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PubMed2002

Dentofacial anomalies related to the digit sucking habit.

Digit (thumb or finger) sucking is the most common oral habit, frequently seen among young children. With an increase in the prevalence of the oral habit in Nigeria in recent years there should be an expected increase in the dentofacial effects of the habit. In this study 81 children, 29 males and 52 females aged 3-16 years were examined. Each child was still actively engaged in the digit sucking habit. Subjects were divided into 3 age groups--3-6 years, 7-10 years and 11 years and above. The dentofacial effects of the habit on each subject were assessed. Increased overjet was observed in 63-705 of the children in the different age groups while the occurrence of anterior open bite ranged from 33.3% to 80% declining in frequency with increase in age. Unilateral posterior crossbite was observed in 8.65 of children while no case of bilateral crossbite was observed. Lip incompetence occurred in 51.8% of children examined, occurring most frequently in the oldest age group. Class 2 skeletal pattern was observed in 22.2% of the sample population. Results show that malocclusion is a frequent result of digit sucking especially when prolonged. There is a need to increase social awareness of the detrimental effects of this habit and if necessary offer alternative non-nutritive sucking methods.

Age Distribution↗
PubMed1992

Orthodontic finalization following therapy with an anterior repositioning splint.

After phase I splint therapy for the management of posterior condylar displacement, it is not unusual to find that a posterior open bite has been created. Finalization of a new occlusal position may be effected via occlusal equilibration, prosthodontics, orthodontics, orthognathic surgery, or a combination of these procedures. Stabilizing the occlusion with orthodontics in the new orthopedic jaw position requires a systemic approach. This article outlines a strategy for orthodontic finalization in phase II therapy. The splint-guided position is maintained while intra-arch and interarch malocclusions are corrected. The objective in treatment of posterior condylar displacement via splint therapy and orthodontics lies in the provision of a sound condylar position and the movement of the teeth and mandible into a stable and esthetic position.

Adolescent↗
PubMed1992

Familial acrodysostosis: can it be distinguished from Albright's hereditary osteodystrophy?

A girl, who presented initially to the orthodontist because of anterior and posterior open-bite, was noted to have short stature and facial dysmorphism suggesting the diagnosis of acrodysostosis. Her father had similar features, though less marked. Photographs of the paternal grandfather showed short stature and a similar facies. This family presents a further example of autosomal dominant inheritance of acrodysostosis and highlights the difficulty in distinguishing between acrodysostosis and pseudohypoparathyroidism.

Adult↗
PubMedDate not supplied

Evaluation of the effects of orthodontic pacifiers on the primary dentitions of 24- to 59-month-old children: preliminary study.

This study was designed to compare the occlusions of 24- to 59-month-old children who used orthodontic or conventional pacifiers to the occlusions of a group of controls who had no sucking habits. Information on the habits was collected by parental questionnaires. Ninety-five children were examined for malocclusions involving overbite, overjet, canine, and molar relationships, and posterior crossbites. Users of orthodontic pacifiers had statistically significantly greater overjets, and there was a significantly higher proportion of subjects with open bite in the conventional pacifier group. There was a trend toward a greater number of subjects in the control and orthodontic pacifier group with overbites less than or equal to 50%. These differences were not clinically significant, however. There appeared to be only minor differences between the occlusions of the two pacifier groups.

Child, Preschool↗
PubMed2004

Comparison of malocclusions and orthodontic treatment needs of handicapped and normal children in Ibadan using the Dental Aesthetic Index (DAI).

This study compared the prevalences of malocclusion and Orthodontic needs between normal Nigerian children and their handicapped counterparts using the Dental Aesthetic Index. The samples consisted of 1,010 children -614 normal (321 males; 294 females) and 396 handicapped (199 males;197 females) aged 12-18 years with mean ages for normal and handicapped children as 14.8+/-1.9 and 15.0+/- 2.2 respectively. They were drawn randomly from their respective schools in Ibadan, Nigeria. Although some differences were observed in the ten malocclusion traits of DAI between the normal and the handicapped children, none was found statistially significant (P> 0.05). Missing teeth were noted in 1.9% of the normal children as against 4.8% of the handicapped. Crowding of incisal segments was observed in 20.0% of the normal and in 21.7% of the disabled children. Spacing of incisal segments was recorded in 47% and 55.5% of normal and handicapped children respectively. Others in that order were: Disatema-31.7% and 32.3%; Anterior maxillary irregularity - 55.5% and 40.9%; Anterior mandibular irregularity- 50.2% and 34.3%; Overjet - 20.7% and 13.1 %; Reversed overjet - 1.9% and 2.3%; Open bite - 7.5% and 9.8% and total deviations from normal molar relation in 23.8% and 31.3%. Also, although higher proportions of handicapped children than the normal group were noted having DAI scores indicative of treatment needs ranging from elective to mandatory, no significant differences were noted (P>0.05). About 13% of the normal and 16% of the handicapped children in the study sample deserved publicly funded orthodontic care.

Adolescent↗
PubMed2004

The role of mandibular repositioning splint in the orthodontic treatment of patients with TMJ dysfunction.

OBJECTIVES: to evaluate the effectiveness of mandibular repositioning splints in the young and adult patients with TMJ dysfunction. SUBJECTS AND METHODS: 23 adult and 14 adolescent patients with TMJ dysfunction selected by Helkimo's index and the criteria of the American Academy of Craniomandibular disorders. RESULTS: upon anamnestic follow up, almost a total disappearance of the functional pain was reported by all patients, while for the headache, a cyclic onset was present, but with an uncertain etiology. Patients had a complete control of the mandibular movements with some articular sounds. But a modicum of muscular tenderness remained possibly due to the psyche of the patient. DISCUSSION: the prevalence of dysfunction in the growing patients was an intriguing observation. Not Angle's classification, but the presence of open bite, deep bite, or unilateral cross was the significant etiological factors.

Adolescent↗
PubMed2004

Vertical ramus osteotomy for treatment of mandibular prognathism.

Following a brief literature review of treatment modalities for mandibular prognathism the authors propose a simplified method for vertical ramus osteotomy. The method was successfully used in 24 patients with mandibular prognathism (alone or in combination with open bite). Postoperative complications (suppuration of the operative wound) were found in 2 patients (8%), and postoperative recurrences--in 5 patients (20.8%). No complications, usually associated with sagittal and vertical intraoral osteotomies (hypoesthesia of the trigeminal nerve, Frey's syndrome, dissecting aneurysm of the internal carotid artery) were found to be consequential to the proposed method.

Adult↗
PubMed2004

Topical review: new insights into the pathology and diagnosis of disorders of the temporomandibular joint.

The collection of conditions affecting the temporomandibular joint (TMJ) and masticatory muscles, the so-called temporomandibular disorders, can be classified according to the Research Diagnostic Criteria for Temporomandibular Disorders. Of the 3 subgroups--muscle disorders (Group I); disc displacements (Group II); and arthralgia, arthritis, and arthrosis (Group III)--the muscle disorders are most frequently seen in community samples; Group II and Group III diagnoses are less prevalent. This may explain the relative scarcity of studies involving intracapsular TMJ disorders. In this review, new insights into the functional anatomy, imaging, and pathology of disorders of the TMJ are presented. Studies of TMJ dynamics may provide insight into the functional anatomy of the TMJ and thereby into the consequences of Group II and Group III disorders. The clinical use of imaging modalities such as computed tomography and magnetic resonance imaging for the TMJ and related structures remains controversial. Nevertheless, imaging is regularly used in the diagnosis of some Group II and Group III disorders. Magnetic resonance imaging may be of use not only for the visualization of disc displacements but also for the study of bone mineral density of the condyle. Cytokines such as interleukin-1 (IL-1) and tumor necrosis factor alpha (TNFalpha) play an important role in TMJ pathology. For example, IL-1beta, which has been associated with TMJ pain, hyperalgesia, and anterior bite opening, is mostly absent in the synovial fluid of healthy joints. Since both IL-1 and TNFalpha are involved in the development of chronic pain and joint destruction, they may be the targets for specific treatments. While the advances reviewed in this paper are significant, multidisciplinary efforts and formation of international research collaborations will be necessary to continue advancement in the understanding of TMJ pathology and diagnosis.

Arthralgia↗
PubMed2004

[Peculiarities of the investigation, clinics and treatment of stylohyoid syndrome and glossopharyngeal neuropathy].

UNLABELLED: The aim of the study was to investigate the causes and the clinics of stylohyoid syndrome and its tendency to convert into glossopharyngeal nerve neuropathy; to investigate clinical peculiarities of glossopharyngeal neuropathy; to estimate differential diagnosis criteria for the glossopharyngeal neuropathy and stylohyoid syndrome; as well as to propose optimal treatment of the neuropathy. MATERIAL AND METHODS: Sixty-five patients with stylohyoid syndrome and 53 patients with glossopharyngeal neuropathy have been treated on. The diagnosis was estimated according to the data of clinical and X-ray investigation. For the localization of affected zone we performed modified facial straight plain radiograms of the patients in open bite position, facial oblique contact radiograms, orthopantomograms and cervical spondylograms. RESULTS: The majority of the patients were females; they comprised 61.5% of patients with stylohyoid syndrome and 56.6% of glossopharyngeal neuropathy sufferers. Older persons had neuropathy, younger--stylohyoid syndrome. The mean age of neuropathy patients was 63.8 years, and of stylohyoid syndrome--57.1 years. Seven years and longer duration of disease was observed in 73.3% of glossopharyngeal neuropathy patients, while duration of 7 and more years was observed in only 3.1% of stylohyoid syndrome patients. The mean duration of glossopharyngeal neuropathy was 10.9 years, and of stylohyoid syndrome--2.6 years. The analysis of etiological factors showed they are the same for both diseases. CONCLUSIONS: The core of the glossopharyngeal neuropathy pathogenesis is destruction at the glossopharyngeal nerve or at the perivascular plexus of carotid artery, because of elongation or dislocation of styloid processus in case of neck osteochondrosis and compression by ossified styloid ligament. In case of stylohyoid syndrome, inflammatory processes occur at the above-mentioned nervous elements.

Anticonvulsants↗
PubMed2004

Orthodontic camouflage in the case of a skeletal class III malocclusion.

AIM: To describe the clinical problem of a male patient, 15 years of age, who had a dolichofacial biotype and a Class III skeletal type at the beginning of treatment, manifesting itself at the dental level. METHODS: To resolve the dental problems, orthodontic camouflage (dentoalveolar compensation) with the extraction of two mandibular premolars was performed. RESULTS AND CONCLUSION: This procedure allowed a more harmonious occlusal relationship at the canine level and provided better occlusal stability of the final result. The procedure choice was based on the fact that some cephalometric values were favorable to attenuation of the skeletal Class III. For example, according to the analyses of Björk and Jarabak, these values are the total sum of 1, 2, 3 (sella angle, articular angle, and gonial angles) and the anterior/posterior facial height (S-Go/Na-Me). However, the same cephalometric data indicate a possible worsening of the existing open bite, which might be corrected with dental extractions and the use of intermaxillary elastics.

Adolescent↗
PubMed2005

[An adjustable appliance in treatment of obstructive sleep apnea-hypopnea syndrome].

OBJECTIVE: The research tended to approach applying of adjustable appliance in the treatment of obstructive sleep apnea-hypopnea syndrome (OSAHS). METHODS: 30 OSAHS patients (24 males and 6 females) participated in the adjustable group, with a mean age of (49.9 +/- 9.9) years old. AHI was (33.1 +/- 22.7) per hour. The control group consisted of 30 OSAHS patients wearing ordinary mandibular advancing appliance in the corresponding period, with age, weight and AHI at the same level. Monoblind way was designed to obtain and analyze the therapy differences. Differences in changes of upper airway, mandible and hyoid bone were also analyzed among the doctor-experience position, final adjusted position and original position. RESULTS: AHI decreased by 85.5% in the adjustable appliance group. The change in AHI was greater significantly (P = 0.025) in the adjustable group than in the control group. In the final adjusted position, the amount of mandibular advancement was (5.8 +/- 1.4) mm [(71 +/- 26)% of the maximum range of protrusion] and that of bite opening (the distance between upper and lower incisor edges) was (4.6 +/- 1.1) mm. CONCLUSIONS: The adjustable appliance had shown better therapy effect in OSAHS patients. The final adjusted position provided useful information on determining mandibular position using other appliances.

Adult↗
PubMed2005

[The use of intermaxillary fixation screws in the management of jaw fractures].

48 patients with fractures of the jaw bones were included in this study. Intermaxillary fixation screws were used for tractions between the upper and lower jaw and to regain occlusion relationship, followed by internal rigid fixation. Two days after reduction of the fractures, intermaxillary tractions were carried out and the fixation screws remained for 2 weeks. All the wounds healed primarily with good occlusion. The wounds for screw placement healed well 3 to 5 days after removal of the screws. Excellent occlusion recovered in 45 patients, while in 3 patients, mild open bite developed which returned to normal after 2 weeks of intermaxillary tractions. It is concluded that intermaxillary fixation screws are time saving and efficient in the management of jaw fractures.

Bone Screws↗
PubMed2005

Psychosocial implications of malocclusion among 12-18 year old secondary school children in Ibadan, Nigeria.

The main purpose of this study was to analyze the current psychosocial implications of malocclusion in Ibadan, Nigeria. The study sample comprised 614 secondary school children (327 males and 287 females) aged 12-18 years (mean age, 14.9 +/- 2.9 SD) who filled in a questionnaire containing general questions about body image and specific inquires concerning self-perception and social implications of dental appearance. The children's occlusions were also assessed using the Dental Aesthetic Index (DAI) and the malocclusion traits related to body image, self-perception, and social implications of dental appearance. Subjects with malocclusion rated only the teeth significantly least satisfactory among other twelve items of body image. The lowest rating was observed in subjects with crowding of the maxillary and mandibular incisor segments. Highly significant differences (P < 0.001) were found between subjects with normal or minor malocclusion and those with marked malocclusion in indicating awareness of malocclusion, dissatisfaction with the appearance of the teeth, and unfavourable appearance of the teeth compared with those of peers. Schoolmates' teasing occurred significantly more often in the presence of malocclusion (P < 0.001). Unfavourable perceptions of the teeth were expressed significantly more often by subjects with anterior maxillary irregularities of up to 1 mm and more, spacing of both maxillary and mandibular incisor segments, midline diastema, crowding (especially of the mandibular incisor segment), anterior open bite and molar relation deviations. It was concluded that certain malocclusions, especially occlusal and space anomalies, may adversely affect body image and self-concept of Nigerian adolescents.

Adolescent↗
PubMed2005

[Angle class I malocclusion in primary dentition and findings in permanent dentition--a follow-up study].

The aim of the study was to examine stability and changes in Angle Class I malocclusion from deciduous to permanent dentition in 168 subjects. All the subjects had Class I malocclusion in deciduous dentition, and were examined by the same orthodontist on two occasions during deciduous and permanent dentition. None of the subjects had received orthodontic therapy in the meantime. The results showed considerable changes from primary to permanent dentition. Crowding in primary dentition was retained in permanent dentition in 45.2% cases. In 16.2% cases it changed into normocclusion and 38.6% subjects developed other types of malocclusion. Open bite was retained in permanent dentition in 17.8% cases and in 17.8% subjects transformed into normocclusion. 64.4% subjects developed other types of malocclusion. Cross bite was retained in permanent dentition in 21.4% cases and in 28.6% subjects changed to normocclusion. Other types of malocclusion in permanent dentition developed in 50% subjects. In 30.8% of cases finding of premature loss of deciduous teeth was accompanied by extraction of some permanent teeth. Normocclusion was retained in 19.2% cases while 50% of children developed some type of malocclusion. Crowding, which was retained in permanent dentition in 45.2% cases, showed the highest degree of stability. Children with this type of anomaly in primary dentition displayed the highest frequency of total malocclusions (83.3% subjects). Out of all anomalies in primary dentition, cross bite most frequently switched to normal occlusion in permanent dentition (in 28.6% cases).

Adolescent↗
PubMed2005

Laypersons' perceptions of the esthetics of visible anterior occlusion.

OBJECTIVE: To analyze 6 different types of visible anterior occlusion, exclusive of extraoral facial features, in terms of their esthetic appeal, as perceived by 91 randomly selected adult laypersons with different levels of education in Lima, Peru. METHODS: Photographic images of 3 examples of each occlusion type (open bite [OB], deep bite [DB], crossbite [CB], end-to-end bite [EE], crowded bite [CwB] and ideal bite [IB]) were prepared. Evaluators used a visual analogue scale (VAS) to rate their perceptions of the esthetic appeal of each view. Analysis of variance (ANOVA) was used to test differences in mean scores among occlusion types and to test the effect of evaluator characteristics on perceived attractiveness. RESULTS: The mean score was highest for IB, followed by EE, DB, CB, CwB and OB. Oneway ANOVA with Bonferroni post hoc test showed no difference between the highestscoring occlusion types (IB and EE, p > 0.99); each of the remaining groups was significantly different from both IB and EE (p < 0.001). The scores for DB, CB, CwB and OB were progressively lower, although not significantly different from one another (p > 0.05). Univariate ANOVA to determine the effects of evaluator characteristics (age, level of education, gender and interaction between level of education and gender) showed that gender was a significant factor (p < 0.034) for all bite groups except OB. Level of education was significant only for OB (p = 0.020) and age only for EE (p = 0.011). The interaction between level of education and gender was significant for all bite types (p < 0.046). CONCLUSIONS: Lay evaluators identified ideal and EE bite occlusal relationships as esthetically most pleasing. They judged DB, CB, CwB and OB bite relationships as less esthetically pleasing but did not differentiate between these types of malocclusions.

Adolescent↗
PubMed2006

Orthodontic objectives in orthognathic surgery: state of the art today.

In treating jaw discrepancies, camouflage and surgery have different treatment modalities, often involving opposite orthodontic mechanics and different extraction decisions. Pretreatment identification of surgical patients is therefore essential. Esthetics, function, stability, and treatment time have to be considered and patients provided the information they need to be part of the decision-making process. The goal of presurgical orthodontics is to position the teeth, allowing an optimal skeletal correction at surgery. While intra-arch alignment is similar to conventional orthodontics, leveling is not carried out automatically in surgical patients. In open-bite cases, steps within the arches are an indication for segmental surgery. Orthodontic leveling will be limited to the segments, and segments will be leveled with differential intrusion at surgery. In deep-bite/short-face cases, leveling a severe curve of Spee should be done after the occlusion is unlocked by surgery. Anteroposteriorly, dental compensations are removed by ideally positioning the teeth relative to their apical bases. This will make the malocclusion look worse presurgically, but it will unravel the true magnitude of the skeletal problem, thus allowing an optimal correction at surgery. It is important to recognize if a transverse problem is skeletal or dental in nature and if the correction should be done orthodontically, by segmental surgery, or by surgically assisted palatal expansion. No orthodontic expansion should be done presurgically in a patient who will have surgical expansion. Any tooth movement with relapse potential should be avoided presurgically. Postsurgical orthodontics will bring teeth into position and proper intercuspation within a reasonable time period.

Decision Making↗
PubMed2004

[Orthodontic treatment needs and indications assessed with IONT].

The aim of this work was to determine the usefulness of the Index of Orthodontic Treatment Need (IOTN) in epidemiological studies undertaken to assess orthodontic treatment need of a given population, as well as in the process of defining indications to orthodontic treatment in individual cases with regard to objective treatment need and expressed demand for treatment. The correlation of the Aesthetic Component of IOTN (AC degree) with demand for treatment, usefulness of IOTN for screening studies, necessary modifications to make IOTN more acceptable to Polish orthodontists, and value of IOTN as a diagnostic and measuring tool for the assessment of orthodontic treatment need were addressed. The correlation between AC and demand for treatment, as well as the usefulness of IOTN in epidemiological studies were investigated with questionnaires and clinical examination using both components of IOTN (Figs. 1, 2, 3). The study group consisted of 264 schoolchildren aged 12 years. The results show that poor dental aesthetics is the main motivating factor to undertake orthodontic treatment (Tab. 1) and that demand for orthodontic treatment exceeds treatment need determined by IOTN (Tab. 2, 3). A regular distribution of AC degrees relative to the demand for treatment was obtained (Fig. 4) revealing the necessity to modify treatment need categories of this component in order to identify individuals with significant subjective treatment need. The modified aesthetic component would comprise the following treatment need categories: Grades (photographs) 1-2--"no demand for treatment"; 3-4--"borderline demand for treatment"; 5-10--"great demand for treatment". Excellent reproducibility of the Index (high values according to Kappa statistics), its universality, usefulness for various purposes, and simplicity in practice make the Index valuable for screening studies and assessment of treatment need in a given population. In order to test the reliability of the Dental Health Component of IOTN (the degree of conformity of this component with treatment tendencies among orthodontists), DHC criteria and subjective evaluation of treatment need were compared. This part of the study was carried out in a group of six orthodontists. 50 pairs of plaster casts covering a wide range of occlusal anomalies were analyzed. The subjective need for orthodontic treatment was stated for each case taking into account treatment priority and occlusal features determining treatment need. The results reveal a moderate conformity of DHC criteria with the orthodontist's opinion (Tab. 4 A, B) and a tendency among orthodontists to qualify for treatment also cases without treatment need according to IOTN recommendations. The discrepancy between the orthodontist's assessment of treatment need and DHC criteria applies mainly to cases with reverse overjet, front open bite, front or total crossbite and crowding in buccal segments of dental arches (Tab. 4 A, B). Matching the dental health component with opinions of Polish orthodontists requires shifting of some criteria from the moderate treatment need to the great treatment need category (Fig. 5).

Age Factors↗
PubMed2006

Associations between a history of breast feeding, malocclusion and parafunctional habits in Puerto Rican children.

UNLABELLED: Studies relating breast-feeding, malocclusion and parafunctional habits in young children are scarce. PURPOSE: The purpose of this study is to evaluate the associations of a history of breast-feeding, incidence of malocclusion and parafunctional habits. METHODS: The dental records of a sample of 540 children aged 6 to 72 months screened for oral conditions and behavioral risk factors were evaluated for variables such as a history of breastfeeding, malocclusion and parafunctional habits. Descriptive statistics using the EPI-INFO Program and Chi-square test at the 0.05 level of probability were performed. RESULTS: The results showed that the mean age of the children was 28 months +/- 14. The mothers' mean age was 26.4 years +/- 6. The prevalence of breast-feeding was 34% with a mean breast-feeding time period of 3 m +/- 3.7. About 95% of the children had a history of bottle-feeding and 90% showed some evidence of malocclusion at the time of dental examination. The main malocclusion problems were space deficiency (closed contacts among incisors) (31%), open bites (6%) and crossbites (5%). A habit of thumb sucking was reported in 32% of the cases and pacifier use in 21%. there were significant differences for the following variables: mother's age and breast-feeding time period; number of children in family and breast-feeding time period; breast-feeding history and breast-feeding time with bottle use, malocclusion and thumb sucking habit; and gender and thumb-sucking habit. CONCLUSION: It is concluded that breast-feeding practices and time period are behavioral factors that contribute in the prevention of malocclusion in addition to decreasing the practice of parafunctional habits in preschool children.

Adolescent↗