orthodontic treatment procedures can minimize or eliminate future costly treatment. This study was designed to assess the potential for this approach in children living in a limited-income environment. A modified index for preventive and interceptive orthodontic needs (IPION) was used to determine the need for such treatment in schoolchildren aged 6 and 9 years. METHODS: Two calibrated examiners examined each child independently and assessed several components of his or her occlusion, including molar relationship, crossbite, open bite, overbite and overjet. Dental variables such as presence of caries and early loss of teeth were also noted. Informed consent was obtained and all children present at school on the day of the field study were included. A total of 395 children were divided into 2 groups, aged 6 and 9 years. RESULTS: A high prevalence of caries in the deciduous dentition (30.4% for 6 year olds; 20.6% for 9 year olds) and early loss of primary teeth (11.9% for 6 year olds; 29.4% for 9 year olds) was observed. A large percentage of children had crossbite in the anterior or posterior segments, or both. Open bites were also a common finding. Future orthodontic problems were identified in 28% of this population by using the modified IPION. No statistically significant differences (p > 0.05) were found between sexes or age groups using the chi2 test. CONCLUSIONS: Most of the developing malocclusions identified in this study would be amenable to interceptive orthodontics, consisting of space maintenance, crossbite correction and arch expansion.

Child↗
PubMed1997

The effectiveness of orofacial myofunctional therapy in improving dental occlusion.

The most significant findings of this study definitively establish the beneficial effects of orofacial myofunctional therapy on improving dental occlusion, decreasing dental open bite, and decreasing dental overjet. The results reported are actually quite conservative because of the method of measuring. Measuring and recording every tooth unquestionably dilutes the results which would have been achieved if only the anterior teeth had been used in the calculations. Some may question the small millimeter change as being significant. The change is reflective of the overall relative value change of incorporating all teeth within the dental arches and not limiting the analysis to only the anterior teeth. The secondary findings of the study confirm that age is not necessarily a factor in predicting success of a therapy program. Further, this study indicates that improvement of open bite and overjet can result from OMT without prior or concurrent orthodontic intervention. Orofacial myofunctional therapy, from a public health standpoint, is a classic form of primary prevention to improve the overall health and well-being of the individual. The end result of OMT therapeutic programs is the establishment of new neuromuscular patterns, correction of functional and resting postures, correction of chewing/swallowing/feeding patterns and elimination of deleterious behaviors. Stabilization and maintenance of therapeutic goals become part of the lifelong learning and change process. Orofacial myofunctional therapy utilizes knowledge and skills acquired through multidisciplinary education and training. Licensed professionals, from dental hygiene, dentistry, speech pathology, medicine, nursing, and other allied health professions with advanced education and training in orofacial myofunctional therapy have demonstrated expertise in providing collaborative, integrated, and interdisciplinary primary care. Reference to earlier research works and anecdotal reports of ineffectiveness unfortunately perpetuate and reinforce the dichotomous quandary of form and function. Instead, recognition of the interrelationship of form and function, as conjoint fundamental processes, would encourage more pro-active patient referrals for orofacial myofunctional therapy services. This would allow the specialty area of orofacial myology to further validate the effectiveness of OMT on tooth movement in a positive, collaborative, and beneficial manner. Acknowledging the small sample size in this study may encourage other clinicians to conduct future research in this area. Additional research is needed on the physiologic adaptive capacity of the orofacial environment. Developmental aspects of orofacial and jaw neurophysiology, especially in children, are scant in the literature. Treatment recommendations for specific dental malocclusions are based on many factors. Each malocclusion classification presents opportunity for OMT research. A major research dilemma for the practicing clinician is the moral and ethical responsibility of providing treatment when dysfunction is diagnosed. Designing a study and identifying a "control group" is difficult due to the unethical aspect of knowingly withholding therapy when the benefits are statistically proven and available. A study design using the sample as its own control can infer and demonstrate validity. The next logical test is replication of this study to determine the level of reliability. This issue of the I.J.O.M. addresses the effectiveness of orofacial myology treatment in improving speech articulation, eliminating digit sucking, and improving dental occlusion. It is time the professions of dental hygiene, dentistry, medicine, and speech pathology move forward and acknowledge current substantive research and literature that supports the philosophies of prevention, early interception (intervention), and corrective treatment. The dark ages of disbelief only remain dark as long as we forget to turn on the light. (ABSTRACT TRU

Adolescent↗
PubMed1976

Measurement of tooth movement.

1. Tooth movement relative to the alveolar bone can be precisely described only by superimposing on fixed points in the bone. Implants are the best known way today. Over short-term studies laminagraphy and the use of bony trabeculations are also useful. Remodeling occurs extensively on bony surfaces, making them too labile for use as stable landmarks. To project small amounts of tooth movement based on the use of such methods is so questionable as to represent little better than a guess or a clinical impression. 2. Growth can be separated into vertical and anteroposterior vectors with respect to the dentition. Since the occlusion is the concern, orientation of vertical and anteroposterior vectors to the occlusal plane is a reasonable baseline. The vertical and anteroposterior dental changes may not show a linear relationship in the anterior and posterior parts of the mouth when jaw rotations are occurring. 3. Growth can be disproportionate in either the vertical and/or the anteroposteroir plane of space. If the vertical increments of the anterior face differ from the vertical increments at the posterior face, mandibular rotations occur. This growth is accompanied by dental compensations that tend to mask the rotation. Therefore, open bite and deep bite are frequently skeletal growth problems. 4. Disproportional forward growth of the maxilla or mandible in an anteroposterior direction can lead to Class II or III relations. The growth that leads to Class II or Class III is accompanied by dental migrations that tend to mask this disproportionate growth. Orthodontic treatment of growth disproportionalities usually represents attempts to make the teeth further compensate. If surgical options are elected, the dental compensations should be removed prior to surgery in order to achieve a full surgical correction. 5. The teeth tend to move and grow in the opposite direction of the growth disproportionality. The teeth tend to mask the disproportionality. Thus, in an open bite, the incisors tend to move vertically further than in deep bites. Vertical imbalances may be more difficult to mask. Backward rotation of the mandible requires more vertical movement at the incisor than at the molar just to maintain vertical incisor relationships.

Child↗
PubMed2002

[Malocclusion and upper airway obstruction].

After more than a century of conjecture and heated argument, the orthodontic relevance of nasal obstruction and its assumed effect on facial growth continues to be debated. Oral respiration disrupts those muscle forces exerted by tongue, cheeks and lips upon the maxillary arch. The main characteristics of the respiratory obstruction syndrome are presence of hypertrophied tonsils or adenoids, mouth breathing, open-bite, cross-bite, excessive anterior face height, incompetent lip posture, excessive appearance of maxillary anterior teeth, narrow external nares, "V" shaped maxillary arch. The purpose of this study is to evaluate relationship between nasal obstruction and severity of malocclusion. The sample analyzed in this article consisted of 49 children aged from 7 to 15 years, who pronounced difficulty in breathing through the nose. Patients and their parents were interviewed, clinical examination was performed, and measurements from dental casts and panoramic radiograph were obtained. All patients were examined by otorhinolaryngologist, and the nasal obstruction was confirmed by posterior rhinomanometry test. This study showed the significant association between nasal resistance and increased overjet (p = 0.042), open bite (p = 0.033) and maxillary crowding (p = 0.037). The tendency of greater nasal resistance was observed for the patients with the first permanent molars relationship Angle II and posterior cross-bite.

Adolescent↗
PubMed1986

Hereditary amelogenesis imperfecta. An epidemiological, genetic and clinical study in a Swedish child population.

Hereditary Amelogenesis Imperfecta (HAI) is a hereditary dental enamel disorder showing a varying clinical picture. Reviewing the literature, there seems to be a need for a better knowledge in many aspects concerning this disorder, not least to enhance the therapeutical approach for individuals suffering from HAI. The aims of this thesis, were to identify and to classify hereditary enamel defects and to estimate their prevalence in a Swedish child population. The oral health of individuals diagnosed as having HAI was also analysed and evaluated. 425 000 children, from the western part of Sweden, aged 3-19 years, were screened in order to identify individuals showing enamel defects of hereditary linkage. In this way, 105 children were identified. They were clinically classified into 12 different subgroups. Genetic analyses were also made. In 99 children, the oral health status was analysed and evaluated. In another patient material, 26 individuals aged 8-20 years and with HAI, the anterior open bite malocclusion was studied. The prevalence of HAI was estimated to be 1 case in 4000. In analyses of genetic data, eight different subgroups of HAI were identified based on the two major types, the hypoplastic and the hypomineralized. The hypoplastic, rough-pitted type with autosomal dominance, represented the most common HAI disorder. A low caries susceptibility was found in children with severely hypoplastic and hypomineralized enamel. Bacteriological and salivary data in the children could not fully support the findings regarding the low caries susceptibility. A high number of restorations were recorded predominantly in severe cases of the hypomineralized type, in which group gingival inflammation, plaque and dental calculus also were frequently found. The open bite occlusion could be associated both with the hypoplastic and the hypomineralized types of HAI. This malocclusion was considered to be of skeletal origin. The prevalence found shows that HAI is a fairly common enamel disorder with a varying clinical expressivity. The oral health findings in individuals suffering from the disorder indicate a need for early treatment planning.

Adolescent↗
PubMed2006

Severe proliferative congenital temporomandibular joint ankylosis: a proposed treatment protocol utilizing distraction osteogenesis.

The classical treatment for temporomandibular joint (TMJ) ankylosis in children: 1) joint release; 2) arthroplasty; 3) reconstruction; and 4) postoperative physical therapy (PT), is often unsuccessful. Postoperative physical therapy is difficult in the young patient due to poor cooperation. Moreover, there is a subgroup of patients who have a refractory congenital proliferative bony process that is the cause of their disease. In these patients, a role for distraction osteogenesis (DO) has been defined. We present a series of young patients with congenital proliferative TMJ ankylosis. Some have failed classic treatment. In such cases, DO is used to expand the mandibular size and soft tissue matrix. This creates a static open bite, facilitates mid-facial growth, and avoids compromise of the airway, speech, nutrition, and oral hygiene. To maintain these objectives, mandibular DO may be repeated as the child matures. Once skeletal maturity is reached, DO is used to normalize occlusion and further expand the soft tissue envelope prior to definitive reconstruction and aggressive post-op PT. In seven patients, this protocol has been used. Five patients are currently in the active phase of growth and undergoing interim treatment with mandibular DO. Two patients have reached skeletal maturity and have completed the protocol of DO with definitive arthroplasty and reconstruction. DO is a valuable aid in the treatment of the problematic child with congenital proliferative TMJ ankylosis. Interim DO, prior to definitive arthroplasty and reconstruction, can provide a static open bite that prevents progressive deformity and its associated functional disturbances.

Ankylosis↗
PubMed1998

Class II correction with magnets and superelastic coils followed by straight-wire mechanotherapy. Occlusal changes during and after dental therapy.

The investigation comprised 18 consecutively selected patients, mean age 14.7 years at the start of treatment, with Class II malocclusion, deep overbite and space deficiency in the maxillary arch. The first phase of the treatment consisted of 6 months simultaneous distal movement of maxillary first and second molars with repelling samarium-cobalt magnets on one side and a superelastic nickel-titanium coil on the contralateral side together with an anterior biteplane to achieve bite opening. For the second phase of the treatment, a straight-wire appliance was used for an average treatment time of 1.3 years. Lateral head radiographs and dental casts were available at the start of treatment, after molar distalisation, at the end of treatment and 1 year post-treatment. The treatment resulted mainly in dental changes. The dental Class II molar relation was corrected to Class I by bodily distal movement of maxillary molars and by mesial movement of the mandibular molars. The correction of molar relation was significantly greater on coil sides than on magnet sides, mean 3.4 mm, and 3.0 mm, respectively. Despite anchorage loss associated with the maxillary molar movement, i.e. mesial movement of the maxillary incisors (mean 1.8 mm), the net overjet was reduced, mean 2.5 mm, by the use of Class II elastics. The average net improvement of bite opening was 2.6 mm, mainly due to extrusion of mandibular and maxillary molars. During the 1-year post-treatment period no significant dental or skeletal changes were found. The long-term implications of the treatment results need further consideration.

Adolescent↗
PubMed2002

Effect of vertical dimension on efficacy of oral appliance therapy in obstructive sleep apnea.

The aim of this study was to assess the effect of bite opening induced by a mandibular advancement splint (MAS) on efficacy and side effects in the treatment of obstructive sleep apnea. In a randomized crossover fashion, 23 adult patients received either MAS-1 (4 mm of interincisal opening) or MAS-2 (14 mm of interincisal opening) for 2 weeks, followed by the alternate treatment for 2 weeks, with an intervening 1-week washout. Complete response was defined as a resolution of symptoms and a reduction in apnea/hypopnea index (AHI) to less than 5 per hour. Partial response was defined as improved symptoms and a reduction in AHI of 50% or more, with the AHI remaining at a value of 5 or more per hour. Both MAS-1 and MAS-2 produced similar reductions in mean (+/- SEM) AHI from baseline: 21 +/- 2 versus 8 +/- 1/hour and 21 +/- 2 versus 10 +/- 2/hour, respectively (p < 0.001). Either complete response or partial response occurred in 74 and 61% of patients with MAS-1 and MAS-2, respectively. Subjective improvements were reported with both appliances by the majority of patients. Patients preferred MAS-1 (78 versus 22%, p = 0.007). This study suggests that the amount of bite opening induced by MAS does not have a significant impact on treatment efficacy but does have an impact on patient acceptance.

Adult↗