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Tandem concept in the nonextraction treatment of class II malocclusion.

1. A systematic controlled nonextraction approach in the treatment of certain Class II malocclusions exhibiting arch-length deficiencies has been presented. 2. Clinical cases, diagnostic criteria for case selection, the biomechanics of this tandem force system, time sequence in tooth movement, and ways to avoid untoward sequelae have also been offered. 3. The major advantages in utilizing the basic extraoral appliance and auxiliary mechanisms are as follows: A. various groups of tooth movements are initiated in one or more areas of both dental arches simultaneously. B. Orthodontic pressures are within physiologic limits. C. A minimum number of bands is required. D. Positive control of anchorage is ensured. E. Class II mechanics is not necessary. 4. In each of the four cases presented, the anteroposterior and mediolateral changes that occurred resulted in an increase in the linear length and width of the maxillary and mandibular dental arches. A sufficient increase in the maxillary apical base was also noted and may prove to be a significant yardstick in measuring the stability index of each case. 5. Photographic and cephalometric evaluation revealed that the facial contour and the relative position of the mandibular incisors were not adversely affected.

Adolescent↗

Clinical management of the mandibular molars.

The complex variety of clinical problems posed by the lower molars requires maximum care in diagnosis and in treatment planning. In this article several therapeutic solutions to these problems are presented. The need to treat positional anomalies of the second molars and to control their drifting in cases of bracing and mandibular insertion, may be an effective auxillary means of treatment of those malocclusions in which lengthening of the dental bracing zones is indicated.

Bicuspid↗

Tooth-size discrepancy in mandibular prognathism.

A Bolton analysis of seventy-eight cases of Angle Class III malocclusion, twenty-six cases of Angle Class I malocclusion, and twenty-six cases of Angle Class II malocclusion was recorded. Frequency of excess mandibular tooth structure, magnitude of the excess, over-all ratios, and anterior segment ratios were computed and analyzed. Two clinical cases were presented to show the advantage of tooth-size harmony in mandibular prognathism. Analysis of the data as presented above suggests the following conclusions: 1. The frequency of mandibular tooth-size excess (over-all ratio) in this sample was greater in cases of mandibular prognathism than in Angle Class I and Angle Class II cases. 2. In those cases with mandibular tooth-size excess, there was a suggestion that the magnitude of the excess was greater in cases of mandibular prognathism than in Angle Class I and Angle Class II cases. 3. A tooth-size discrepancy analysis should be included as one part of the diagnostic records for mandibular prognathism.

Adolescent↗

Anterior interocclusal relations. Part II.

Part I of this article pointed out that correction of discrepancies in anterior interocclusal dental arch length may be accomplished by increasing the lingual and distal inclination of the upper anterior teeth and/or by mesiodistal crown reduction of the lower anterior teeth. Part II will discuss three-mandibular-incisor cases in which it was possible to establish normal anterior interocclusal relation in treatment of the following problems: deficient upper anterior dental arch length, missing upper and/or lower anterior teeth. Class II maxillary protrusion nongrowers with procumbent or crowded lower anterior teeth, and Class I bimaxillary protrusion with crowding of the anterior teeth.

Anodontia↗

Influence of tooth-to-denture-base discrepancy on space closure following premature loss of deciduous teeth.

Influence of tooth-to-denture-base discrepancy on so-called physiologic migration of the first molar was studied on serial dental casts of 116 boys and girls, obtained through a dental health program for school children in an area in which there was no dentist. The alteration of spaces following premature loss of deciduous molars was examined comparing the anterior to posterior discrepancies between tooth and denture base. Modes of space alteration showed positive correlation with the size of the discrepancy, especially in the mandibular dental arches. The space deficiency in the posterior region seemed to have a positive effect on the mesial migration of the first molar. Mesial migration of the first molar seems to be pathologic rather than physiologic and is strongly affected by tooth-to-denture-base discrepancies. Space maintenance does not seem to be useful, because it is not necessary in minimum discrepancy cases and is not effective in severe discrepancy cases.

Adolescent↗

Effects of storage of jaws in saline and of velocity of loading on the force required to extract the rat mandibular first molar.

Storage of jaws in cold saline for up to 32 h did not cause significant changes in the ultimate loads required to extract the rat mandibular first molar. The mean ultimate loads were 33.05, 34.91 and 36.38 newtons at the extension rates 1, 5 and 25 mm/min respectively, though the differences were not significant between groups. The force required to extract the tooth would be fairly constant even after the storage of the dissected jaws in cold saline for longer periods of time. Changes in the force required were not detectable within the range of the velocities of loading employed.

Animals↗

Glycosaminoglycans in human gingival crevicular fluid as indicators of active periodontal disease.

The glycosaminoglycans (GAG) in gingival crevicular fluid (GCF) were investigated by cellulose-acetate electrophoresis of samples from individual sites of defined conditions variously affecting the tissues of the periodontium. The non-sulphated GAG, hyaluronic acid, was present in all samples and was the only major band from sites of chronic gingivitis. An additional sulphated GAG band identified by enzymic digestions as chondroitin-4-sulphate, was detected in GCF from sites of untreated-advanced periodontitis. Initial samples from sites of early periodontitis and juvenile periodontitis yielded a similar additional band which was not detected, however, in samples collected after either surgery to eliminate deep pockets or daily subgingival irrigation with a chlorhexidine solution. Sulphated GAG was also present in fluid from the control situations, i.e. of teeth either undergoing orthodontic movement or showing evidence of trauma from occlusion, and from healing tooth-extraction wounds. Thus the presence of such a component in GCF correlates with those clinical conditions in which degradative changes are occurring in the deeper-periodontal tissues. The electrophoretic profile of GAG in a sample of GCF may be a sensitive laboratory method of indicating active phases of destructive periodontal disease at individual sites.

Chronic Disease↗

Method of administration determines the effect of naloxone on pain.

The opiate antagonist, naloxone, produces dose-dependent biphasic changes in clinical pain. The mechanism of the analgesia produced by low dose naloxone is unknown. To study the analgesic effect of naloxone, we have used a programmable infusion pump, which eliminates placebo-induced endorphin-mediated analgesia, to administer different doses of naloxone. We report that use of machine infusion of naloxone exclusively produces analgesia. The implications of this finding to the mechanism of naloxone-induced analgesia are discussed.

Analgesics↗