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At least 1,135 records · Page 63Linked to original sources
PubMed2006

Intraarch and interarch relationships of the anterior teeth and periodontal conditions.

This study was undertaken to investigate the association between orthodontic anomalies and periodontal conditions. Three parameters of the intraarch relationship on both dental arches (displacement of contact point, crowding, and spacing) and four parameters of interarch relationship (overjet, open bite, crossbite, and overbite) assessed with either Index of Orthodontic Treatment Need or Index of Complexity, Outcome and Need were correlated with parameters of periodontal condition, ie, hygiene (Plaque Index and Retention Index), inflammation (gingival inflammation and Gingival Bleeding Index), and periodontal disease severity (pocket depth, clinical attachment loss, and gingival recession). In the main, weak but significant correlations were found between certain parameters of intraarch and interarch relationship and some indices of periodontal conditions. Within the limitations of this study, it was concluded that providing orthodontic treatment on the ground of deleterious effect of malocclusion and malpositioned teeth on periodontal condition is justified.

Adult↗
PubMed2006

Mandibular distraction osteogenesis and maxillary osteotomy in a class II division 1 patient with chronic juvenile arthritis.

A patient with juvenile chronic arthritis presented with a malocclusion characterized by mandibular hypoplasia, symphysial deficiency, and an increased mandibular occlusal plane angle. Correction of the mandibular defect required both the horizontal advancement of the mandible and a counterclockwise rotation of the proximal segment to reduce the mandibular occlusal plane angle. This was achieved by a combination of distraction osteogenesis to horizontally advance the mandible (14 mm), followed by manipulation of the postdistraction regenerate to reduce the mandibular occlusal plane and increase the symphysial projection. The counterclockwise rotation of the mandibular body resulted in the creation of a posterior open bite. After a three-month period to allow consolidation of the mandibular distraction osteogenesis, secondary maxillary surgery at the Le Fort 1 level was performed to reestablish maxillary occlusal contact at the new mandibular occlusal plane. A genioplasty was also performed to improve chin projection.

Adolescent↗
PubMed2000

An unusual case of furcation external resorption.

AIM: To describe the presentation and management of an unusual external root resorption. SUMMARY: An unusual external inflammatory root resorption presented in the furcation of a mandibular first molar. Review of earlier radiographs suggested that the lesion was non-progressive. Occlusal trauma associated with anterior open bite was the most likely aetiological factor. No active treatment was prescribed. KEY LEARNING POINTS: External resorption may occur following loss of the external root surface. Occlusal trauma may be a propagating stimulus for progressive resorption. Lesions may sometimes be non-progressive, and treatment may therefore be more damaging than observation.

Adult↗
PubMed2002

Moebius syndrome with oral involvement.

The oral findings of 12 patients with Moebius syndrome are described. Facial weakness, hypoplastic upper lip, microstomia, mouth-angle drooping, hypoplasia of mandible, gothic palate, tongue weakness, fissured tongue, tongue atrophy and open bite were found. In addition to describing the oral findings, this report discusses some implications for dental treatment of patients with this syndrome.

Child↗
PubMed1997

Cephalometric evaluation of dento-skeletal changes during treatment with the Bionator type 1.

Treatment effects of the Bionator functional appliance were studied on the pre- and post-treatment cephalograms of 49 Class II, Division 1 cases. After treatment, a significant more ventral localization of the anterior structures of the mandible was recorded in comparison with the pretreatment situation. The proclination of the maxillary incisors was reduced. No absolute inhibitory effect on maxillary growth was observed. In this study no significant differences in the measured treatment effects on cephalometric radiographs could be demonstrated in cases with a tendency to skeletal open bite from those with a tendency to skeletal deep bite according to the criteria used in this study.

Activator Appliances↗
PubMed2000

Morphological differences in individuals with lip competence and incompetence based on electromyographic diagnosis.

The study group consisted of 19 subjects with positive overjet and overbite, and 17 subjects with skeletal open bite. Two bipolar surface electrodes were attached to the skin of the upper and lower lips. The mean integrated amplitude of the electromyographic (EMG) activity was obtained at the mandibular rest position with the lips in contact and with the lips apart. Subjects were divided into two groups based on positive or negative values of the difference in integrated EMG activity of the mentalis muscle between the two lip positions. Subjects displaying a negative value were classified as having competent lips and those displaying a positive value were classified as having incompetent lips. The EMG activity of the mentalis muscle was found to be more indicative of lip sealing as compared with the EMG activity of the depressor of the lower and the upper lips. The activities of the mentalis muscle at the mandibular rest position with the lips in contact and with the lips apart appear to offer an objective criterion for the evaluation of lip incompetence. In addition, the vertical dimension of the face, as well as the proclination of the incisors, appear to affect lower lip function.

Adult↗
PubMed2003

Dentoalveolar reconstruction of a missing premaxilla using bone graft and endosteal implants.

We report here on a patient with bilateral cleft lip and palate (BCLP) and a missing premaxilla, who underwent dentoalveolar reconstruction of the cleft and premaxillary alveolus using endosteal implants after bone grafting. The patient, whose maxillary incisors and premaxilla were missing, had corticocancellous bone grafting from the iliac crest, followed by excellent bone formation at the anterior alveolus. After the placement of the endosteal implants and the completion of the pre-surgical orthodontic alignment, orthognathic surgery was performed for the restoration of a Class III open bite. After post-operative orthodontic preparation, the final fixed prostheses were completed. This treatment procedure offers an option of dentoalveolar reconstruction for BCLP patients with an excised premaxilla.

Adult↗
PubMed2003

Changes in temporomandibular joint dysfunction after orthognathic surgery.

PURPOSE: We sought to evaluate the effects of orthognathic surgery on temporomandibular joint (TMJ) dysfunction in patients with known presurgical TMJ internal derangement who underwent double-jaw surgery for the treatment of dentofacial deformities. PATIENTS AND METHODS: Treatment records of 25 patients with magnetic resonance imaging and clinical verification of preoperative TMJ articular disc displacement who underwent double-jaw surgery only were retrospectively evaluated, with an average follow-up of 2.2 years. Signs and symptoms of TMJ dysfunction, including pain, range of mandibular motion, and presence/absence of TMJ sounds, were subjectively (visual analog scales) and objectively evaluated at presurgery (T1), immediately postsurgery (T2), and at longest follow-up (T3). Surgical change (T2-T1) and long-term stability of results (T3-T2) were calculated using the superimposition of lateral cephalometric and tomographic tracings. RESULTS: Presurgery, 16% of the patients had only TMJ pain, 64% had only TMJ sounds, and 20% had both TMJ pain and sounds. Postsurgery, 24% of the patients had only TMJ pain, 16% had only TMJ sounds, and 60% has both TMJ pain and sounds. Thus, presurgery 36% of the patients had TMJ pain, and postsurgery, 84% had pain. Average visual analog scale pain scores were significantly higher postsurgery and none of the patients with presurgery TMJ pain had relief of pain postsurgery. In addition, 6 patients (24%) developed condylar resorption postsurgically, resulting in the development of Class II open bite malocclusion. CONCLUSIONS: Patients with preexisting TMJ dysfunction undergoing orthognathic surgery, particularly mandibular advancement, are likely to have significant worsening of the TMJ dysfunction postsurgery. TMJ dysfunction must be closely evaluated, treated if necessary, and monitored in the orthognathic surgery patient.

Adolescent↗
PubMed2001

Temporomandibular joint replacement in rheumatoid-induced disease.

We report a series of seven patients with rheumatoid arthritis whose temporomandibular joints were replaced using the Christensen joint system. Patients were assessed before and after operation both subjectively (pain and dietary interference) and objectively (interincisal distance). Patient's satisfaction with the outcome of operation was also recorded. All patients showed improved visual analogue scores for pain and dietary interference after their operations and an improvement in interincisal distance was recorded in five of the patients (the remaining two having had the operation for anterior open bite). Overall satisfaction was high and no patient has rejected the prosthesis or had any substantial complications. The mean follow up period is 30 months (range 8-50). We suggest that patients with severe, rheumatoid-induced temporomandibular disease should be considered for arthroplasty as it is possible to restore some normal function and appearance.

Adult↗
PubMed2001

Bimaxillary osteodistraction for the treatment of facial asymmetry in adults.

Nine patients with hemifacial microsomia or facial asymmetry were treated between April 1998 and November 1999. The ages of the patients ranged from 21 years to 45 years (mean: 24.6 years); six were female and three were male. The follow-up period ranged from 6 months to 24 months (mean: 15.3 months). The operative procedure was based on Ortiz Monasterio's simultaneous mandibular and maxillary distraction technique. This technique frees only the pterygo-maxillary junction of the affected side, thereby leaving the nasal septum and the pterygo-maxillary junction of the unaffected side intact. It also uses an external corticotomy on the mandible. In contrast, we modified Ortiz Monasterio's method by using a complete LeFort I osteotomy with both a complete separation of the pterygo-maxillary junction and a mandibular osteotomy to avoid any resistance during distraction. In one patient with scleroderma and severe atrophy of the mandible and soft tissue on the right side of the face, a free scapular osteocutaneous flap was used; 1 month later we performed simultaneous distraction of the maxilla and transfer of the scapula bone to the mandible. In one patient with hypoplasia of the zygoma, zygoma expansion was also performed simultaneously. Bidirectional distraction was performed in one patient and intraoral devices were applied in three patients. After a latent period of 5 days, distraction was performed at a rate of 1 mm per day. After a consolidation period of 6-8 weeks, the intermaxillary fixation and distraction devices were removed. Preoperatively, the deviation of the occlusal plane ranged from 8degrees to 13 degrees (mean: 10.5 degrees); the distraction distance ranged from 7 mm to 17 mm (mean: 13 mm). In two patients there was radiologic evidence of relapse 6 months after distraction, but no significant change in facial appearance was observed. Seven patients maintained a stable preoperative occlusal relationship and the preoperative lateral open bite was improved postoperatively in two patients. The postoperative occlusal plane was between 0 degrees and 1 degree in every case.

Adolescent↗
PubMed2000

Sagittal and vertical changes after treatment of Class II Division 1 malocclusion according to the Cetlin method.

This cephalometric study was designed to evaluate the dentoskeletal anteroposterior and vertical changes produced by Cetlin therapy (lower lip bumper, ACCO, cervical headgear) to correct Class II Division 1 malocclusion in the late mixed dentition. All measurements were made on 2 lateral headfilms, at pretreatment and at 1 year after beginning treatment. The selected sample (n = 110; 67 boys and 43 girls; mean age, 10 to 11 years) and the control group (n = 100; 48 boys, 52 girls; mean age, 10 to 11 years) matched for number, age, and malocclusion. The average observation interval was 13 months. The final measurements between intervals were averaged and tested for significance by analysis of variance. A one-factor (group) repeated measure model and a two-factor (group and facial type) repeated measure model were fitted to each variable separately and significance values were set at P </=.05. The Class I molar relationship was achieved in all treated subjects primarily through distalization of upper first molars. A significant distal tipping was found in 70% of the treated cases. The results showed a significant forward growth limitation of the maxilla with the use of cervical headgear. No significant change of mandibular position was found in the treated group compared with the control group. Both bite opening and proclination of upper and lower front teeth occurred. Cetlin therapy is reliable and effective for space recovery and interceptive Class II Division 1 treatment. Additional therapy may be needed later.

Analysis of Variance↗
PubMed2001

A relatively minor adult case becomes significantly complex: A lesson in humility.

A 41-year-old white woman with no particular concerns about facial esthetics was first seen with bilateral Class II molar relationship, a Class I right canine, and a Class II left canine. Overjet was 3 mm and overbite was 0.5 mm, with no incisor contact. A maxillary right premolar was missing for unknown reasons and all 4 third molars had previously been extracted. The maxillary midline was 2 mm to the right of the facial midline, and the mandibular midline was 3.5 mm to the left of the maxillary midline. There was 7 mm of crowding in the maxillary arch and 6 mm of crowding in the mandibular arch, with an increased curve of Spee. The patient had a well-positioned maxilla, a retrognathic mandible with increased convexity, a Class II denture base relationship, and a vertical facial pattern. The treatment plan consisted of extracting the maxillary left first premolar and the mandibular left central incisor. After 4 months of treatment, an open bite from second premolar to second premolar was noted. After 6 months of treatment, the patient expressed concern with her chin position and mentalis hyperactivity. It was apparent that the orthodontic treatment had resulted in molar extrusion, which the musculature was not able to withstand. Treatment continued and the case was set up for posterior maxillary impaction and mandibular advancement surgical procedures.

Adult↗
PubMed2001

Comparison of dental arch measurements in the primary dentition between contemporary and historic samples.

The purpose of this study was to investigate secular changes that may have occurred in dental arch dimensions by comparing a sample of contemporary North American white children (born between 1992 and 1995) in the primary dentition to those children found in an earlier study of North American white children (born between 1946 and 1948). The sample of contemporary children has been followed prospectively since birth and was assessed at 4(1/2) to 5 years of age. Data for the historic sample were obtained from 5-year-old children who were enrolled in the Iowa Growth Study. The 2 samples were similar in terms of geographic location, racial and ethnic backgrounds, and socioeconomic status. To further enhance the comparison and to match the 2 groups, the 2 samples were restricted to white children with a normal overjet (<4 mm) and normal anteroposterior molar relationship, no anterior open bite, and no crossbite. In addition, individuals were excluded if any permanent teeth were erupted. Measurements of maxillary and mandibular arch lengths and intercanine and intermolar arch widths were made, with measurements of overjet and overbite. The results indicated that maxillary and mandibular arch lengths in both sexes were significantly shorter in the contemporary sample; all arch widths were significantly smaller in contemporary boys, but not in girls. These findings suggest that average arch dimensions may be smaller in contemporary children than in past generations. Further research is needed to determine whether smaller arch dimensions are associated with more crowding in the primary, mixed, and permanent dentitions.

Case-Control Studies↗
PubMed2001

Role of lateral cephalograms in assessing severity and difficulty of orthodontic cases.

To assess the role of lateral cephalometric films in the evaluation of orthodontic patients, 16 certified orthodontists examined 80 sets of dental casts and lateral cephalograms. The patients included 5 subgroups: Class I with mild crowding, Class II Division 2, Class III, open bites, and bimaxillary protrusion. A 5-point Visual Analogue Scale was used to assess the degree of severity and difficulty of each case. Severity was defined as the degree of deviation from ideal occlusion, while difficulty was defined as the probability of attaining an ideal occlusion when all treatment options were available. The examiner then chose one or more of the following treatment options: growth modification, extraction, nonextraction, and surgery. All examiners scored the degree of severity and difficulty of each case with casts only at Time 1 (T1), then with casts and cephalograms at Time 2 (T2). The observed ratings from the Visual Analogue Scale were scored by using the Rasch model, which transforms the nonlinear ordinal ratings to a linear interval scale. Intersubgroup differences and differences between T1 and T2 difficulty and severity were assessed by using a 5 x 2 repeated measures analysis of variance. A paired t test examined the amount and direction of the differences between T1 and T2 of each subgroup. Multiple contingency tables were used to compare treatment option changes between all subgroups at each time. Severity and difficulty scores highly correlated. Analysis of variance showed significant differences among subgroups for both severity and difficulty; however, there were significant time differences for severity only. Paired t tests revealed a small increase in severity for the bimaxillary protrusive group and small but significant decreases for the subgroups Class II Division 2 and Class III when cephalograms were added. The multicontingency table analysis demonstrated that a significant number of examiners did change their treatment options at T2 for bimaxillary protrusive, nonextraction, and Class II Division 2 patients. It was concluded that lateral cephalometric films showed a significant influence on a clinician's determination on severity of some types of orthodontic malocclusions.

Adolescent↗
PubMed2000

Changes in the edentulous maxilla in persons wearing implant-retained mandibular overdentures.

STATEMENT OF PROBLEM: It has been suggested that risk for severe resorption in the anterior maxilla is increased in persons wearing mandibular implant-retained overdentures. However, little information is available about the changes in the edentulous maxilla after mandibular implant treatment. PURPOSE: This study determined the possible changes in the width of the maxillary residual ridge 6 years after receiving mandibular implant-supported or implant-mucosa-supported overdentures and evaluated the association between the anatomic changes and subjective complaints with maxillary complete dentures. METHODS AND MATERIAL: The subjects for this study (n = 55), enrolled among the participants of a prospective clinical trial, were randomly assigned into 3 groups treated with: (a) implant-supported overdentures on a transmandibular implant system (n = 21); (b) implant-mucosa-supported overdentures on 2 IMZ implants (n = 20); or (c) conventional complete dentures (n = 14). A lingual contact occlusion concept with anterior open bite was used for tooth arrangement in all subjects. Diagnostic casts were made at baseline, and again at the 6-year follow-up. Most prominent points perpendicular to the crest of residual ridge were located in the incisor, canine, and premolar regions, after which the width of the ridge was recorded at these points with a Boley gage. Subjects' opinions on their dentures were evaluated with a questionnaire. RESULTS: Significant reduction in the width of the ridge was found in all measurement areas (mean difference = 0.4 to 0.6 mm; P <.0001). However, changes were small and not associated with the type of prosthetic restoration in the mandible. In subjects with implant-mucosa-supported overdentures, complaint of loose maxillary denture correlated with the decrement of residual ridge width. CONCLUSION: The width of residual ridge decreases with time, despite the type of mandibular prosthetic restoration.

Aged↗
PubMed1998

Craniofacial growth in juvenile chronic arthritis.

The craniofacial growth in children with juvenile chronic arthritis (JCA), especially that of the mandible, and the degree of destruction of the mandibular condyles vary depending on the heterogeneity in duration and intensity of the disease. In JCA children showing destruction of the temporomandibular joint, the dentofacial morphology is characterized by overall smaller dimensions of the mandible, mandibular retrognathia, a steep mandibular plane, Class II malocclusion, dental crowding, and frontal open bite. In children with unilateral condylar destruction, asymmetries will develop, with the chin deviating to the affected side. The facial morphology of JCA children with condylar lesions becomes more abnormal during growth, reflecting a decelerated mandibular development and a backward-rotating growth pattern. The main single cause of the deviating craniofacial growth is mandibular condylar destruction. Other factors that may influence the craniofacial growth are head posture, soft tissue stretching, disease activity and drug therapy, type of onset of the disease, muscle weakness, decreased functional ability, and orthodontic treatment.

Arthritis, Juvenile↗
PubMed1992

Development of alloplastic materials for temporomandibular joint prosthesis: a historical perspective with clinical illustrations.

This paper gives the history of the development of alloplastic materials presently used in the temporomandibular joint (TMJ). It discusses the evaluation of TMJ implants, from those being used primarily for ankylosis to the more varied and sophisticated implant designs used today. There is a discussion on the treatment of osteoarthritis with implants and also a discussion on the use of TMJ implants to repair skeletal and dental malrelationships, primarily anterior open bites. Included is a presentation of the latest research by Schellhas et al., which establishes that previously undiagnosed organic disease in the joint proper is a common cause of skeletal and dental malrelationships and that TMJ disease can cause malocclusion.

Adult↗