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PubMed1992

Variations in occlusal and space characteristics in a series of 6-18-year olds, in Ilala District, Tanzania.

This study was carried out in Ilala District, Tanzania as part of a major oral health survey. The aim of the study was to investigate the variation in different occlusal and space characteristics among children and adolescents in different age group. A total of 698 children and adolescents aged 6-18 years were examined clinically. The subjects were categorized into three age groups, 6-9 years with early mixed dentition, 10-14 years with late mixed dentition and 15-18 years with permanent dentition. The examiners were calibrated before the survey and the agreement was satisfactory. Anteroposterior relationships of the dental arches were measured according to Angle's classification. Other occlusal and space variables included overjet, overbite, openbite, crossbite, crowding, spacing, and separate determination of diastema mediale. Most of the subjects in different age groups, 93-96%, had Angle's Class I molar occlusion. Large overjet (> 5 mm) occurred in 3-5% of the subjects. Deep bite (> 5 mm) was observed in about 2% of the children in all age groups. Anterior open bite was the most prevalent occlusal anomaly in all age groups, noted in 9-13% of the subjects. Transversal occlusal anomalies were rare. More than 33% of the subjects had spacing while less than 10% had crowding of the dentition. These results indicate that using the present criteria, most 6- to 18-year olds in Ilala district have optimal sagittal occlusion and a lot of spacing. The most common occlusal anomaly was anterior openbite.

Adolescent↗
PubMed1992

Surgical-orthodontic correction of mandibular deficiency: five-year follow-up.

Changes in dental and skeletal relationships at 5 years postsurgery were evaluated in a group of 35 patients whose mandibular deficiency had been corrected by the same surgeon, using sagittal split osteotomy of the mandibular ramus. From 1 to 5 years postsurgery, there was a small (0.9-mm) but statistically significant mean decrease in mandibular length (condylion to point B). In six patients, the decrease in mandibular length was 2 to 4 mm, and in two it was more than 4 mm, but only one of these individuals had more than a 2-mm increase in overjet. There was no mean change in overjet, but three patients had a 2 to 4-mm increase. Of these, one had 3.2 mm shortening of the mandible, one had 1.4 mm shortening of the mandible, and one had no change in mandibular length but repositioning of the incisors. Most patients had a deep overbite initially, and there was a tendency for the bite to deepen between the first and fifth years postoperatively, more as a result of extrusion of incisors than of mandibular rotation. Remodeling of the gonial angle area, with vertical and/or horizontal repositioning of gonion, was noted in more than half the subjects. It appears that morphologic changes related to continued skeletal remodeling, often compensated for by small changes in mandibular posture or tooth positions, continue after 1 year postsurgery for many patients.

Adolescent↗
PubMed1992

Treatment of Class II, div. 1 malocclusion with the activator and with the Begg technique.

The effect of treatment of Angle Class II, division 1 malocclusion with an Andresen activator or with the Begg technique with or without premolar extraction was studied retrospectively with X-ray cephalometry. The treatment with the Begg technique was followed by a phase of retention with an activator. Three groups of 25 children who had been treated with one of the methods were compared regarding facial morphology and soft tissue profile before and after the treatment and changes during the period of treatment. The treatment effect (correction of the distal occlusion and normalisation of the overjet and overbite) was similar with the three methods. The overjet was mainly corrected through skeletal changes, which accounted for 70%, 77% and 62% of the overjet correction produced by the activator, Begg extraction and Begg non-extraction treatment, respectively. Thus, all three methods of treatment had a skeletal (orthopedic) effect. The dental component of the overjet correction was with all three methods of treatment a retroclination of the upper incisors. This was to some extent offset by a retrusion of the lower incisors, which also occurred in all groups. The facial morphology and the soft tissue profile after the treatment were similar in the three groups. There were no differences in the soft tissue profile and only marginal differences in facial morphology as a result of the three methods of treatment.

Activator Appliances↗
PubMed2003

[Three-dimensional measurement of tooth inclination in cases with successful treatment].

OBJECTIVE: This study aimed to observe the differences of tooth inclinations among post-treatment good cases of different malocclusions and untreated normal occlusions in order to give references on clinical adjusting of tooth inclinations. METHODS: 157 post-treatment good cases were chosen and tooth inclinations were measured on post-treatment casts using YM-2115 three-dimensional measurement instrument. The measurement results were compared with those of untreated normal occlusions. RESULTS: The inclination values of upper and lower incisors of Class I groups are most close to those of untreated normal occlusions, which of upper central and lateral incisors are 9.6 degrees and 8.7 degrees, and of lower central and lateral incisors are 1.1 degrees and -1.1 degrees. In Class II groups, lower incisors are markedly proclined (5.6 degrees and 2.1 degrees) and upper incisors are similar with untreated normal occlusions. In Class III groups, upper incisors are markedly proclined (15.2 degrees and 12.1 degrees) and lower incisors are markedly retroclined (-3.7 degrees and -4.9 degrees). CONCLUSION: In order to achieve normal overjet and overbite, it is necessary to adjust the inclinations of upper and lower incisors when treated Class II and Class III malocclusions only by the method of orthodontic treatment.

Humans↗
PubMed2002

[Treatment using the Lehman apparatus in patients with malocclusion in light of teleradiologic tests and dental arch measurements].

The aim of this study was to assess the usefulness of Lehman's appliance for the management of distocclusion and to establish indications and contraindications to its use. The mean duration of treatment was also determined and compared to such in similar form of malocclusion treated with other types of functional appliances. Linear measurements were performed on dental plaster casts before and after treatment. Cephalometric analysis served to establish the mechanism of Class II correction (skeletal or dentoalveolar) and to reveal any increase in mandibular length caused by Lehman's appliance. The material consisted of thirty-three Class II patients (18 girls and 15 boys), aged 9 to 15 years, treated successfully with Lehman's appliance for distocclusion. Dental plaster casts and lateral cephalograms were obtained at the beginning and end of treatment. Improvement in occlusal relationship in the molar, canine and incisor segments was the result of dental and skeletal changes. Metric analysis of dental casts before and after treatment showed that active treatment was associated with an increase in transversal dimensions of the upper arch ranging from 1.8 to 2.4 mm. Overbite and overjet decreased considerably. Anterior length of upper arch was reduced significantly in boys only and was accompanied by distraction and transition from a V-shaped to U-shaped type of arch. These changes helped to harmonize transversal dental relationship of both arches and improved conditions for functional skeletal base adaptation. Treatment with Lehman's appliance improved the intermaxillary relationship and led to a decrease in the ANB angle attributable to a change in the SNA angle in girls and the SNB angle in boys. The mandibular reaction in girls with Class II/2 was interesting: the SNB angle increased considerably, indicating "unblocking" of the mandible. Changes in the vertical skeletal relationship were limited to a minor reduction in the index. Maxillary incisors moved little, but mandibular incisors showed significant proclination. The present findings demonstrate an additional increase in total mandibular length achieved with Lehman's appliance. This important effect contributed to a successful treatment of Class II malocclusion. Nevertheless, it should be remembered that this growth process depends on other factors, such as age, growth potential, growth pattern, and duration of appliance use. Average duration of treatment was 15 +/- 5.2 months in girls and 17.1 +/- 7.1 months in boys. In the case of girls, treatment in skeletal Class I was shorter than in skeletal Class II; the contrary was true in boys. Duration of treatment was shorter in patients with orthognathic type of face, irrespective of gender. Patients with deep vertical relationship showed a better prognosis in terms of duration and effects of treatment.

Adolescent↗
PubMed2003

Lip sucking and lip biting in the primary dentition: two cases treated with a morphological approach combined with lip exercises and habituation.

Lip sucking and lip biting in the primary-dentition period can cause the upper incisors to tip labially and the lower incisors to collapse lingually with the lower lip wedged between the upper and lower anterior teeth. The resulting lip incompetence further aggravates maxillary protrusion. Thus, there is a causal relationship between lip sucking/lip biting and maxillary protrusion. Orofacial myologists provide lip training to activate the flaccid upper lip and raise the child's awareness to help stop the sucking or biting of the lower lip, sometimes using an oral screen. Two primary-dentition cases with lip sucking and lip biting were treated with a functional appliance (F.A.), resulting in the elimination of the habits in 5 to 6 months along with the improvement of the overjet, overbite and facial profile. The authors prioritize myofunctional therapy (MFT) when treating open bite cases with tongue thrust in the primary dentition. However, the treatment of maxillary protrusion due to lip sucking and lip biting is approached differently with priority given to morphological improvement to create an oral environment that makes lip sucking and lip biting difficult, which is complimented with lip exercises and habituation. This combined approach was found to be effective in breaking the lip-sucking and lip-biting habits.

Cephalometry↗
PubMed2003

Stability of combined Le Fort I maxillary advancement and mandibular reduction.

BACKGROUND: There have been reports that correction of severe Class III abnormality by single jaw surgery may invite relapse in the long-term. The purpose of this study was to retrospectively evaluate the stability of combined Le Fort I maxillary advancement and bilateral sagittal split osteotomies for mandibular reduction. METHODS: Thirty patients with a skeletal Class III malocclusion underwent bimaxillary surgery using rigid fixation and interpositional bone grafting of the maxilla. The average age was 24.4 years, and the mean follow-up period was 20 months (Range: 12-63 months). Post-operative changes were measured on lateral cephalometric radiographs using an anatomical best-fit technique. RESULTS: The maxilla was advanced, on average, 6.1 mm (SD: 1.8 mm) and repositioned superiorly at PNS 1.9 mm (SD: 2.1 mm). The mandible was repositioned posteriorly 5.6 mm ISD: 4.2 mm) at menton, which also auto-rotated superiorly. At follow-up, the maxilla relapsed horizontally 0.6 mm (SD: 1.1 mm, p < 0.01) with no significant vertical change. The maxillary central incisors were proclined and the interincisal angle was reduced. Menton relapsed anteriorly 1.4 mm (SD: 2.7 mm, p < 0.01), and gonion rotated superiorly 1.5 mm (SD: 2.3 mm, p < 0.001). In 67 per cent of cases menton moved anteriorly less than 2.5 mm. The overjet and overbite did not change significantly. CONCLUSIONS: The data show that 12-months post-operatively, maxillary advancement combined with mandibular setback was relatively stable in the horizontal and vertical planes.

Adolescent↗
PubMed2003

Oral hygiene status and occlusal characteristics of orthodontic patients at University College Hospital, Ibadan, Nigeria.

Patients seeking orthodontic care are expected to maintain good oral hygiene status and there is still a debate as to whether occlusal characteristics are associated with oral hygiene status and invariably periodontal health. The aims of this study were to assess the pattern of oral hygiene status (OHS) of orthodontic patients at University College Hospital (UCH), Ibadan, Nigeria and to ascertain possible relationship between their OHS and occlusal characteristics. A prospective study of 178 consecutive orthodontic patients (44.4% males and 55.6% females) with mean age of 16.21 +/- 7.81 years seen in the hospital between January 2000 and September 2002 was done. Oral hygiene status was assessed using Greene and Vermillion simplified oral hygiene index while occlusal characteristics were assessed using Angle's classification of malocclusion and Jackson's method for overjet and overbite relationships. In all, 59.6%, 38.2% and 2.2% had good, fair and poor oral hygiene status respectively. Generally, no significant relationship was found between oral hygiene status and various occlusal features (P > 0.05). It was concluded that the patients had satisfactory oral hygiene status and the various occlusal features did not affect their oral hygiene status significantly.

Adolescent↗
PubMed2003

A mandibular protruding device in obstructive sleep apnea and snoring.

UNLABELLED: The overall purpose behind treatment in sleep-breathing disorders is to ease breathing and thereby reduce the risk of morbidity. The mandibular protruding device (MPD) is one method of treating both obstructive sleep apnea (OSA) and snoring. The aims of the studies were to study MPD users after 2 years and evaluate the following aspects of the MPD: subjective and objective effects on sleep, influences on airway passages and hard tissues, and the incidence and types of adverse events of the masticatory system including temporomandibular disorders. Further aims were to evaluate the impact of body posture and the effects of the MPD on pharyngeal width and to validate two methods for measuring mandibular protrusion and MPD advancement. MATERIALS AND METHODS: Seventy-seven subjects with OSA or snorers without OSA. were admitted to the study after a medical examination, which included a somnographic registration. The patients completed questionnaires regarding sleep quality and symptoms from the masticatory system, and underwent a clinical jaw function examination, were given an MPD, and were subjected to lateral cephalometric examination. Two follow-ups, 6 months and 2 years after MPD treatment were conducted. The study population comprised 65 patients at the 2-year follow-up. RESULTS: At the 2-year follow-up, a significant reduction of the subjective complaints was noted by 90% of the MPD users. In the objective evaluation, the oxygen desaturation index (ODI) of the OSA group (n = 39) decreased significantly from a mean of 14.7 to 3.1 and the mean arterial oxygen saturation (SaO2) increased significantly from 78% to 89%. The snorers maintained their initial values. In the total group, MPD treatment significantly increased most pharyngeal measures and lifted the hyoid bone. The pharyngeal area decreased significantly--by more than 50%--when the patient was supine, and the velum area increased significantly. At the 2-year follow-up, on upright cephalogram without MPD, the pharyngeal area had significantly increased and the velum area had significantly decreased. The mandible was posteriorly rotated (P < 0.01) as well as the lower incisors were proclined (P < 0.05). Mandibular advancement and vertical opening with an MPD, as measured with a ruler, compared well with measurements taken from a cephalogram. At the 2-year follow-up significant changes in the mean mandibular range of protrusion (+0.6 mm), overjet (-0.5 mm), and overbite (-0.8 mm) were registered. Nine of the 65 patients had developed a lateral open bite, and 2 were aware of the change. The reported frequency of headache was significantly reduced. At the 2-year follow-up there was a significant reduction in pain during mandibular movements. CONCLUSIONS: MPD treatment significantly reduced subjective complaints of sleep disturbances and significantly reduced ODI values among OSA patients. A high MPD compliance rate after 2 years (84%) indicated a well-tolerated treatment and a low rate of side effects were noted. The key factor in OSA and snoring is the obstruction of pharynx. The MPD treatment significantly increased the pharyngeal passages and significantly reduced the size of velum and thereby facilitated the breathing.

Adult↗
PubMed2002

[Clinical results of skeletal class III malocclusion in 11 children aged from 10 to 14 years].

OBJECTIVE: The aim of this study is to investigate the clinical effects of combined protraction facemask and rapid maxillary expansion in the treatment of Class III malocclusion in 11 children aged from 10 to 14 years. METHODS: The observation group included 11 subjects in late mixed dentition or early permanent dentition, and the control group included 32 subjects in early mixed dentition. Protraction facemask and rapid maxillary expansion device was used and the mean treatment time was 6 months. Cephalometric radiographs were taken at the initiation of treatment (T1) and after 6 months of treatment (T2). In this way,(T2-T1) represented cephalometric changes after the treatment and cephalometric analysis based on a new basecranical reference system was used to compare the changes. RESULTS: All the subjects had the following changes: the maxilla moved forward,the mandible exhibited a downward and backward rotation and the forward growth was restricted. The overjet correction of the observation group was 5.3mm, 51% of the overjet correction was due to skeletal changes and 49% due to dental changes.9 cases obtained normal overjet and overbite and molar relationship. CONCLUSION: The combination of protraction facemask and rapid maxillary expansion is helpful to the correction of Class III malocclusion in children aged from 10 to 14 years. It can alleviate the degree of deformation,avoid surgery, and improve the relationship between hard and soft tissue.

English Abstract↗
PubMedDate not supplied

The effects of infant feeding patterns on the occlusion of the primary dentition.

The purpose of this study was to investigate the effects of different methods of infant feeding on the development of the occlusion in the primary dentition. The study included 126 children. Parents completed questionnaires regarding feeding and health history, and the primary dental occlusion was recorded for each child. The authors found that: (1) predominant bottle-feeding between 0 and 6 months of age was associated with the development of a pacifier habit; (2) children who used a pacifier were more likely to develop a nonmesial step occlusion, an overjet >3 mm, and an open bite; (3) children who sucked their thumb were more likely to develop an overjet >3 mm; and (4) in the absence ofnonnutritive oral habits, children who were predominantly bottle-fed between 0 and 6 months of age were more likely to develop an overbite >75%, although just shy of nominal statistical significance.

Age Factors↗
PubMed2004

[The biomechanical research on the different stress distributions between complete and defective dentition].

PURPOSE: To evaluate the stress distribution of crowns under mastication from the biomechanical respect, and observe the physical effects on different teeth through the interproximal contacts. METHODS: A healthy adult skull with both maxilla and mandible was selected, which had normal overbite and overjet, standard occlusal relationship, and tightly contacting with interproximal teeth. After preparation, a 1mm x 1mm strain foil was bonded on every crown. In centric occlusion, 20 kg vertical load was applied on it. The stress value of crown(GPa) was detected by the YJD-17strain gauge. There were three groups: group 1 with complete dentition, group 2 with the first molar missing, and group 3 with missing of right mandibular first molar, lateral incisor and central incisor. RESULTS: The stress value in complete dentition was 3.4641 in second molar, 0.5132 in second premolar, 1.0264 in canine, and 0 in others. In group 2, the stress value was 5.003 in second molar, 1.4113 in second premolar, the values of other teeth equal to that of group 1. In group 3, the stress value was 5.2603 in second molar,1.6679 in second premolar,3.2075 in canine, 0 in first premolar, respectively. CONCLUSION: In complete dentition, the occlusal strength is distributed through the contact area between interproximal teeth, therefore, the stress value of crown is low. However, in the area near the defective dentition, it will be obviously high.

Biomechanical Phenomena↗
PubMed2004

[Preliminary study of non-surgical treatment of severe Class III malocclusion in 18 patients of 12-20 years old].

OBJECTIVE: To analyze effects of non-surgical treatment on subjects of 12-20 years old with severe skeletal Class III deformity and to directly evaluate dental and facial profile changes. METHODS: Eighteen patients with severe skeletal Class III malocclusion (male 5, female 13), diagnosed as indication for orthognathic surgery, were included in the study. The average age was 14.6 +/- 2.5 years old., with age range from 12 years old to 20 years old. 12 cases were treated with Tip-Edge straight-wire technique and 6 cases with Begg light wire technique. The average treatment time was 2.5 +/- 0.8 years. The selection criteria included: (1) mesial or superior mesial Class III molar relationship, with maxillary first molar occlude the buccal groove of the mandibular second molars (2) no mandibular shift (3) ANB < -1.5 degrees (4) high angle cases with average value of SN-MP 34.9 degrees +/- 5.9 degrees, 4 cases present with openbite (5) concave facial profile (6) originally classified as surgery cases. Lateral cephalometric films taken at the beginning and the end of the treatment were analyzed with traditional cephalometric analysis. The arithmetic mean (Mean) and standard deviation (SD) were calculated for each variable. Paired t-test was performed to evaluate the significant treatment change. RESULTS: Normal overjet and overbite were established with proclination of upper incisors and retroclination of lower incisors. Inclination of upper incisors was increased 5.9 degrees when measured with the angle of upper incisor to SN plane (P < 0.01). Inclination of lower incisors was decreased 6.6 degrees when measured with the angle of lower incisor to mandibular plane (P < 0.001). Negative value of the distance difference of upper lip and lower lip to Sn-Pg' at the beginning of treatment changed to positive value with significant difference (P < 0.001). CONCLUSION: Successful treatment effects could be obtained with non-surgical therapy in severe skeletal Class III malocclusion in permanent dentition. Remarkable soft-tissue change was noted after the treatment and concave facial profile changed to straight profile.

Adolescent↗
PubMed1993

[A study of the reasonable vertical thickness of stabilization splint]

It was proved in this study through the measurement and calculation of the shape and size of dentition and jaws and the position of the hinge axes that the thickness of stabilization splint was difficult to be confirmed within free way space, it was therefore suggested that attention should be paid on forming a flat and smooth occlusal plane during the design and manufacture of splint, so that the points to a flat plane contact relation could be presented between the split and the tops of working cusps. Guidance effect on inclines must be eliminated. The thickness of splint should depend upon the height of cusp and the overbite degree of the patient, so that free way space wasn't absolutely inviolable in the set of stabilization splint.

Journal Article↗
PubMed2004

[Combined orthodontic-periodontal treatment on periodontal patients with anterior displaced incisors].

OBJECTIVE: Combined orthodontic-periodontal treatment with supracrestal fiberotomy was undergone on the periodontal patients with anterior displacement of incisors. Evaluate of the changes before and after treatment. METHODS: Periodontal indices, periapical x-ray analysis, and model analysis were used for investigating the changes of alveolar bone height and periodontal health by orthodontic treatment following supracrestal fiberotomy of anterior displaced incisors on periodontal patients. RESULTS: Alveolar bone height was increase by 1.2 mm in fiberotomy patients. The overjet was reduced from 7.0 mm to 2.0 mm, while the overbite was decreased from 4.0 mm to 2.0 mm, and the periodontal health maintained as well. CONCLUSION: Combined orthodontic periodontal treatment with supracrestal fiberotomy could correct the malpositioned teeth, and improve the periodontium conditions and gain the crest bone.

Adolescent↗
PubMed2003

[Treatment of crossbite with the quadhelix appliance and lower lingual arch to maintain constant lower intermolar width].

The quadhelix appliance is often recommended for the treatment of children with crossbite. It is characterized by high effectiveness, low cost and short treatment time. Its modification with asymmetric arms enables asymmetric expansion of the upper arch. However, no clinical studies confirming such action are known. During maxillary expansion the lower arch tends to follow the maxillary teeth by tipping laterally. This phenomenon hinders crossbite treatment. The aim of the present study was to evaluate the effect of asymmetric arms of the quadhelix appliance during treatment of crossbite and to assess the effectiveness of the lower lingual arch in maintaining lower intermolar width. The study group included 20 children with crossbite. The treatment procedure comprised slow maxillary expansion with the quadhelix appliance. A lower lingual arch activated 1 mm inwards was simultaneously used in order to prevent increase in the lower intermolar width through occlusal contacts. The maxillary intermolar widths were measured between the central fossae of the right and left first permanent upper molars. Mandibular intermolar widths were measured between medial buccal cusps. The mean increase in upper intermolar width was 4.1 mm. The mean change in the lower intermolar width was -0.1 mm and was statistically insignificant. Posterior crossbite was eliminated in 16 children (80%). In 20% of children an improvement (e.g. reduction of the number of teeth in crossbite) was noted. The subtraction sum of the upper and lower intermolar widths was -5.7 mm before treatment and -1.4 mm after treatment. The upper dental arch before treatment had an asymmetric shape in all subjects. The width of the more deficient side was 19.65 mm and the wider side measured 22.3 mm. This difference was statistically highly significant (p < 0.0001). After treatment, the width of the side where the shorter arm was used was 22 mm. The width of the opposite side was 23.7 mm. The difference was statistically significant (p < 0.003). The width of the palate increased on the average by 3.5 mm. The change in overbite was statistically insignificant, enabling safe application of this method in patients with crossbite and open vertical skeletal configuration. The length of the upper arch increased by 0.2 mm (p < 0.01). The average treatment time was 17 weeks, depending on the number of teeth in crossbite before treatment (Rs = 0.58; p < 0.007). Longer treatment times (6-7 months) were reported in other studies describing patients of the same age. The quadhelix with asymmetric lateral arms is recommended for the treatment of crossbite with an asymmetric upper dental arch. The simultaneous application of lower lingual arch prevents lower intermolar expansion, thus shortening the time of treatment.

Adolescent↗
PubMed2003

[Efficacy of orthodontic treatment according to the Peer Assessment Rating index].

The work deals with assessment of orthodontic treatment using the Peer Assessment Rating (PAR) index. The objective was to rate the results of orthodontic treatment in the following groups: 1. All patients seen at the Department of Orthodontics, Pomeranian Academy of Medicine; 2. Patients treated by individual dentists at the Department of Orthodontics, Pomeranian Academy of Medicine; 3. Patients with distocclusion; 4. Patients treated with fixed appliances. 1. Rating in patients treated at the Department of Orthodontics, Pomeranian Academy of Medicine Mean reduction in PAR for all patients treated at the Department of Orthodontics was 70%. On this basis, the efficiency of treatment in this group can be termed as high, with 18% of patients classified to "marked improvement", 73% of patients to "improvement" and 9% to "deterioration--no change" groups. This reduction in PAR index is a good result in comparison with published data. 2. Rating in patients treated by individual dentists at the Department of Orthodontics, Pomeranian Academy of Medicine Reduction in PAR ranged from 48% to 83%, depending on the dentist concerned. Orthodontist A achieved the highest reduction (83%), while orthodontists C and E achieved lowest reduction (64% and 48%, respectively). Analysis of patients treated by orthodontists A and C demonstrated that the median PAR for orthodontist A was higher by 5 points than for orthodontist C. 80 malocclusions treated by orthodontist A were difficult to manage. Besides, treatment by orthodontist A was approximately 4 months shorter than by orthodontist C. Patients of orthodontist A had approximately two visits less than patients of orthodontist C. Average costs of treatment for orthodontist A were approximately PLN 500 lower than costs for orthodontist C. In 25% of patients of orthodontist A "marked improvement" was achieved as opposed to only 17% of for orthodontist C. 3. Rating in patients with distocclusion The most significant improvement in this group was achieved with Lehman's appliance (84%). Significant improvement was also noted in patients treated with a two-arch fixed appliance (82%). The lowest reduction in PAR was observed in patients treated with one-arch fixed appliance (64%). High efficiency of treatment with Lehman's appliance or with two-arch fixed appliance in patients with distocclusion is comparable with published results. 4. Rating in patients treated with fixed appliances Patients treated with two-arch fixed appliance achieved higher reduction in PAR than patients treated with one-arch fixed appliance. The main criterion was overcrowding of lower incisors. Results show that treatment with two-arch fixed appliance, in spite of lack of overcrowding of lower incisors, improves the efficiency of treatment. Patients treated with two-arch fixed appliance achieved better qualitative and quantitative results than patients treated with one-arch fixed appliance. In effect, the former patients were managed more effectively. The following conclusions were drawn: 1. The efficiency of treatment at the Department of Orthodontics, Pomeranian Medical University, was high; 2. The efficiency of treatment by orthodontists at the Department of Orthodontics, Pomeranian Medical University, was high; 3. Treatment efficacy for patients with distocclusion was highest with Lehman's appliance and with two-arch fixed appliance; 4. Although costs of treatment were reduced with one-arch fixed appliance, efficiency was lower than for two-arch fixed appliance. Moreover, it is necessary to: 5. Treat abnormalities of occlusion affecting the esthetics of bite, but also abnormalities with importance for normal occlusion that the patient is not aware of, like abnormalities in buccal segments, compression of lower incisors, marked overbite and centerline shift; 6. Control right and left buccal occlusion to the same extent; 7. Treat both jaws using removable and fixed appliances.

Dental Occlusion↗
PubMed2004

[Treatment effects with expansion and multiloop edgewise arch wire technique on skeletal class III malocclusion with mandibular deviation].

OBJECTIVE: The purpose of this study is to evaluate the methods of treatment on Class III malocclusion with mandibular deviations, and clarify the principles of expansion and multiloop edgewise arch wire technique. METHODS: 8 skeletal class III with mandibular deviations patients were selected (male 3, female 5, aged 12-18). They were all corrected with maxillary expansion and multiloop edgewise arch wire technique. RESULTS: In all cases, molar relationships were class I, the overbite and the overjet were normal, and the upper and lower midline were harmony. CONCLUSION: Mild and moderate skeletal class III with mandibular deviation can be corrected successfully by maxillary expansion and multiloop edgewise arch wire technique.

Adolescent↗