[Establishment of a reference plane for the deciduous dentition, mixed dentition and permanent dentition].
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We investigated the fully developed deciduous dentition in 408 children, and re-examined the situation four years later. The nature of the milk teeth (spaced, unspaced, crowded) has a considerable influence on subsequent development. Orthodontic treatment of the mixed dentition is most likely (76,7%) if there has been crowding of the milk teeth. Frontal crowding, distal occlusion, increased overjet, lateral cross-bite and prognathism of the lower jaw are most frequently retained in the mixed dentition. However, individual development follows this trend to a varying degree. On the basis of the situation in the primary dentition it is not possible to make a definitive prediction of the vertical relationships of the upper and lower front teeth in the permanent dentition.
Mixed dentition space analyses form an essential part of orthodontic diagnostic procedures to determine the amount of space available for the accommodation of permanent teeth. The Moyers' probability tables for computing the sizes of unerupted canines and premolars were formulated at the University of Michigan from a sample consisting of northern European white subjects and are currently used worldwide. Because tooth sizes vary significantly between different population groups, it was the purpose of this study to construct relevant probability tables that would be more applicable to black subjects. Data were collected from a series of 100 randomly selected study models of black patients. The sample was equally subdivided by gender and all subjects had Angle Class I molar relationships with only minor malocclusions such as minor crowding, rotations, or diastemas. Two investigators independently measured the teeth on the study casts with a Vernier gauge that had sharpened calliper tips. Intraexaminer and interexaminer reliability was determined at 0.2 mm. All teeth to and including the first molars were measured. These data were then utilized in regression equations for both maxillary and mandibular arches, to enable the prediction of the mesiodistal widths of the canines and two premolars. The equations and predicted values were compared with those of the Moyers' probability tables, and significant differences (p <0.05) were found (except for the prediction of maxillary canines and premolars in females at the 85 and 95 percentile probability level). New probability tables for black subjects were formulated. It is envisaged that the proposed probability tables would be more accurate for black patients of African ancestry.
The mixed dentition phase of tooth eruption can continue for up to six years from the eruption of the permanent molars to the complete replacement of all deciduous teeth. Early intervention is indicated to intercept developing problems in function. This paper will discuss the treatment of ectopic eruption of maxillary first permanent molars with removable appliances and the correction of molar crossbites with fixed appliances.
This manuscript provides the current standard passive space maintenance recommendations and identifies the appropriate space maintainer for premature loss of teeth in the primary dentition, early mixed dentition, and late mixed dentition.
In the mixed dentition, the goal of orthodontic treatment is to maintain or improve arch integrity for the eruption of the permanent teeth, and to prevent the development of a more complicated malocclusion. The importance of correct diagnosis prior to the treatment of mixed-dentition patients cannot be over emphasized. An understanding of the mixed dentition's normal development allows clinicians to determine if the occlusion is developing outside of the normal range. Appropriate treatment can only be planned after this determination has been made. Once it is concluded that orthodontic treatment is required, decisions must be made regarding the timing of treatment, the specific type of treatment needed, and the provider of treatment. By employing a systematic approach to examination and treatment planning, the general dental practitioner can provide an important service to patients with a mixed dentition.
Lateral crossbite on mixed dentition does not always cause facial asymmetry or functionally abnormal movement of the mandible in children. However, it is often observed that facial asymmetry will worsen during growth in the absence of orthodontic treatment. In adult cases, lateral crossbite is one of the etiological factors of temporomandibular joint disorder. This case report presents two cases of lateral crossbite of mixed dentition. The terms of treatment were shorter than those in cases with permanent dentition. Also, methods of treatment were simpler, and the patients developed favorably. The opposite results were obtained in cases of permanent dentition.
Mixed dentition treatment is an important subject because early treatment could not only correct the occlusion but also may ensure normal development of the teeth. Proper arch form and dental relationships in the mixed dentition lessen the need for additional orthodontic treatment. The objectives in mixed dentition orthodontic therapy are to correct dental arch irregularities, occlusal and jaw relation abnormalities, and to eliminate functional interferences.
The treatment planning in mixed dentition period has changed from extraction to non extraction. Any orthodontic treatment must take into consideration the growth trends and the pubertal growth spurt. The two cases presented here were treated during mixed dentition period in different ways: one with fixed appliances and the other with removable myofunctional appliance therapy, with satisfactory results. Hence for a conservative treatment approach, the non-extraction treatment is recommended in mixed dentition period.
Prosthetic measures in the mixed dentition must allow for the actualities of this developmental phase. Traumatic or developmental injuries to enamel and dentine, accidental tooth loss and hypodontia or oligodontia are indications for prosthetic treatment in school children, at which orthodontic aspects should always be considered. The prosthetic approach is characterized by the respect to preventive aspects related to the further biomorphosis of the dentition. With reference to the different phases of mixed dentition, methodical suggestions are given in the form of tables.
The mixed dentition stage of development may provide a useful window of opportunity to embark upon orthodontic therapy to correct an isolated malocclusion or provide preliminary treatment as a precursor to more comprehensive therapy at a later stage of the patient's physical development. As in all forms of orthodontic treatment, the planning of any correction must be carried out with care so that meaningless tooth movement can be avoided. Growth modification procedures can also be considered during this stage of development but, as this is connected intimately to increased height velocity, these procedures are most usefully carried out in the late mixed dentition, or more frequently in the early permanent dentition as this coincides more closely with peak height velocity. Several studies have suggested that approximately 20 per cent of patients presenting with a malocclusion can be treated appropriately during the mixed dentition. There would appear to be a genuine risk of falling off in cooperation levels in needed, permanent dentition treatment in many patients who have experienced one or more treatment procedures at an earlier stage in dental development. These findings reinforce the need for careful treatment planning during the mixed dentition.
The purpose of this epidemiological cross-sectional study was to determine the prevalence of malocclusion and caries in children and to investigate whether a relationship exists between prevalence of caries and studied malocclusion. The study consisted of 8,864 preschool and schoolchildren with primary dentitions (mean age 4.5 years) and mixed dentitions (mean age 8.9 years). 1997 WHO dental caries criteria were applied to both groups. The existence of an increased caries risk was deducted from the dmft and DMFT indices related to age. Malocclusion in primary and mixed dentitions was classified into seven types. Fifty-seven percent of all children had some form of malocclusion. Prevalence of malocclusion increased and was significantly greater in the mixed dentition sample (p < 0.001) than in the primary dentition sample. Seventy-four percent of children with primary dentitions and 23% of children with mixed dentitions had zero dmft and DMFT scores. Mean dmft indices in subjects with primary and mixed dentitions were 1.02 and 1.53, respectively. No positive correlation between prevalence of caries and malocclusion could be established in the sub sample with primary teeth only. However, statistically significant parallelism in prevalence of malocclusion and caries were found for posterior cross-bite (p= 0.050) and mandibular overjet (p= 0.013) in children with mixed dentitions.
Occlusal factors, body posture and TM disorders were examined in forty children with primary dentition and forty children with mixed dentition. The purpose of the study was to test the hypothesis that there is a relationship between TM disorders and malocclusion, as well as that there is a relationship between body posture and TM disorders in the examined population. Clinical examination was done by two investigators, who used a stethoscope to detect TMJ sounds. The results showed that forward head position had a significant relationship to TM disorders in the mixed dentition. Also many of the occlusal factors were closely related to TM disorders in the population examined. The prevalence of TM disorders in primary dentition was 2.5% and in the mixed dentition it was 90% in the population studied.
Secular changes in the mixed dentition were studied. Permanent tooth size and dental arch dimensions were examined in Norwegian children born in the 1960s and 1980s, Swedish children born in the 1960s and 1980s, Norwegian Sami children born in the 1980s, and a sample of Norwegian skulls dating from the 14th to the 19th century. The Norwegian Sami children were nomadic in the summertime. A sample of pigs was studied before and after a maceration process to determine what dimensional changes might occur in such a process. A shrinkage of 0.3%-1.7% was found. This information was used when the skulls were compared with the modern groups. Lateral dental arch lengths were shorter in the children born in the 1960s compared with the children born in the 1980s. This was a result of the higher prevalence of caries in the second deciduous molars in the 1960s groups. Children who had lost a deciduous canine prematurely were found to have smaller dental arch perimeters. When compared with other data, this was blamed on a pre-existing crowding. Permanent tooth size was smaller in the skulls compared with the modern groups. Improved nutrition is considered to be the main reason for the difference. Relative dental arch space differed in the group born in the 1960s from that in the other groups, indicating a greater prevalence of crowding in the former. Relative dental arch space in the skulls and in the group born in the 1980s was similar. A more traditional way of living, as practised by the Sami group in this thesis, was not favorable for relative dental arch space. The transverse intermaxillary relation in boys changed from the 1960s to the 1980s, which indicated that the 1980s group ran a greater risk of developing a posterior cross-bite. Before the same conclusion could be made in the girls, the mesial drift of the first permanent molars had to be corrected for, because of a higher prevalence of caries in the 1960s group. The sex-pooled analysis of the skulls and the contemporary groups revealed that the risk for developing a posterior cross-bite in the 1980s group was greater than in the skulls. The skulls had smaller arch depths than the modern groups.
The purpose of this study was to develop a model describing the sites and patterns of dental caries in the mixed dentition for children with one of five caries experiences in the primary dentition. Dental records were used from 317 children followed an average of 7.8 years in private pediatric dental offices to assess specific caries experiences in children from early primary dentition to middle or late mixed dentition. Eighty-four per cent of the children who were caries-free in the primary dentition remained so in the mixed dentition. Children with the pit and fissure caries pattern in the primary dentition were more likely to develop smooth surface caries of primary teeth in the mixed dentition (32%) than caries-free children (14%, X2 = 5.6;P less than 0.05). For children with molar-approximal lesions in the primary dentition, 57% developed lesions on additional molar-approximal surfaces in the primary teeth in the mixed dentition. Children with the faciolingual pattern (baby bottle tooth decay) were at the highest risk of any group for developing additional carious lesions. The model could serve as a basis for a prospective study.
In the mixed dentition, arch length preservation, maintaining the leeway space, can often provide adequate space to resolve lower incisor crowding. Yet the frequency of this occurrence is not known. To obtain this information, lingual arches were placed in the mandibular arches of 107 consecutive mixed dentition patients with incisor crowding to preserve arch length and make the leeway space available to resolve the crowding. Arch length decreased only 0.44 mm whereas the intercanine, interpremolar, and intermolar dimensions increased between 0.72 and 2.27 mm. There was adequate space to resolve the crowding in 65 (60%) of the 107 patients. If perfect arch length preservation had occurred, there would have been adequate space to resolve the crowding in 73 (68%) of the 107 patients. The correlation between leeway space and tooth size-arch size discrepancy was only 0.44.