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[Indication and effectiveness of the J-hook headgear].

In this article the three most important types of J-hook headgears, the horizontalpull, the high-pull and the verticalpull are demonstrated. Indications of these headgearsamples are the (asymmetrical) retraction of teeth and groups of teeth, intrusion of anterior teeth including a very effective support of torque control, inhibition of horizontal and vertical growth of maxilla and mandible, compensation of side effects of Class I and Class III rubberbands, midline-corrections and retention following surgical correction of open bites. The headgear force can either be distributed directly on the teeth to be moved, on hooks which are soldered on the archwire, on chin caps or mandibular troughs resp. on functional appliances. The advantages of the J-hook headgear are an excellent control of anchorage, the variability (primarily of the vector of forces), but also a consistency after having established the assigned force vector, a consistency which also includes the amount of choosen force. Further advantageous is the simultaneous retraction of teeth in both arches as is the easy and safe handling of this headgear by patients and by the orthodontic team. In contrast to these outstanding advantages there are only very few disadvantages. These have mainly to be seen in a tendency of dental arch expansion and the rare occurrence of certain pressure induced problems in the soft tissues of the skull. In the first case a constriction of the archwire and even more a transpalatal arch will help to prevent this from happening. In the second case the best counter measure is the use of accessory soft pads.

Adolescent↗

Cystic fibrosis: a current review.

Cystic fibrosis (CF) is the most common severe genetic disorder seen in Caucasians. Defective exocrine gland secretions result in chronic diseases of the respiratory and gastrointestinal systems. However, the CF gene recently has been located and cloned. Currently, genetic technology allows identification of sibling carriers and antenatal diagnosis within families. Oral implications associated with CF include enamel hypoplasia and tooth discoloration, salivary gland involvement, reduced incidence of dental caries, reservoir for potentially pathogenic respiratory bacteria, mouth breathing, and anterior open bite associated with nasal and sinus obstruction. Continued efforts to improve early diagnosis and treatment of CF should increase life expectancy. Affected patients are expected to seek regular dental care more frequently as they learn to view the disease as manageable.

Cystic Fibrosis↗

[Dental malocclusions in children with cerebral palsy].

The purpose of this research is to compare the prevalence of dental malocclusions in a group of Cerebral Palsy children and a group of normal children. Throughout this investigation it was seen that Cerebral Palsy children have a greater tendency toward a Class II malocclusions and Open Bite.

Cerebral Palsy↗

[The possible influence of bad habits on tooth morphogenesis. Clinical case].

Thumb sucking, if continued beyond the age of two, is commonly acknowledged to compromise correct craniofacial development, with consequent dental malposition. The observation of a deciduous central incisor morphology, lost traumatically by a thumb-sucking three years old boy with an apparent open-bite, makes us think this bad habit can influence teeth morphogenesis too.

Child, Preschool↗

[Treatments of major skeletal anomalies in adults].

This article deals with orthodontics and maxillofacial surgery as an integrated treatment. During the last fifteen years orthognathic surgery has made extensive progress, and almost all great malocclusions combined with facial anomalies can be treated with good and stable results. Because the surgical methods are more refined and sophisticated, greater demands have been put on the planning of the treatment making this a team effort between the orthodontist and the surgeon. Treatment of anterior crossbite, extreme overjet and open bite are shown as examples of what can be achieved by this team approach. The outlines of the treatment are given and it is stressed that the orthodontic treatment must be done with fixed appliances. The complications are few, and the results are usually stable. This integrated treatment can therefore be recommended to those patients who are motivated for it and really need it.

Adult↗

Enlarged tonsils and the effect of tonsillectomy. Characteristics of the dentition and facial skeleton. Posture of the head, hyoid bone and tongue. Mode of breathing.

Associations between craniofacial morphology, its development and growth on the one hand and functional factors on the other hand have been eagerly debated in the literature during the last 20 years. The aim of the present thesis, based on five publications, was to evaluate the effect of enlarged tonsils and tonsillectomy on the dento-facial morphology, the posture of the head, the position of the hyoid bone and tongue, and on the mode of breathing. The material comprised 146 Swedish children (66 boys and 80 girls), 5.3-17.3 years old, with a mean age of 10.1 years. Of these children 73 were judged by one otolaryngologist to have enlarged tonsils and were, on this criterion, selected for the investigation. The remaining 73 children comprised the control group and matched the tonsil group for sex and age. The controls were nosebreathers and had no history or symptoms of Ear-Nose-and-Throat-problems. During the investigation 18 of the tonsil children underwent tonsillectomy and 29 remained unoperated. Comparisons between the groups were based on anamnestic and clinical records, measurements on plaster study models and lateral skull radiographs. The results indicate that the children with enlarged tonsils, when compared with the control children, had retroclined lower incisors, protruded upper incisors, shorter lower dental arch, smaller overbite, larger overjet and a greater incidence of lateral crossbites. Furthermore they had retrognathic, posteriorly inclined mandibles, larger anterior lower facial height and skeletal open bite. They also displayed extended headpostures, low posture of the hyoid bone, anterio-inferior posture of the tongue and large oro-pharyngeal depth. 62.5% of the children in the tonsil group were mouthbreathers during the day and 84.7% during the night. The effect of tonsillectomy was mainly associated with a dorsal reposturing of the base of the tongue, change in hyoid bone posture cranially and change to nosebreathing during the night. Furthermore, a decrease in lower inter-molar width and in the tendency to lateral crossbite, as well as a slight increase in the posterior lower facial height had occurred postoperatively. Associations between postural and functional changes mutually, as well as between these changes and morphological changes were found. Enlarged tonsils thus seem to be associated with a characteristic postural and functional pattern, which in its turn seems to have had some influence on the dentition and craniofacial morphology.

Adolescent↗

[Role of prolonged sucking in the development of dento-skeletal changes in the face. Review of the literature].

Thumbsucking is the earliest and most common habit in children, affecting almost the 45% of young population in the world, from birth through adolescence. Infantile digital sucking and other non-nutritive sucking habits have been significantly correlated with malocclusion in both primary and permanent dentitions. The severity of malocclusions correlated with such habits depends on the frequency, the duration, the intensity and the position of the thumb in the mouth. Prolonged fingersucking may cause an anterior open bite, diastema, proclination and protrusion of maxillary incisors, increased overjet and overbite, retrusive position of mandible, posterior cross-bite. Self correction of malocclusions may occur if the habit is discontinued before 4 y.o.

Age Factors↗

[Results of the caries prevention program in Gödöllö. III. Orthodontic studies].

The ratio of dental anomalies is nearly 50% which corresponds to the value 40 to 60% estimated on basis of international statistics. In the examined two years (1986 and 87) the deep and open bite was more seldom with the elderly age group while toth jam and canine ectopy were characteristic of children of 12 years of age. The Angle II anomaly was twice or three times more frequent than the Angle III one. Early recognition and treatment are very important in order to diminish an inclination to second attacks.

Child↗

Mandibular fractures in children-immediate reduction and fixation with orthodontic resin.

Mandibular fractures are not common in children. In Chang Gung Memorial Hospital from 1983 to 1987, we had 354 mandibular fractures but only 12 cases happened to children under 10 years old. Mandibular fractures in children under 10 years cannot be treated in the same way as patient with permanent teeth since possibly neither intermaxillary, nor interosseous fixation can be applied. Complication have been observed in 3 (25%) of these 12 patients, including malocclusion, infection and open bite. In 1988, orthodontic resin was adopted as the fixation material after immediate reduction in three cases. There is no complication and the patients have had a better postinjury quality of life compared with those patients treated from 1983 to 1987. The importance of immediate reduction for mandibular fracture in children and the application of resin cap splint are stressed.

Child↗

[An experimental study on change on the contralateral temporomandibular joint after unilateral condylectomy on one of the bilateral joints].

In this study I examined the macroscopic, radiological and histopathological changes on the contralateral temporomandibular joint following condylectomy on one of the bilateral temporomandibular joints on adult female Macaca fuscatas. I made a standardized radiographic apparatus for the temporomandibular joint and head for the Macaca fuscata on an experimental basis for radiological observation through the whole passage of time before making the experiment. The results were as follows: 1) In macroscopic observation, I noticed the entire mandible directed toward the operated side at opening the mandible and the anterior and molar (unoperated side) open bite after the operation. Besides the masticatory side altered and the degree of tooth attrition made progress with the passage of time. 2) According to radiographic investigation with an anteroposterior radiograph, complicated shift and rotation of the mandible were observed since the operation. According to the radiograph of condyle, distal displacement of the temporomandibular joint, widening of joint space and clockwise rotation of the mandible were confirmed. A shadow of bone was found in the articular surface of the mandibular head on the 123rd day. 3) The following findings were obtained in histopathology. (1) Heterotopic calcification appeared in an articular disk of one Macaca fuscata in control group and two in the 83rd-day-passaged Macaca fuscatas. (2) In the articular disk and the tissue around them, a tiny projection of connective tissue appeared in the posterior synovial portion of the superior articular cavity on the 10th day. And the intermediate zone of the articular disk showed itself to be fibrous small bundle daily as days passed on and cartilaginoid cells were found. (3) In the front edge of mandibular corpus and attachment region of the lateral pterygoid muscle, absorption of bone was observed by the 40th day from the operation, and additions of bone were observed during the period between the 40th and 83rd days from the operation. (4) The thickness of the cartilaginous lamina of mandibular head and fibrous velum varied much in different periods and areas. In the 83rd-day-passaged sample, osteosclerotic change and the irregularity on the articular surface were remarkably noticed. On the 123rd day the back of the mandibular head and the contralateral front wall of the back of the articular process showed absorption of the bone on a large part. (5) A large part of the articular surface in articular tubercle was irregular and some osteosclerotic change was observed. And on the 83rd day a good number of clones of cartilage cells were found.

Animals↗

[Anterior body ostectomy for mandibular prognathism].

The mandibular body ostectomy is indicated for the correction of select cases of; Mandibular prognathism, Class III open-bite deformity, Anterior crossbite in the adult. The anterior body ostectomy is indicated primarily in selected cases of mandibular prognathism, class III malocclusion when the posterior teeth are not in crossbite or the crossbite is dental in nature and can readily be resolved with conventional orthodontics. As with the correction of other dentofacial deformities, carefully done model surgery and a cephalometric prediction tracing are imperative in planning the anterior body ostectomy. In this paper, a case of mandibular prognathism which is corrected by the technique of anterior body ostectomy is presented.

Adult↗

[Cephalometric investigation and comparison of the effect of Edgewise and Begg technique therapies on the facial skeleton in hyperdivergent cases].

The purpose of this study is to investigate the changes occurring during Edgewise and Begg technique therapies in skeletal open-bite cases and to compare the two techniques. The material consists of 60 lateral cephalometric films of 30 patients with hyperdivergent skeletal structure, 10 had been treated by Standard Edgewise Technique, the other 10 by Begg technique and the remaining 10 had been used as the Control group which had no treatment. 18 variables were included in the study. To determine the homogeneity of the three groups pretreatment (control) values were examined. Next, the pre and posttreatment (control) values of all the three groups were investigated and they were compared with each other. The overall results show that Edgewise technique restricted the growth of point A more than the Begg technique. The two techniques restricted the spontaneous growth of the mandible, Edgewise technique showed posterior rotation of the mandible in relation to the Begg technique.

Cephalometry↗

[Case report of maxillary protrusion].

The patient, a 10-years and 7-month-old boy, demonstrated maxillary protrusion (a pseudo class I malocclusion) complicated by horizontal open bite, space defect of 5 5, and represented that point A was +3.0 mm, pogonion was -8.0 mm to McNamara line respectively. His 4 first premolars were extracted and he was treated with an edgewise appliance together with a high pull head gear, palatal bar, class III elastics, class II elastics and up-down elastics for 3 years. A functional occlusion and good profile was obtained with good growth, chin control and tooth movement.

Child↗

[Etiological study of relationship between impacted permanent teeth and malocclusion].

This investigation was undertaken to determine the causes of impacted permanent teeth and whether they have any influence on dentition, occlusion and skeletal patterns. The materials used were dental X-rays, occlusal dental X-rays, panoramic radiograms and cephalograms and dental casts of 194 cases (51 males and 143 females) which revealed impacted permanent teeth among 3979 cases (1215 males and 2764 females) from 1964 to 1985 in the Department of Orthodontics, School of Dentistry, Aichi-Gakuin University. The results obtained were as follows: 1. The incidence of impacted permanent teeth in these samples was 4.9% of the entire number of orthodontic patients. There was no significant difference between sexes. 2. The incidence according to the number of impacted permanent teeth was as follows: one impacted tooth, 74.8%; two impacted teeth; 21.1%, three impacted teeth; 3.6%, four impacted teeth; 0.5%. The incidence of two symmetrically impacted teeth was 61.5%. 3. As to the type of impacted teeth, the frequency of maxillary central incisors was the largest (33.7%), followed by 3 (25.0%), 5 (22.2%), 5 (11.9%), 2 (4.4%), 3 (1.2%), 4 (0.8%), 4 (0.4%), and 7 (0.4%). But no impacted teeth were found in the regions of 1, 2, 6, 6, 7 and 7. 4. As to impacted teeth and the type of malocclusion, the spaced arch in the anterior region had impacted teeth most frequently followed by crowding, open bite and lateral cross bite. Malocclusions with the smallest incidence were cross bite and upper protrusion. The spaced arch had a higher incidence of impacted teeth than bimaxillary protrusion. In the posterior region (impacted molar teeth), the lateral cross bite, spaced arch, and upper protrusion had impacted molars most frequently, crowding was second and cross bite had the least. 5. In the direction of long axis, the impacted tooth with a horizontal direction was found most frequently (35.2%), followed in the order of frequency by inverse direction (32.7%), labial or mesial tipping (22.0%), lingual or distal tipping (5.7%), and right-angled (4.4%). Moreover, the inverse maxillary central incisor and mesially tipped maxillary canine were found most frequently. The frequency of maxillary central incisors with crooked roots was 64.7%, which was higher than that of maxillary canines (19.0%). 6. Lack of space is the most frequently found cause of impacted teeth, and in the anterior region this was the main cause of canine impacted teeth. Eruption impediment by supernumerary teeth and trauma were found to be characteristic causes of anterior impacted teeth.

Adult↗

[Survey on nutrition of infants in the Tokyo metropolitan area. 1. Carious dentitions, anomalies of occlusion and ways of eating].

In September, 1987, a survey on the nutrition of infants was conducted with 1,235 children from 3 to 6 years of age selected from six nurseries and six kindergartens in the metropolis of Tokyo. We compared the survey results with other similar survey reports with respect to three areas; 1, caries attack on primary teeth, 2, anomalies of dentition and occlusion and 3, how foods are eaten, to observe the difference by age and also between children in nurseries and in kindergartens. The following are the results of this comparative investigation. 1) The ratio of caries attacks on the 4-year-old in this survey was 69.6%, which was lower than the 83.4% of the nationwide survey of 1987 conducted by the Ministry of Health and Welfare, while the average value of the df index per person was 4.7, which was lower than the 6.1 of 1981. 2) The caries incidence rate was higher with children in kindergarten than those in nurseries and many kindergarten children had had more than one caries attack. 3) The frequency rate of anomalies of dentition and occlusion in the entire survey sample was 12.9% for deep overbite, 11.4% for open bite and 10.7% for edge-to-edge bite. 4) In the survey of how foods were eaten, the question, "Does your child like to eat things that are hard to bite on?" was asked, and 10.4% of the group answered "My child prefers eating soft food," which was quite high. To the question, "Does your child often eat things that are difficult to eat?", 17.1% of the entire group answered, "My child refuses to." This tendency was greater among the children in kindergaretens.

Child, Preschool↗

[Epidemiology of dental-facial anomalies in slightly mentally-retarded children at Slavonska Pozega].

The introductory part of the article concerus the statistical data on the frequency of dental and facial anomalies. 93 children with mild form of mental retardation were examined. The anomalies were registered in 77.40% of cases. Compression was registered in mast patients (41.70%) and open bite only in 4.2% of cases. Inherited anomalies, such as progenia and Class II, division 2 malocclusion were identical (8.3%).

Child↗

[Posterior hypsomaxilla: diagnostic and therapeutic considerations].

Posterior maxillary excess is a well individualized dento-alveolar anomaly which distorts the maxillary occlusal plane and induces clockwise rotation of the mandible. The dysmorphosis issued from is a skeletal open bite syndrome without dento-labial dysharmony. Surgico-orthodontic combined management is the adequate therapeutic procedure, on the following stages: during youth, a dento-facial orthopedic treatment is attempted to control posterior alveolar growth; pre-surgical alignment of teeth by orthodontic means correcting sagittal and transversal dental dystopies; surgical correction of the sole posterior hypsomaxilly is carried out by SCHUCHARDT osteotomy. In case of associated maxillary anomalies, LEFORT I osteotomy is indicated, mobilising the hole maxillary plate; post-surgical orthodontic affinement of final occlusion. When no orthodontic treatment had been effectuated, the prosthodontist will act for obtaining maximal dental intercuspidation; the plastic surgeon will harmonize facial profile, if needed.

Adolescent↗

[Posterior vertical excess: surgical impact].

Maxillary posterior hyperplasy is a frequent dento-facial deformity. A dento-alveolar origin seems to be more frequent than a squelettic one; in our experience, there is a direct relationship between the volume of the tongue and the open bite--surgical correction was done with a LE FORT 1 osteotomy and a tongue reduction was done simultaneously in half of the patients--a sliding genioplasty sometimes was done to improve the profile--for us, post chirurgical relapse was frequent with patients without tongue reduction.

Adolescent↗